The Difference Between Graves and Hashimotos

by William M. Kleber, DC, DABCI

In a hypothyroid condition such as Hashimotos, TSH is almost always elevated. TSH is the body’s natural way of asking the thyroid to secrete more hormone. In the case of Graves disease, the thyroid secretes excessive amounts of thyroid hormone even though the TSH is low. Considering this situation, one must ask the question, “If TSH is not stimulating the thyroid to release thyroid hormone, then what is?”

The answer is antibodies. The difference between Hashimotos and Graves is that in Hashimotos T lymphocytes are attacking the thyroid as a result of Th1 dominance and in Graves antibodies are attacking the body due to a Th2 dominance.

Cytokines are chemical messengers of the immune system. Interleukins and interferons are cytokines grouped into Th1 and Th2 classifications. Th1 cells promote cell mediated immunity and Th2 promote humoral immunity. The humoral response is an antibody response. One can test Thyroid Stimulating Immunoglobulin (TSI) as a way to aid in the differential diagnosis of Graves disease. In both Hashimotos and Graves, one can expect to see elevated levels of Anti Thyroglobulin Antibody (TG) and/or Anti Thyroid Peroxidase Antibody (TPO).

From the perspective of symptoms, hyperthyroidism is not the opposite of hypothyroidism. A lot of people believe that if hypothyroid people are sluggish, tired and overweight, hyperthyroid people are energetic, enthusiastic and slim. Hyperthyroid patients are anxious, fatigued and can have a lot of end organ damage to areas like the heart and eyes.

One thing that Graves and Hashimotos have in common is the underlying causes, a dysfunctional immune system that is not addressed. In both instances the thyroid is an innocent victim of an upregulated and rogue immune response.

Graves disease is a very cruel disease as many victims don’t outwardly appear ill. As immune systems are under attack more now than ever before, expect to see more autoimmune disease in general and a lot more autoimmune thyroid disease.


William M. Kleber, DC, DABCI

William M. Kleber received his Doctor of Chiropractic at New York Chiropractic College in 1982. He also earned his Diplomate Degree from the American Board of Chiropractic Internists (ABCI) in 2000. His interest in internal medicine began when he came to believe that his patients were suffering from more than just subluxations, but serious internal disorders continually exacerbating the subluxations. His desire to learn more about these issues stemmed from his dedication to improve not only the health of his patients, but the quality of their life, with natural medicine.

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4 Comments Leave yours

  1. thais ewers #

    Hi, if hashimotos t antibody’s are attacking the the mediated side which antibodys are attacking the humoral side? you just say graves antibody’s, do you mean the b calls?

  2. thais ewers #

    Hi, if hashimotos t antibody’s are attacking the the mediated side which antibodys are attacking the humoral side? you just say graves antibody’s,… do you mean b cells?

    • Yes. The process starts with common lymphoid precursors from the bone marrow. The lymphocytes that go through the thymus have memory and are T lymphocytes and thgey provide the cell mediated response in hashimotos. The b cells are part of humoral immunity and stimulate the thyroid to produce thyroid hormone by binding to the same receptor sites that TSH stimulates.

  3. Pelham #

    I have Hashimoto’s and am taking GTA forte and Thyrostim combined (2 morning and night) But I am still just below normal on lab test – how much ought I to take? Is there an optimal time of day? Also they make me feel pretty sick when I take them. Thanks

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