Both Graves’ disease and Hashimoto’s thyroiditis are autoimmune diseases that affect the thyroid gland. Autoimmune diseases occur when the body’s immune system mistakenly attacks the body’s own cells and organs. (6) While both conditions affect the thyroid gland, they do so in different ways. Because the thyroid gland is responsible for regulating many bodily functions, both conditions can both lead to issues with various bodily functions. (8)(9) Continue reading to learn the difference between Graves’ disease and Hashimoto’s thyroiditis and how they can affect the body.
What is the thyroid gland?
The thyroid is a butterfly-shaped gland in your neck that sits slightly above your collarbone. The thyroid is one of the body’s endocrine glands, which are responsible for producing and releasing hormones into the bloodstream. (10) The hormones produced by the thyroid are responsible for regulating many essential bodily functions, such as:
- Blood circulation
- Body temperature
- Body weight
- Brain and nerve function
- Digestion
- Growth and development
- Heart rate
- Menstruation
- Muscle contraction
- Respiration (breathing)
- Waste elimination (through urine and feces) (4)(9)

What is Graves’ disease?
Graves’ disease is an autoimmune disorder that affects the thyroid gland. Graves’ disease leads to an overactive thyroid gland, resulting in the overproduction of thyroid hormones, which is referred to as hyperthyroidism. Excess production of thyroid hormones may cause many of the body functions to speed up. (7)
Symptoms and complications of Graves’ disease
Because graves’ disease speeds up many of the body’s functions, symptoms of Graves’ disease include:
- Anxiety or nervousness
- Enlarged thyroid gland (goiter)
- Excess sweating and difficulty tolerating heat
- Fatigue
- Frequent bowel movements
- Hand tremors
- Irregular periods
- Trouble sleeping
- Unexplained weight loss (7)(9)
Eye problems
Almost 50% of people with Graves’ disease develop an eye condition called Graves’ orbitopathy (GO). GO occurs when the immune system attacks the tissues and muscles around the eyes. If left untreated, GO can lead to blindness. (1) Symptoms of Graves’ orbitopathy include:
- Blurry vision
- Bulging eyes
- Gritty vision
- Pressure or pain in the eyes
- Puffiness
- Sensitivity to light (1)(7)

Skin problems
In some cases, Graves’ disease can cause Graves’ dermopathy. Graves’ dermopathy can cause the skin on the front of the legs to become red and swollen. (9)
How is Graves’ disease diagnosed?
Your practitioner will diagnose Graves’ disease based on your medical history, a physical examination of your neck and thyroid gland, and blood tests to measure levels of the thyroid hormones TSH (thyroid stimulating hormone), free T3, and free T4. (3)

What is Hashimoto’s thyroiditis?
Similar to Graves’ disease, Hashimoto’s thyroiditis is an autoimmune disorder that affects the thyroid gland. In people with Hashimoto’s, the immune system produces antibodies that attack the thyroid. Hashimoto’s causes an underactive thyroid, which results in the underproduction of thyroid hormones, referred to as hypothyroidism. (8)
Symptoms of Hashimoto’s thyroiditis
Hashimoto’s disease hinders the thyroid gland from producing enough thyroid hormones to regulate body functions. Symptoms include:
- Constipation
- Difficulty tolerating cold
- Dry skin
- Enlarged thyroid gland (goiter)
- Excessive menstrual bleeding
- Fatigue
- Joint and muscle pain
- Slow heart rate
- Weight gain (8)
Complications associated with Hashimoto’s
The hormones produced by the thyroid gland play a vital role in many bodily functions; therefore, damage to the thyroid gland from untreated hypothyroidism can lead to:
- Heart disease
- Heart failure
- High blood pressure
- High cholesterol
- Myxedema, a rare but serious condition in which the body’s functions slow down, potentially leading to death (2)(8)
How is Hashimoto’s diagnosed?
Hashimoto’s disease is diagnosed the same way as Graves’ disease. Your practitioner will diagnose Hashimoto’s based on your medical history, a physical examination of your neck and thyroid gland, and blood tests to measure levels of the hormones TSH, free T3, and free T4. (5)
Learn more about hyperthyroidism and hypothyroidism on the Fullscript blog.
The bottom line
Both Graves’ disease and Hashimoto’s thyroiditis are autoimmune disorders that affect the thyroid gland and thus thyroid hormone levels. Graves’ disease causes an overactive thyroid gland while Hashimoto’s causes an underactive thyroid gland. Both Graves’ disease and Hashimoto’s can have severe complications if left untreated. Speak to your healthcare practitioner about testing and treatment if you believe you may have a thyroid condition.
- Bahn, R. S. (2010). Graves’ Ophthalmopathy. New England Journal of Medicine, 362(8), 726–738.
- Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017). Hypothyroidism. The Lancet, 390(10101), 1550–1562.
- Girgis, C. M., Champion, B. L., & Wall, J. R. (2011). Current concepts in Graves’ disease. Therapeutic Advances in Endocrinology and Metabolism, 2(3), 135–144.
- Metabolism. Medline Plus. Retrieved March 7, 2022, from https://medlineplus.gov/ency/article/002257.htm
- Mincer DL, Jialal I. Hashimoto Thyroiditis. . In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459262/
- National Institutes of Health. Dictionary Definition: autoimmune disease. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved March 7, 2022, from https://www.niddk.nih.gov/Dictionary/A/autoimmune-disease
- National Institutes of Health. Graves’ Disease. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved March 7, 2022, from https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease
- National Institutes of Health. Hashimoto’s Disease. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved March 7, 2022, from https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease
- U.S. National Library of Medicine. Graves disease: MedlinePlus Genetics. Medline Plus. Retrieved March 7, 2022, from https://medlineplus.gov/genetics/condition/graves-disease/
- U.S. National Library of Medicine. Thyroid Diseases. Medline Plus. Retrieved March 7, 2022, from https://medlineplus.gov/thyroiddiseases.html