I’ve had a number of people ask me whether it’s possible to have both Graves’ Disease and Hashimoto’s Thyroiditis at the same time. I’ve also had some people tell me they have been diagnosed as having both conditions. Although both Graves’ Disease and Hashimoto’s Thyroiditis are autoimmune thyroid disorders, there of course are differences between the two conditions.
Graves’ Disease is an autoimmune hyperthyroid condition, while Hashimoto’s Thyroiditis is an autoimmune hypothyroid disorder. Both could involve the presence of TPO antibodies, while TSI antibodies are involved with Graves’ Disease. Other types of antibodies can be involved as well. But of course Graves’ Disease involves an excess production of thyroid hormone, while Hashimoto’s Thyroiditis involves a decrease in thyroid hormone.
There are times when people seem to fluctuate between Graves’ Disease and Hashimoto’s Thyroiditis. For example, some people will be diagnosed with Graves’ Disease, but then over time will develop a hypothyroid condition, and will be diagnosed with Hashimoto’s Thyroiditis. There are some people who will fluctuate back and forth between the two conditions, although this is rare. And of course someone with Graves’ Disease who receives radioactive iodine or thyroid surgery and doesn’t address the underlying cause of the condition has a pretty good chance of developing another autoimmune disorder, such as Hashimoto’s Thyroiditis.
But to answer the original question, one cannot have both conditions at the same exact time. If the definition of Graves’ Disease is an autoimmune hyperthyroid condition and Hashimoto’s Thyroiditis is an autoimmune hypothyroid condition, then hopefully you can understand why it’s not possible to have both conditions simultaneously. However, a person can have different thyroid antibodies, and so once again it is possible to fluctuate between the two conditions.
Can Following A Natural Treatment Protocol Help?
For someone who has thyroid antibodies for both Graves’ Disease and Hashimoto’s Thyroiditis, a natural treatment protocol can frequently help with this. Just as is the case with someone who only has thyroid antibodies for a single condition, the goal is to get to the underlying cause of the condition. And while it’s rare for someone to fluctuate back and forth between Graves’ and Hashimoto’s Thyroiditis, following a natural treatment protocol consisting of eating well, taking certain supplements and herbs, and modifying other lifestyle factors can potentially restore this person’s health back to normal.
This doesn’t mean there can’t be some challenges when trying to help someone with such a condition. For example, while people with Graves’ Disease who have an iodine deficiency can supplement with iodine, the same thing isn’t always true for someone with Hashimoto’s Thyroiditis, although there is some controversy over this. So if someone is fluctuating between both conditions and has an iodine deficiency, one might want to hold off on giving that person iodine until the autoimmune response is addressed.
Similarly, the herb Bugleweed is commonly recommended for people with Graves’ Disease, but is contraindicated for people who have Hashimoto’s Thyroiditis. So a person who fluctuates between the two conditions probably shouldn’t take Bugleweed, or any other herb which is contraindicated for either Graves’ Disease or Hashimoto’s Thyroiditis.
But for the most part, such a condition is handled in a similar manner as someone who is diagnosed with just Graves’ Disease or Hashimoto’s Thyroiditis. While there might be fluctuations between the thyroid blood tests and thyroid antibody tests, this is why other tests are usually recommended (adrenal testing, hormone testing, hair mineral analysis, etc.). So regardless of the autoimmune thyroid condition, the ultimate goal is to find the underlying cause of the condition and do what is necessary to correct the problem.
In summary, it isn’t impossible for someone to have both Graves’ Disease and Hashimoto’s Thyroiditis at the same exact time. However, it is possible for someone to have thyroid antibodies for both conditions, which can cause them to switch back and forth from one autoimmune thyroid disorder to another. Either way, for anyone looking to restore their health through natural treatment methods, the goal is to find out what the underlying cause of the condition is, and then put the person on the appropriate protocol in order to correct the cause.
Hello, thank you for the valuable information. i have been reading your articles, and appreciate you sharing your empowering experience. I have had Graves disease in the past, and now have been having fluctuating level of thyroid hormone production. My doctor wants me to have a radioactive iodine scan. How safe is it? Do you know of any other safer – less invasive test? I appreciate your response. Thank you.
Dr. Eric says
Well, any test that involves radiation isn’t completely safe. It definitely isn’t as harsh as receiving radioactive iodine treatment, but it all depends on what they are going to do with the results. They can use ultrasound to look for thyroid nodules, and of course a TSI test to confirm if you have Graves’ Disease.
