Thyroid UK

Hashimoto's or Hypothyroid?

Hi there

What's the difference between Hashimoto's and Hypothyroidism? I have Primary Sjogren's Syndrome and an underactive thyroid - ( I don't know that the GP ever gave it a definite name - just that I had an underactive thyroid and I needed T4 supplementation in the form of 100mg Eutroxsig). Is the treatment for Hashimoto's different for that of Hypothyroidism? I think I need to get back to my Rheumatologist and find out which it is I have coz now I'm a bit confused :)

6 Replies

tracyd59 Hashimoto's means that you have autoimmune thyroid disease, where thyroid antibodies (Thyroid Peroxidase or Thyroglobulin or both) are present and attack your thyroid, eventually destroying it causing Hypothyroidism. It is the most common cause of Hypothyroidism but not the only cause. Plenty of us are hypothyroid but don't have Hashimoto's.

The treatment is no different but a patient may have symptoms before the blood test results are bad enough for a doctor to start treatment.

Antibody attacks may possibly be reduced by adopting a strict gluten free diet (many members have great success with this), supplementing with selenium daily, and keeping TSH very low or suppressed.

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Hashimoto's is an Autoimmune Thyroid Disease and you have antibodies in your system which attack the thyroid gland, and antibodies wax and wane so sometimes you feel feel hyper sensations. Eventually you will be hypothyroid.

Hashimotos is the commonest form of a dysfunction of the thyroid gland.

To try to lower antibodies many members have found a benefit of going gluten-free.

However, the antibody attacks will continue till you are hypothyroid and treatment for both conditions are exactly the same.

The treatment is the same levothyroxine. Some doctors think that once TSH is anywhere in range we're on sufficient. That's not the case we need a TSH of 1 or lower with FT4 and FT3 in the upper part of the range.

Always get a print-out of your results with the ranges for your own records and you can post if you have a query.

The appointments for hormones should be at the very earliest, fasting (you can drink water) and allow 24 hours between last dose of levo and test and take afterwards. If you've not had B12, Vit D, iron, ferritin and folate tested recently ask for these too as we are usually deficient.


Hi Tracy,

Hypothyroidism is the condition when your thyroid doesn't produce enough hormone to power your body properly, Hashimoto's is the cause of about 90% of cases of this. Hashimoto's is an auto-immune condition - as is your Sjogren's - and since individuals with one auto-immune are more prone to more, this may well be what you have. In this case your immune system is attacking your thyroid gland, gradually destroying it. Hashimotos has no distinct treatment, rather it is the resulting hypothyroid that is treated with replacement T4 (as in your case) or sometimes with some combo with T3 or NDT. Hashis does tend to produce swings in symptoms from hypo to hyper, as the dying tissue will release a lump of hormone at one go and you may well then feel hyper for a while, though it will then go back to more hypo again.

To confirm if you have Hashis you need a blood test including TPoab and Tgab anti-bodies. An positive result for either means you have Hashis.

Many people with Hashis find that going gluten free helps reduce symptoms (some need dairy free as well) and it is also strongly inked with leaky gut which should be addressed. I am sorry I don't have any links to the reference material for all of this, hopefully one of the admins will be along soon with these. Supplementation with 200mcg per day of selenium has also been demonstrated to help reduce anti-bodies.

Good luck


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And there you go - we were all typing at the same time!

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Wow! Thank you everybody for this explanation. I'm so glad I found this site👍🏻. I'll certainly try the selenium supplement. And consider the gluten free diet too.


For selenium, look for L-selenomethionine and take 200mcg daily.

Apparently quite a lot of selenium supplements have an unpleasant smell, I use this one which doesn't smell and is a nice small tablet (and it's on 3 for 2 at the moment)

Do try gluten free, so many members swear by it. Some people notice a difference very quickly, with others it takes longer.

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