Find Hashimoto Disease Specialists near you

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FAQs:

What is Hashimoto's Disease?

Hashimoto's disease is an autoimmune disorder affecting the thyroid gland. The thyroid is a butterfly-shaped gland located at the base of the neck just below the Adam's apple. The thyroid produces hormones that help regulate many functions in the body. An autoimmune disorder is an illness caused by the immune system attacking healthy tissues. In Hashimoto's disease, immune-system cells lead to the death of the thyroid's hormone-producing cells. The disease usually results in a decline in hormone production (hypothyroidism). Although anyone can develop Hashimoto's disease, it's most common among middle-aged women. The primary treatment is thyroid hormone replacement. Hashimoto's disease is also known as Hashimoto's thyroiditis, chronic lymphocytic thyroiditis and chronic autoimmune thyroiditis.

Who is More Likely to Have Hashimoto’s Disease?

Hashimoto’s disease is 4 to 10 times more common in women than men. Although the disease may occur in teens or young women, it more often develops in women ages 30 to 50. Your chance of developing Hashimoto’s disease increases if other family members have the disease.

You are more likely to develop Hashimoto’s disease if you have other autoimmune disorders, including:

- celiac disease, a digestive disorder that damages the small intestine

- lupus, a chronic, or long-term, disorder that can affect many parts of the body

- rheumatoid arthritis, a disorder that affects the joints

- Sjögren’s syndrome, a disease that causes dry eyes and mouth

- type 1 diabetes, a disease that occurs when your blood glucose, also called blood sugar, is too high

What is the Difference Between Hashimoto's Disease and Hypothyroidism?

Hypothyroidism and hyperthyroidism are opposite conditions. Hyperthyroidism occurs due to excessive thyroid hormone production; hypothyroidism develops due to a shortage.

People with Hashimoto's disease may develop hypothyroidism, although this is not always the case. While Hashimoto's disease comes before hypothyroidism in certain instances, you can have Hashimoto’s disease without having hypothyroidism. 

You can also be diagnosed with hypothyroidism without testing positive for Hashimoto's thyroiditis. Therefore, while Hashimoto’s disease can lead to hypothyroidism, it is not the only cause.

The disease is commonly misdiagnosed because the signs and symptoms are non-specific and can be easily mistaken for other health issues like hypothyroidism or hyperthyroidism. Hashimoto’s disease may exhibit vague symptoms in its earlier phases because it develops gradually.

As thyroid hormone production reduces, your body's metabolism does too, leading to symptoms like fatigue, depression, and weakness, which are common symptoms for hypothyroidism, Hashimoto's disease, and a range of other medical conditions.

How Serious is Hashimoto's Disease?

If Hashimoto’s goes untreated, it can become severe and lead to several complications. These complications may include heart problems or myxoedema coma, a rare condition in which the body’s functions slow down to a dangerous level. With early diagnosis, treatment, and no other underlying complications, Hashimoto's disease is not serious for most people.

What Does Hashimoto's Disease Do to Your Body?

Hashimoto's thyroiditis can cause your thyroid to not make enough thyroid hormone. It is an autoimmune disease. It occurs when your body makes antibodies that attack the cells in your thyroid. Symptoms may include an enlarged thyroid gland (goiter), tiredness, weight gain, and muscle weakness.

Can You Have Hashimoto's Disease Without a Thyroid?

The answer is yes. Even after the thyroid gland is removed, the immune system can still produce antibodies that attack the thyroid gland. While antibody levels typically drop significantly after thyroid surgery, they can remain elevated, indicating that the autoimmune Hashimoto’s is still active. Some Hashimoto’s patients who have had their thyroid removed report continued symptoms after thyroidectomy, including fatigue, joint and muscle tenderness, dry mouth, and dry eyes, weight gain, and depression.

What Autoimmune Diseases are Associated with Hashimoto's?