I just recently have been diagnosed with both Graves and Hoshimotos…it has been a roller coaster ride to say the least! I see a ND and firmly believe in this method of medicine. I apparently have been fluctuating between the two for years going unnoticed by my MD… I had my gall bladder removed 8 years ago and a complete hysterectomy 4 years ago. Hot flashes up to 15 a day, drenching! Tried every method known to mankind to alleviate the flashes to no avail…will just have to live with them. Just yesterday I was given Thyrocsin to try to level out the thyroid for a month trial…any suggestions??? Is this safe and effective?? I was diagnosed with an autoimmune disorder a year and a half ago and have just now narrowed it down to Hoshimotos. For the past year I have changed my diet, taking supplements and now am hopeful for a more normal life, as normal as can be with hot flashes!
Dr. Eric says
Balancing the levels of thyroid hormone can sometimes help with the hot flashes, although not always. Frequently an imbalance between the hormones estrogen and progesterone can be responsible for hot flashes as well, and so I definitely would recommend having your sex hormones tested.
Dr Fields says
I feel your pain mackenzie. Even being a medical professional with access to multiple specialists does not always guarantee an answer to relieve your symptoms. Depending on where you live you need to find a doctor that does bio-identical hormone replacement and or functional medicine. I had been fatigued for years with horrible periods,weight gain and then started the hot flashes and menopause. My ob told me I needed to exercise more, and my TSH and CBC were normal. I found a physician who found that my B12, vitamin D, iodine,progesterone and testosterone were low. I feel like a different human being, more like 34 than 54. I changed the direction of my career and now practice functional medicine in Savannah. Feel free to email me -firstname.lastname@example.org
Dr Eric, is bugleweed contraindicated prior to a thyroid scan?
Dr. Eric says
As far as I know, Bugleweed isn’t contraindicated prior to a thyroid scan. You might want to ask your endocrinologist just to play it safe, although there is a chance he or she might not know what Bugleweed is.
I’m sorry, but I have to disagree with you. I have antibodies that indicate Graves and Hashis and yes, my T3,4 and TSH swing too high and too low…but all the while, I feel symptoms of both conditions. So, tell me what proof there is that both aren’t occurring simultaneously? Scientific proof is what I mean. Because as a patient who knows what Hypo and Hyper feel like and then feeling like both happen at the same time other times. I just totally disagree.
Dr. Eric says
I never said that one can’t have hyperthyroid and hypothyroid symptoms. It definitely is possible to have a fluctuation of symptoms, and of course there is some overlap as well. But with regards to the thyroid hormone levels at any specific time, they are either high or low.
I went for years with hyper symptoms (resting pulse at 100+, inability to gain weight, etc.) with normal labs, or they would swing slightly out of either range end only to return to “normal” by the time I was able to get in to an endo. No one ever bothered to run my antibodies however. Flash forward 10 years and my labs and symptoms started cycling between hyper and hypo for months at a time with both high TPO and TSI. I was also diagnosed with early onset osteoporosis with no family history or other risk factors.
It’s my firm belief that one can have both Hashi’s and Graves at the same time, but that together they typically produce labs that are seen as normal or mildly transient. Like stacking each side of a teeter totter, you get an unhealthy balance from binding, blocking and stimulating antibodies. It’s not until one or both diseases progress that you can say that one is the prominent, or that a patient cycles from one to the other. Why else would I have osteoporosis, a common side effect of untreated Graves, before ever having labs outside of range for any length of time? Keep in mind, scientists are finding out more and more that osteoporosis is not just caused by too much T3 from a hyperactive thyroid, but that it can also be linked to subclinical Graves.
Since both Graves’ disease and Hashimoto’s are autoimmune conditions that have extra-thyroid autoimmune activity on the body that have nothing to do with thyroid hormone production, it doesn’t make sense that they are mutually exclusive.
When I had my thyroid surgically removed due to Graves’ disease, the surgeon noted a lot of backward growth that had impinged on the esophagus that is characteristic of Hashimoto’s disease. Since Graves’ and Hashimoto’s antibodies work on different receptors on the thyroid, I see no reason they can’t both be active at the same time. I can see how their activity can be at war and even produce a temporary euthyroid state, but that doesn’t mean that either of the antibody groups are inactive.
