Hashimoto’s and Graves’ disease are both autoimmune thyroid disorders in which your immune system mistakenly attacks your thyroid gland. In this article, we’ll discuss the similarities and differences between these two conditions and how we approach treatment from a functional medicine standpoint.
Hashimoto’s vs. Graves’: What’s the Difference?
Hashimoto’s and Graves’ are both autoimmune disorders affecting the thyroid, a butterfly-shaped gland located at the front of your neck. In both of these conditions, the body creates differing antibodies that attack and damage the thyroid gland. In the United States, Hashimoto’s and Graves’ are the most common causes of hypo- and hyperthyroidism, respectively.
These disorders tend to have opposing symptoms, but they do share some similarities as well:
To diagnose Hashimoto’s or Graves', your doctor will likely order a test to look at the levels of TSH and free T4 in your blood.
If you have hypothyroidism:
- TSH is high
- T4 is low or normal
If you have hyperthyroidism:
Functional medicine providers
generally prefer a narrower and more optimal range for TSH (1.0 - 2.5 mlU/L) than conventional medicine standards. It is also important to test for thyroid antibodies, as this confirms the diagnosis of an autoimmune thyroid disorder.
- Thyroid Peroxidase Antibodies (TPO Ab)
- Thyroglobulin Antibodies (TG Ab)
- Thyroid Stimulating Immunoglobulin (TSI)
- Thyrotropin Receptor Antibodies (TRAb)
Following antibody levels in people with autoimmune thyroid disorders can help us assess your response to the functional medicine treatment plan. We are able to do this for members
of our functional medicine program.
Conventional treatment of both of these autoimmune thyroid conditions is relatively straight-forward with a goal of replicating normal thyroid function by prescribing medication. In Hashimoto’s, your doctor may prescribe a pill that provides thyroid hormone to correct hypothyroidism. Conventional treatment for Graves’ usually involves prescribing a medication to slow down production of thyroid hormones to correct hyperthyroidism.
While thyroid medication often reduces most major symptoms, conventional treatment fails to treat the root cause of these conditions. This can lead to further problems down the road. For example, about 25 percent of people with one autoimmune condition end up developing an additional autoimmune disease, like rheumatoid arthritis or celiac disease (1
). Plus, many individuals continue to experience symptoms despite taking thyroid medication and/or having a normal TSH level.
Functional Medicine Treatment
We recognize there are benefits to conventional treatments of Hashimoto’s and Graves’ disease, and there is a time and place to use medication. At Root, we will replace needed thyroid hormone for Hashimoto’s or work in tandem with the endocrinologist who is managing antithyroid medication for Graves’, while also working on root causes.
Conventional treatment is not your only option if you have these conditions. While Hashimoto’s and Graves’ disease vary in terms of diagnosis and symptoms, treatment from a functional medicine standpoint is rather similar because they both have an autoimmune component. Here are a few key areas we would target in patients who have an autoimmune thyroid condition.
Improve Gut Health
Poor gut health is a major contributing factor to the development of autoimmune thyroid disorders, which is why improving gut health is always a crucial treatment strategy. Plus, once an autoimmune disease is present, ongoing gut issues can worsen symptoms.
We use the 5R system to treat gut imbalances in Hashimoto’s and Graves’:
- Remove bacterial overgrowth, pathogens, and foods that compromise gut health (added sugar, refined grains, alcohol, food sensitivities etc.)
- Replace everything your body needs for optimal digestion, like stomach acid and/or digestive enzymes.
- Repair the gut lining with healing nutrients like L-glutamine or immunoglobulin.
- Reinoculate the gut with healthy bacteria via fermented foods and a probiotic supplement.
- Rebalance your lifestyle to promote whole body health and reduce stress levels.
Stress reduction and lifestyle management is crucial to treating Hashimoto’s or Graves’ disease. In fact, reducing stress may even lower thyroid antibody levels (2
Because it is a natural part of life, we need to find a productive way to reduce the effects of everyday stress on our bodies. Here are some effective ways to reduce stress hormone levels:
- Spend time in nature. Just 20 minutes in nature can lower stress levels.
- Keep a gratitude journal.
- Implement mind-body practices to center yourself like yoga, prayer, or meditation.
- Practice box breathing.
- Invest in therapy to cope with stressful relationships, experiences, or trauma.
Balance Your Blood Sugar
We find that many of our patients with autoimmune thyroid disorders also have insulin resistance. Insulin resistance occurs when your cells become resistant to insulin, a hormone responsible for controlling blood sugar levels. Over time, this leads to higher levels of chronic inflammation in the body, which is especially detrimental to someone with Hashimoto’s or Graves’ disease.
A diet high in refined carbs, inflammatory fats, and added sugar worsens insulin resistance. On the other hand, an anti-inflammatory
diet containing wholesome sources of protein, fat, and fiber improves your body’s sensitivity to insulin, balances your blood sugar, and provides the necessary nutrients to optimize thyroid function. At Root, we use a method called PFC Balance via The Root Plate™
. PFC is a simple formula that ensures you have protein, fat, and fiber-rich carbohydrates on each plate. Read our article explaining our Hypothyroidism Meal Plan
for examples of meals and snacks using the PFC method.
Replete Nutrient Deficiencies
Your thyroid plays a major role in various bodily functions and requires many different nutrients for optimal function. For example, zinc and selenium are required to make thyroid hormones and convert T4 into the active T3
version. Plus, some studies show selenium supplementation may lower thyroid antibodies (3
). Vitamin C and vitamin E both provide antioxidant support to lower inflammation. You can boost intake of these nutrients by eating more fruits, vegetables, nuts, and seeds! However, some individuals may need additional supplementation to replete deficiencies or fill the gaps missing from their diet. In this case, we may recommend our Thyroid Support
supplement, as it provides crucial nutrients for optimal thyroid function.
Hashimoto’s and Graves’ disease are both autoimmune thyroid disorders. In the United States, Hashimoto’s is the most common cause of hypothyroidism, and Graves’ is the most common cause of hyperthyroidism. While treatment may vary between individuals, a functional medicine plan usually involves improving gut health, reducing stress, balancing your blood sugar, and boosting intake of thyroid supportive nutrients.