The main complication associated with Hashimoto’s is that it greatly increases your risk of developing another autoimmune disorder, such as Addison’s disease, Graves’ disease, type 1 diabetes, lupus, or rheumatoid arthritis. In very rare cases, Hashimoto’s might also increase your chances of developing a type of thyroid cancer known as thyroid lymphoma.

How Common is Hashimoto’s Disease?

Hashimoto’s disease is common. It affects about 5 in 100 people in the United States. Hashimoto’s disease is the most common cause of hypothyroidism in countries with widely available iodized salt and other iodine-enriched foods. Iodine deficiency is the most common cause in other countries.

Is Hashimoto's Disease a Disability?

Hashimoto's thyroiditis, once diagnosed, is usually easy to treat and manage. Therefore, the vast majority of people with the condition do not qualify for long-term disability support.

However, it may be possible to receive a temporary disability while you get your condition under control. Also, Hashimoto's disease is often comorbid with other autoimmune diseases, some of which might be more likely to interfere with your ability to work and thus be considered disabilities by a judge.

Remember that treated Hashimoto's disease should have few, if any, manifestations. But if you continue to have debilitating symptoms, talk to your doctor about other possible diagnoses rather than apply for disability with a limited chance of approval for Hashimoto’s disease alone.

Once your physician has investigated other possible diagnoses, the full extent of your medical condition will be clarified. You can then receive treatment that will, hopefully, facilitate your return to health and a regular work schedule.

Can Hashimoto's Disease Be Cured?

Hashimoto's thyroiditis has no definite cure. However, if you're diagnosed with it, there are several treatment options that can help balance your thyroid hormone levels and manage the condition. These include conservative treatment, synthetic thyroid hormone (T4) medication, and thyroid gland surgery.

How Important is Thyroid in Your Well-Being?

The thyroid gland is responsible for producing thyroid hormone that controls every cell, tissue, and organs in your body. If the thyroid gland stops operating at usual speed, it can produce a bulk amount of thyroid hormone, which causes the body system to speed up (a condition termed as hyperthyroidism) or can create too minimal thyroid hormone slowing down the body systems (a condition known as hypothyroidism). If you suffer from thyroid disease, leaving it untreated can lead to drastic effects like elevated cholesterol levels, subsequent heart disease, infertility, and osteoporosis. Some studies also claim that there’s a strong genetic connection between the thyroid disease and onset of other autoimmune diseases like diabetes, arthritis, and anemia.

Symptoms of Hashimoto's Disease

Hashimoto's disease progresses slowly over the years. You may not notice signs or symptoms of the disease. Eventually, the decline in thyroid hormone production can result in any of the following:

- Fatigue and sluggishness

- Increased sensitivity to cold

- Increased sleepiness

- Dry skin

- Constipation

- Muscle weakness

- Muscle aches, tenderness and stiffness

- Joint pain and stiffness

- Irregular or excessive menstrual bleeding

- Depression

- Problems with memory or concentration

- Swelling of the thyroid (goiter)

- A puffy face

- Brittle nails

- Hair loss

- Enlargement of the tongue

Causes of Hashimoto’s Disease

Hashimoto’s disease is an autoimmune disease, which means your body’s immune system attacks your cells and organs.

Normally, your immune system protects your body against harmful outside invaders, like bacteria and viruses. But in Hashimoto’s disease, the following happens:

1. Your immune system makes antibodies that attack your thyroid tissue for unknown reasons.

2. Large numbers of white blood cells (specifically, lymphocytes), build up in your thyroid.

3. This buildup causes inflammation (thyroiditis) and damages your thyroid.

4. Over time, the damage can prevent your thyroid from making enough thyroid hormone that your body needs. This leads to hypothyroidism. However, not everyone with Hashimoto’s disease develops hypothyroidism.

Risk Factors of Hashimoto's Disease

The following factors are associated with an increased risk of Hashimoto's disease:

1. Sex. Women are much more likely to get Hashimoto's disease.

2. Age. Hashimoto's disease can occur at any age but more commonly occurs during middle age.

3. Other autoimmune disease. Having another autoimmune disease — such as rheumatoid arthritis, type 1 diabetes or lupus — increases your risk of developing Hashimoto's disease.

