Hypothyroidism, Hyperthyroidism, and the Hidden Story of Autoimmunity

When I was ill, people often said to me:

“If you just take thyroxine, you’ll be fine. My nan’s been on it for years.”

But the truth it’s not that simple. Thyroid disease is rarely straightforward, and in many cases, autoimmunity sits at the root.

Hypo vs. Hyperthyroidism: The Basics

The thyroid is a small butterfly-shaped gland at the base of the neck, yet its hormones regulate metabolism, energy, mood, digestion, and even heart rhythm.

Hypothyroidism (underactive thyroid): The body slows down. Symptoms may include fatigue, brain fog, weight gain, constipation, low mood, hair loss, and dry skin.

Hyperthyroidism (overactive thyroid): The body speeds up. Symptoms often include anxiety, palpitations, tremors, weight loss, insomnia, and heat intolerance.

Medication such as levothyroxine for hypothyroidism and antithyroid drugs for hyperthyroidism can be lifesaving. But they don’t answer the deeper question: why is the thyroid struggling in the first place?

The Autoimmune Connection

In iodine-sufficient countries, the two most common causes of thyroid disease are autoimmune conditions:

Hashimoto’s Thyroiditis – the most common cause of hypothyroidism. Here, the immune system gradually attacks and damages thyroid tissue.

Graves’ Disease – the most common cause of hyperthyroidism, driven by antibodies that stimulate the thyroid to overproduce hormones. It can also cause Graves’ ophthalmopathy (eye disease) and skin changes.

Autoimmunity changes the story. Thyroid dysfunction is not always just “too much” or “too little” hormone—it is often the downstream result of the immune system turning against its own tissues.

Why Hashimoto’s Is So Often Missed

Research consistently shows that Hashimoto’s thyroiditis is one of the most underdiagnosed autoimmune conditions worldwide [1,2]. Reasons include:

Early disease looks “normal.” In the beginning, TSH (thyroid stimulating hormone) and T4 may be in range—even when thyroid peroxidase (TPO) or thyroglobulin (Tg) antibodies are elevated. Symptoms can exist years before labs confirm “abnormality.”

Testing gaps. Many healthcare systems use a TSH-first “cascade” approach, meaning antibody testing is rarely ordered unless TSH is abnormal. Yet antibody positivity can precede thyroid failure by years [3].

Slow, creeping symptoms. Fatigue, weight changes, and low mood develop gradually, making it easy to dismiss them as stress, age, or depression.

Overlap with women’s health. Pregnancy, postpartum changes, and perimenopause can both trigger and mask Hashimoto’s, leaving women especially vulnerable to misdiagnosis [4].

Epidemiological studies estimate that 4–7% of adults in Europe may have undiagnosed hypothyroidism, much of it autoimmune in nature [5,6]. That means millions of people are living with unexplained symptoms that could be identified sooner with broader testing.

Graves’ Disease: The Other Face of Autoimmunity

Graves’ disease is the autoimmune counterpart, where the thyroid is overstimulated rather than destroyed. It can be severe, leading to:

Persistent high thyroid hormone and cardiovascular strain

Muscle weakness and bone loss

Graves’ ophthalmopathy in up to 30% of cases [7]

Like Hashimoto’s, it demonstrates how the immune system’s imbalance is central to thyroid disease.

Beyond the Blood Test

Of course, medication is essential. Levothyroxine replacement prevents dangerous complications of hypothyroidism, and antithyroid drugs or surgery are critical in Graves’ disease. But tablets alone don’t address why the immune system went astray.

Autoimmunity is shaped by:

Chronic stress and trauma history

Gut and microbiome health

Environmental triggers

Nervous system regulation

This is why my work combines evidence-based nervous system support with holistic practices: IEMT (Integral Eye Movement Therapy), Safe and Sound Protocol (SSP), somatic enquiry, and deep rest practices. These approaches don’t “cure” autoimmunity overnight—but they help create an internal environment where resilience and healing become possible.

A Call for Awareness

The reality is simple:

Thyroid autoimmunity is common.

Hashimoto’s and Graves’ are the most frequent causes of thyroid disease.

Yet too many people are told they’re “fine” when their bodies say otherwise.

Better testing, earlier recognition, and a whole-person approach could save years of suffering.

My Story, Your Next Step

I chose to listen to my body, research deeply, and rebuild my health by working across every level—medical, emotional, and spiritual.

If you’re navigating thyroid challenges, know this: you are not broken, and you are not alone.

Through my 1:1 programmes and group course Rebalance & Rebuild, I support people in combining medical care with nervous-system restoration—so healing becomes more than numbers on a test.

References

Vanderpump, M. P. (2011). The epidemiology of thyroid disease. British Medical Bulletin, 99(1), 39–51.

Caturegli, P., De Remigis, A., & Rose, N. R. (2014). Hashimoto thyroiditis: Clinical and diagnostic criteria. Autoimmunity Reviews, 13(4–5), 391–397.

McLeod, D. S. A., & Cooper, D. S. (2012). The incidence and prevalence of thyroid autoimmunity. Endocrinology and Metabolism Clinics of North America, 41(1), 33–50.

Stagnaro-Green, A. (2012). Postpartum thyroiditis. Best Practice & Research Clinical Endocrinology & Metabolism, 26(4), 693–700.

Garmendia Madariaga, A., et al. (2014). The incidence and prevalence of thyroid dysfunction in Europe: A meta-analysis. Journal of Clinical Endocrinology & Metabolism, 99(3), 923–931.

Hollowell, J. G., et al. (2002). Serum TSH, T4, and thyroid antibodies in the United States population. Journal of Clinical Endocrinology & Metabolism, 87(2), 489–499.

Bartalena, L., & Tanda, M. L. (2009). Clinical practice: Graves’ ophthalmopathy. New England Journal of Medicine, 360(10), 994–1001.