I often get messages from readers who say that they have hypothyroidism, but not Hashimoto’s. But often times they have BOTH.

So what is the difference between hypothyroidism and Hashimoto’s?

Hypothyroidism, by definition, is a clinical state. It is a state of low levels of thyroid hormone in the body.

The low levels of thyroid hormone can occur as a result of a variety of different reasons, such as iodine deficiency, surgical removal of the thyroid, excess use of thyroid suppressing medications, pituitary suppression or damage to the thyroid (physical or disease induced).

Most cases of hypothyroidism in the United States, Canada, Europe and in most countries that add iodine to their salt supply are caused by Hashimoto’s, an autoimmune condition. Depending on the source, estimates are that between 90-97% of those with hypothyroidism in the United States actually have Hashimoto’s.

Unfortuantely many people think that if they had Hashimoto’s, their doctors would have certainly told them.

But that’s not usually the case.

Many doctors simply don’t test their patients for Hashimoto’s. That’s because the conventional medical model treats autoimmune thyroid disorders in the same way as they would treat someone with a nutrient deficiency induced thyroid disorder, congenital defect of the thyroid gland, someone who was born without a thyroid or someone who had their thyroid removed or treated with radioactive iodine… with synthetic thyroid hormones.

I recently found a useful tool called Google Trends that allows you to looks at the search trends in Google searches for various topics.


Below you will find a chart showing searches in RED for HYPOTHYROIDISM and searches in BLUE for HASHIMOTO’S.  As you can see the number of searches for HYPOTHYROIDISM clearly surpasses those for HASHIMOTO’S.

PictureGoogle searches for Hashimoto’s vs Hypothyroidism over the last decade

These trends lead me to wonder if the people searching for hypothyroidism have ever been tested for Hashimoto’s…

After being diagnosed with hypothyroidism, many people are told that their “thyroid is sluggish”, and that these things happen with age and often hear “Just take this pill, you’ll be fine”…

But they’re not told that they have an autoimmune condition.

Thus they never think to ask the question “Why is my immune system attacking my thyroid?”, therefore they never know to address the immune system imbalance and never get an opportunity to prevent or reverse the progression of the disease.

If you’ve been diagnosed with hypothyroidism, you should also be tested for Hashimoto’s. 

Often times, a person will be diagnosed with Hashimoto’s after already being diagnosed with hypothyroidism. Thus she will have both Hashimoto’s and hypothyroidism.

But it’s also possible to have Hashimoto’s and not yet have hypothyroidism. 

Other times I’ll get messages from readers with lots of Hashimoto’s related symptoms, who say they’ve been repeatedly tested for thyroid issues, but all of their tests have come out “fine”. Because they never have the specific tests for Hashimoto’s.

Studies have found that thyroid antibodies indicative of Hashimoto’s can be present for as long as a decade before the person develops impaired thyroid function. I suspect that they can be elevated for much longer, and it may take a person many decades to learn that he/she has hypothyroidism due to inadequate use of the TSH screening test.

Elevated thyroid antibodies have been connected with feelings of distress, anxiety and depression in those with Hashimoto’s.

Also, the higher the antibodies, the more likely you are to experience symptoms of hyperthyroidism, when the thyroid cells are broken down and stored hormone is dumped into the bloodstream, as well as hypothyroidism when we don’t have enough thyroid hormone. But your TSH screening tests may still fall into the “normal range”. Thus, in the early stages of Hashimoto’s, the person may still be able to make enough thyroid hormone, and thus will have “normal” thyroid function.

The higher the Thyroid Antibodies, the higher your likelihood of developing overt hypothyroidism, and possibly additional autoimmune conditions.

The autoimmune attack on the thyroid develops decades before a person becomes hypothyroid, catching the condition early allows us to prevent progression and needless suffering. The person may suffer with symptoms of Hashimoto’s for years before they are finally diagnosed with hypothyroidism and placed on medications. 

Recently two women in my family were diagnosed with Hashimoto’s. I love and admire them both very much.  Both are in their sixties and struggled with symptoms like anxiety, fatigue, cold intolerance, weight fluctuations and brain fog for many decades.

They are both very highly educated women (one has a doctorate degree, the other has a masters), and have been very health conscious as far back as I can remember, going to fitness classes, eating organic foods and lecturing me on my liberal use of sugar in my younger days 🙂

Both of them have also been tested for thyroid problems by their doctors… repeatedly, and told that their thyroid function was “normal”. This is because their doctors did not run the correct tests, just an outdated “screening test”.

Both women requested the correct tests at my insistence, and sure enough, they both have Hashimoto’s. I’m glad that we finally have an anwer to their mysterious symptoms and we can now get them on the right path to healing so that we can prevent the progression of their conditions.

I am a proponent of not just using medications for hypothyroidism caused by Hashimoto’s, but also of rebalancing the immune system to prevent further attack on the thyroid. You can read more in my post on various opportunities for intervention.

Ideally, a person would get diagnosed with Hashimoto’s before she is diagnosed with hypothyroidism, that way she would know that she is at risk for hypothyroidism and would have an opportunity to identify the underlying reasons for her immune system’s attack on the thyroid.

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