4. Genetics and family history. You're at higher risk for Hashimoto's disease if others in your family have thyroid disorders or other autoimmune diseases.

5. Pregnancy. Typical changes in immune function during pregnancy may be a factor in Hashimoto's disease that begins after pregnancy.

6. Excessive iodine intake. Too much iodine in the diet may function as a trigger among people already at risk for Hashimoto's disease.

7. Radiation exposure. People exposed to excessive levels of environmental radiation are more prone to Hashimoto's disease.

Complications of Hashimoto's Disease

Thyroid hormones are essential for the healthy function of many body systems. Therefore, when Hashimoto's disease and hypothyroidism are left untreated, many complications can occur. These include:

1. Goiter. A goiter is enlargement of the thyroid. As thyroid hormone production declines due to Hashimoto's disease, the thyroid receives signals from the pituitary gland to make more. This cycle may result in a goiter. It's generally not uncomfortable, but a large goiter can affect your appearance and may interfere with swallowing or breathing.

2. Heart problems. Hypothyroidism can result in poor heart function, an enlarged heart and irregular heartbeats. It can also result in high levels of low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol — that is a risk factor for cardiovascular disease and heart failure.

3. Mental health issues. Depression or other mental health disorders may occur early in Hashimoto's disease and may become more severe over time.

4. Sexual and reproductive dysfunction. In women, hypothyroidism can result in a reduced sexual desire (libido), an inability to ovulate, and irregular and excessive menstrual bleeding. Men with hypothyroidism may have a reduced libido, erectile dysfunction and a lowered sperm count.

5. Poor pregnancy outcomes. Hypothyroidism during pregnancy may increase the risk of a miscarriage or preterm birth. Babies born to women with untreated hypothyroidism are at risk for decreased intellectual abilities, autism, speech delays and other developmental disorders.

6. Myxedema. This rare, life-threatening condition can develop due to long-term, severe, untreated hypothyroidism. Its signs and symptoms include drowsiness followed by profound lethargy and unconsciousness. A myxedema coma may be triggered by exposure to cold, sedatives, infection or other stress on your body. Myxedema requires immediate emergency medical treatment.

Treatment for Hashimoto’s Disease

Not everyone with Hashimoto’s disease develops hypothyroidism. If you have high antibody levels but don’t have clinical hypothyroidism, your healthcare provider will likely monitor your thyroid levels instead of starting treatment. If Hashimoto’s disease leads to hypothyroidism, the go-to treatment is a medication called levothyroxine. It’s a synthetic (manufactured) form of the hormone T4 that your thyroid makes.

Brand names of levothyroxine include:

- Ermeza®.

- Euthyrox®.

- Levo-T®.

- Levolet®.

- Levoxyl®.

- Synthroid®.

- Thyro-tabs® (formerly known under the name Levothroid).

- Thyquidity®.

- Tirosint®.

- Unithroid®.

This medication helps restore the normal levels of thyroid hormone your body needs. You’ll need to take it every day for the rest of your life.

Over time, you may need a different dose of the medication. Your provider will know how to adjust your dose to make sure that your hypothyroidism is well-managed.

Side effects of Levothyroxine

If you experience side effects from levothyroxine, it’s most likely because your dose is too high. This can cause thyrotoxicosis — too much thyroid hormone.

Symptoms of thyrotoxicosis include:

- Rapid heartbeat (tachycardia) — usually a heart rate higher than 100 beats per minute.

- Irregular heartbeat (arrhythmia).

- Unexplained weight loss.

- Feeling shaky.

- Feeling nervous, anxious and/or irritable.

- Increased sensitivity to heat and sweating more than usual.

- Changes in your period.

Foods to Eat If You Have Hashimoto’s Disease 

If you have Hashimoto’s thyroiditis, a nutrient-dense diet may help reduce the severity of your symptoms and improve your overall health. Focus on the following foods:

1. Fruits: berries, pears, apples, peaches, citrus fruits, pineapple, bananas, etc.

2. Non-starchy vegetables: zucchini, artichokes, tomatoes, asparagus, carrots, peppers, broccoli, arugula, mushrooms, etc.

