Differences between Graves disease and Hashimoto’s Thyroiditis

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Compare and Contrast Graves disease vs Hashimotos Thyroiditis: Differences and Similarities

Graves disease and Hashimotos Thyroiditis may be confusing when you do not know the differences between them. I will compare and contrast Hashimoto thyroiditis and Graves disease to help you understand them. I will use their causes, symptoms, signs, ultrasound scan findings and Treatment modalities.

What is Hashimoto and Graves Disease?

Hashimotos Thyroiditis is caused by Destruction of the Thyroid cells by Autoantibodies; while Graves Disease is caused Over Stimulation of the Thyroid cells by Autoantibodies.

Differences between Hashimotos Thyroiditis and Graves disease

  1. Graves vs Hashimotos Antibodies: Graves disease antibodies cause stimulation of Thyroid cells whereas that of Hashimotos Thyroiditis cause Destruction of thyroid cells.
  2. Graves disease only causes Hyperthyroidism(Thyrotoxicosis) but Hashimotos thyroiditis can cause both Thyrotoxicosis and Hypothyroidism
  3. Hashimotos thyroiditis does not cause bulging or protruding eyes but Graves disease causes bulging eyes.
  4. Graves disease can be treated by antithyroid drugs but Hashimotos thyroiditis patients end up being treated with Levothyroxine.
  5. A biopsy is needed to confirm Hashimotos thyroiditis but a blood test alone can confirm Graves disease.
  6. Hashimotos thyroiditis is also known as lymphocytic thyroiditis whereas Graves disease is also known as Diffuse toxic Goiter
  7. Hashimotos thyroiditis has two stages (Early and Late stages with different manifestations) whereas graves disease has a single stage

Similarities between Hashimotos Thyroiditis and Graves Disease

  1. Both are Autoimmune diseases
  2. Both are commoner in women than in Men
  3. Hashimotos Thyroiditis and Graves disease can both cause Thyrotoxicosis (excess of thyroid hormones in the blood from any source)
  4. Both can cause goiter (swelling of the neck)
  5. Both have Genetic Predisposition
  6. Graves disease vs Hashimotos thyroiditis ultrasound both show homogeneous hypoechogenicity
  7. Hashimotos thyroiditis Ultrasound shows Peripheral hypoechogenicity
  8. Graves disease ultrasound shows Central hypoechogenicity

Is Hyperthyroidism and Graves Disease the same thing?

Hyperthyroidism refers to increase in the activity of the thyroid gland leading to excess production of Thyroid hormones (A condition referred to as Thyrotoxicosis). There are many things that can make the thyroid to become overactive. One of the causes of over activity of the Thyroid is Graves disease.

If you know how their pathophysiology is, it is very easy to distinguish these two types of diseases even though it is difficult to differentiate them clinically especially at the early phase of Hashimotos thyroiditis which mimics thyrotoxicosis and therefore may seem confusing as Graves disease. However, the use of Good History, Clinical examination, Laboratory and Radiological investigations, a diagnosis of both can be made and each can be differentiated from another one.