Linda Henretta says
My son (23) has just been diagnosed with hyperthyroidism, Graves, and Hashimoto’s. Even I thought that was crazy given Graves = hyper and Hashimoto’s = hypo. The doctor he saw 2 weeks ago which gave him the diagnosis is in the Dallas area, but my son has now moved to the Provo, Utah area to go to school. I’m wanting a referral to a good thyroid doctor in that area and was wondering if you could give me one or recommend how I can find a doctor we can trust. Thank you for your help.
Dr. Eric says
I don’t know any natural healthcare professionals in Provo Utah, but I would contact some of the local chiropractors, naturopaths, and functional medical doctors to see if any of them focus on endocrine conditions. You also might want to check out the Institute of Functional Medicine’s website, as they have a directory where you can search for a functional medicine doctor.
Dana Petco says
I was diagnosed with Hashimoto’s and put on 1grain of nature throid and 5mg of cytomel ( just to get me through the day , by 2 pm I was exhausted and very sleepy). I was feeling much better not optimal but close to myself. Got my labs done on July 03 with this results: T4 free 1.7. , TSH 0.07 , T3 free 7.4 , T3 reverse 17 and TPO 314
Was told I am hyperthyroid now even that I had no symptoms for that. At the time of the blood work my hair was falling very bad and I still dieting in order to loose weight , also I was constipated on and off.
July 17 got more blood work done with this results : T4 free 1.6 , TSH 0.07 , T3 free 6.6. , Anti-thyroglobulin Ab 1.6 ,
Iron total 88 , Iron binding capacity 352 , Ferritin 111 , B12 670 , Vit D 41 and also my TSI 246???
I was told that I was misdiagnosed with Hashimoto’s and that I actually have Grave’s disease!!!!
How that can be true when I never have palpitations , high blood pressure – I always have low blood pressure – I am tired al the time , constipated , loosing my hair and on a diet for the last 6 years hopping to loose some weight….
Now they want me to stop my meds , i cut back on nature throi from 1 grain to 1/2 grain and I did eliminate the cytomel complete and I feel horrible , brain fog is back , my headaches are back too , I have no energy , sleepy al the time I am loosing myself again.
I have tried to find some answers but it seems I am alone in this …I would really appreciate some guidance if you have the time , I am loosing hope , I struggle with this since I had my daughter 6 years ago, when from 125 lbs I went up to 170 just to be told that I am getting old and it’s normal to gain some weight …I am 43 now , 145 lbs , we eat very healthy , organic , no GMO , MSG, whole foods. I drink coffee, no alcohol , never drugs or painkillers. No soda no process foods…maybe once a year I have slip… Also I am active. My doctor said that blood work shows I am almost in perfect health beside my tyroid. Please help me….if you could recomend my a doctor in the North Scottsdale are of Arizona I would appreciate. Thank you!
Dr. Eric says
As I discussed in this post, it is possible for someone to have the antibodies to both Graves’ Disease and Hashimoto’s, and if this is the case it’s possible to have hypothyroid symptoms with positive TSI antibodies. Remember that regardless of whether someone has Graves’ Disease or Hashimoto’s, the goal is to address the autoimmune component. And while it’s great that you eat well and consume mostly organic foods, along with exercising regularly, you probably have other compromised areas which aren’t showing up on a blood test. Unfortunately I don’t know of any doctors in your area, but in addition to contacting some of the local naturopaths, chiropractors, and holstic medical doctors to see if any of them focus on thyroid and autoimmune thyroid conditions, you might want to visit the website of the Institute of Functional Medicine, as they have a search option which allows you to look for a functional medicine doctor in your area.
Sorry, but your article is wrong: you can have Hashimoto’s antibodies and Graves antibodies at the same time: I do! These two autoimmune diseases are not the same as a hypothyroid or hyperthyroid condition: they are the #1 cause of the conditions, respectively. Symptoms may fluctuate between hyper and hypo and antibodies may fluctuate; but you don’t “fluctuate” between the two autoimmune diseases: that is like saying a person fluctuates Celiac and Crohn’s, two separate and distinct diseases that happen to affect /destroy the same organ yet you can have both at the same time. Go figure.
Dr. Eric says
I agree with you, as if you read the last paragraph where I summarize the post, it states that “it is possible for someone to have thyroid antibodies for both conditions”. I definitely agree that people don’t fluctuate between different autoimmune conditions, but they can fluctuate between hypothyroid and hyperthyroid symptoms.