3. Starchy vegetables: sweet potatoes, potatoes, peas, acorn and butternut squash, etc.

4. Healthy fats: avocados, avocado oil, coconut oil, olive oil, unsweetened coconut flakes, full fat yogurt, coconut yogurt, etc.

5. Animal protein: salmon, eggs, cod, turkey, shrimp, chicken, etc.

6. Gluten-free grains: brown rice, rolled oats, quinoa, brown rice pasta, etc.

7. Seeds, nuts, and nut butters: cashews, almonds, macadamia nuts, sunflower seeds, pumpkin seeds, natural peanut butter, almond butter, etc.

8. Beans and lentils: chickpeas, black beans, lentils, etc.

9. Dairy and nondairy substitutes (fortified with calcium and/or vitamin D): coconut milk, coconut yogurt, almond milk, cashew milk, full fat unsweetened yogurt, goat cheese, etc.

10. Spices, herbs, and condiments: turmeric, basil, rosemary, paprika, saffron, black pepper, salsa, tahini, honey, lemon juice, apple cider vinegar, etc.

11. Beverages: water, unsweetened tea, sparkling water, etc.

Keep in mind that some people with Hashimoto’s thyroiditis avoid a few of the foods mentioned above, such as grains and dairy. It’s important to experiment with your diet to find out what foods work best for you.

Foods to Avoid If You Have Hashimoto's Disease

Eliminating or restricting the following foods may help reduce Hashimoto’s symptoms and improve your overall health:

1. Added sugars and sweets: soda, energy drinks, cakes, ice cream, pastries, cookies, candy, sugary cereals, table sugar, etc.

2. Fast food and fried foods: french fries, hot dogs, fried chicken, etc.

3. Refined grains: white pasta, white bread, white flour tortillas, bagels, etc.

4. Highly processed foods and meats: frozen dinners, margarine, microwave dinners, bacon, sausage, etc.

5. Gluten-containing grains and foods: wheat, barley, rye, crackers, bread, etc.

6. Some healthcare professionals suggest that people with Hashimoto’s thyroiditis avoid soy and dairy as well — and sometimes even nightshades and all grains.

However, although these recommendations may help many individuals, it’s important to experiment with your diet to find the best method for you.

Working with a dietitian who specializes in autoimmune diseases like Hashimoto’s thyroiditis can help you narrow down potentially problematic foods and set up an eating pattern that’ll help you feel your best.

Helpful Supplements for Hashimoto’s Disease

Several supplements may help lower inflammation and thyroid antibodies in people with Hashimoto’s thyroiditis. Plus, those with this condition are more likely to be deficient in certain nutrients, so supplementing may be necessary.

Beneficial supplements include:

1. Selenium. Studies show that taking 200 mcg of selenium per day may help reduce antithyroid peroxidase (TPO) antibodies and improve well-being in people with Hashimoto’s thyroiditis.

2. Zinc. Zinc is essential for thyroid function. Research suggests that when used alone or alongside selenium, taking 30 mg of zinc per day may improve thyroid function in people with hypothyroidism.

3. Curcumin. Animal and human studies have shown that this powerful anti-inflammatory and antioxidant compound may protect the thyroid. Plus, it may help treat autoimmune diseases in general.

4. Vitamin D. People with Hashimoto’s thyroiditis have been shown to have significantly lower levels of this vitamin than the general population. What’s more, studies link low vitamin D levels with Hashimoto’s thyroiditis severity.

5. B complex vitamins. People with Hashimoto’s thyroiditis likewise tend to be low in vitamin B12. Taking a high quality B complex vitamin boosts levels of B12 and other important B vitamins.

6. Magnesium. Low levels of this mineral are associated with an increased risk of Hashimoto’s thyroiditis and higher thyroid antibodies. Plus, correcting magnesium deficiencies may improve symptoms in people with thyroid disease.

7. Iron. People with Hashimoto’s thyroiditis are more likely to develop anemia. Iron supplements may be needed to correct a deficiency.

8. Other supplements like fish oil, alpha-lipoic acid, and N-acetyl cysteine may also help people with Hashimoto’s thyroiditis.

9. Note that supplementing with high doses of iodine in the absence of an iodine deficiency may lead to adverse effects in those with Hashimoto’s. Don’t take high dose iodine supplements unless a healthcare professional has directed you to do so.

How to Prevent Hashimoto's Disease with Diet Changes

Specific diets help reduce the risk of Hashimoto's disease. Some of the evidence-based dietary tips you should consider are: 

Mediterranean diet

The Mediterranean diet is an eating pattern that focuses on fruits and vegetables, seafood, whole grains, and healthy fats. The Mediterranean diet has an anti-inflammatory diet pattern that can help with an overactive immune system. Hashimoto’s disease causes inflammation of the thyroid gland, leading to hypothyroidism. Therefore, by following this diet, you might be able to prevent some of the signs of Hashimoto’s disease, such as goiter. 

Consider Foods Low in Iodine

Foods low in iodine can help people with hypothyroidism. Since Hashimoto’s disease can cause hypothyroidism, consuming food low in iodine can help reduce the effects of this condition. If you decide to eat low-iodine foods, talk to your healthcare provider for advice on this diet. Remember, a low-iodine diet doesn’t meet the suggested allowance for your nutritional requirement. That’s why you need to consider the help of a healthcare provider to make the right decision about your low-iodine diet. 

Eat Anti-Inflammatory Foods

Eating anti-inflammatory foods can help you manage Hashimoto's disease. A study³ involving 218 women with Hashimoto's disease revealed that oxidative stress markers were lower for people who ate vegetables and fruits frequently. Other anti-inflammatory foods you could consider eating include spices, fatty fish, and vegetables.

When to See an Endocrinologist

Endocrinologists are doctors who have special training in diagnosing and treating endocrine system disorders, including Hashimoto’s disease. Sometimes,  it's a good idea to see an endocrinologist when:

1. You're experiencing hypothyroidism symptoms that aren't getting better with treatment

If your symptoms persist despite taking thyroid hormone replacement medication, you may wish to set up an appointment with an endocrinologist to get a second opinion. Some people with hypothyroidism have a harder time finding the right thyroid hormone medication concentration that works best for them. A specialist can usually help in these situations.

2. You have a lump or thyroid nodule

Your thyroid gland is situated right below your voice box in the front of your neck. If you have a nodule, lump, or another type of growth on your thyroid, it's best to have an endocrinologist look at it. Most lumps are typically benign (noncancerous) and harmless, but in some cases, more severe changes can occur. Some thyroid nodules turn out to be cancerous. And, while it's rare, some can cause hypothyroidism.

3. You have a goiter or enlarged thyroid gland

If you have a goiter, the endocrinologist can help determine why it developed and what type of treatment can help. They can also determine if you have hypothyroidism or not.

4. You have a pituitary gland condition that causes hypothyroidism

Your pituitary gland is located at the base of your brain, along with your hypothalamus. It controls your body's thyroid hormone production. It's extremely unusual, but in some people, this gland can fail to give off the thyrotropin-releasing hormone (TRH) that helps stimulate thyroid hormone production. Because this condition is complicated, seeing an endocrinologist will assist you in your next steps.

5. You're trying to conceive or are pregnant

It's important to know how Hashimoto's disease can affect your pregnancy or how pregnancy can affect your condition because hormone levels change considerably during pregnancy. If you're looking to become pregnant or already are, you should see an endocrinologist to closely monitor your thyroid hormone treatment. Leaving hypothyroidism untreated also increases your miscarriage risk, which is another reason you should see an endocrinologist if you're pregnant.

Sources:

Mayo Clinic

Health Match

NIH

Cleveland Clinic

Johns Hopkins

Paloma

Health Central

Nayarana Health

Healthline

 

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.