The ins and outs of Hashimoto’s disease

June 2, 2023 Providence Health Team


In this article:

  • Hashimoto’s disease, also called Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis, is an autoimmune disease that can cause hypothyroidism.

  • If you suffer from hypothyroidism, you may feel fatigued, experience weight gain, have trouble tolerating the cold and suffer from joint and muscle pain.

  • When you catch Hashimoto’s disease early, it can be easy to treat. Your healthcare provider will likely prescribe medication that will boost your thyroid hormones.

One common challenge with managing your health is that when you experience a group of symptoms, there are often many different diseases or conditions those symptoms could indicate. Often, your primary care provider may order blood tests or imaging exams to start ruling out conditions.

Because it is so common, Hashimoto’s disease is one of the first ailments to emerge on a provider’s radar — especially if a patient is a woman who is feeling tired or sluggish. Also called Hashimoto’s thyroiditis, this is a disease that can be simple to treat but can cause many problems if left untreated.

What is Hashimoto’s disease?

The thyroid is a butterfly-shaped gland that sits in the front of your neck and produces hormones that regulate body temperature, growth and development, and mood. These hormones also control how the body uses energy, which affects nearly every organ in the body.

In people who have Hashimoto’s, the immune system attacks the thyroid, which can lead to hypothyroidism, a condition in which the body doesn’t make enough of the thyroid hormone (also referred to as underactive thyroid). In rare cases, Hashimoto’s can cause hyperthyroidism — when the body makes too much thyroid hormone. Because the immune system is attacking the body’s natural functions, Hashimoto’s is considered an autoimmune disease.

While the number of people who have Hashimoto’s is unknown, the disease is the most common cause of hypothyroidism, which the National Institute of Health (NIH) says affects about 5% of Americans. It is especially common in women — females are four to 10 times more likely to develop Hashimoto’s disease than males. It most often occurs when women are in their 30s to 50s, and may develop after a woman has given birth.

What causes Hashimoto’s disease?

Researchers don’t know exactly what causes Hashimoto’s disease, but they have observed that it tends to occur in more than one member of the same family, so they believe there is a genetic factor.

People may be at greater risk of developing Hashimoto’s disease if they have other autoimmune disorders, including:

  • Celiac disease
  • Lupus
  • Rheumatoid arthritis
  • Type 1 diabetes

Other causes of Hashimoto’s (specifically hypothyroidism) include:

  • Medicines that contain iodine that are used to treat abnormal heart rhythms
  • Exposure to nuclear radiation
  • Medicines that are used to treat bipolar disorder or other mental health problems

Symptoms of Hashimoto’s disease

Hashimoto’s disease can often take years to progress, which means that its symptoms can be subtle at first. As the disease progresses, people with Hashimoto’s may experience some symptoms of hypothyroidism, including:

  • Feeling tired
  • Weight gain
  • Depression
  • Joint and muscle pain
  • Constipation
  • Dry skin
  • Brittle fingernails
  • Thinning hair or hair loss
  • Trouble tolerating cold
  • Reduced heart rate

People with Hashimoto’s disease may also develop a goiter, or enlarged thyroid, in the front of their throat. Though the goiter is usually not painful, it does create a feeling of fullness in the throat.

Complications of Hashimoto’s disease

Because thyroid hormones are important to help the body function, Hashimoto’s disease and hypothyroidism can cause significant health problems if left untreated. Those problems include:

  • Pregnancy problems – If a woman has untreated hypothyroidism during pregnancy, she is at risk for miscarriage or pre-term birth. Her baby, meanwhile, is at risk for autism, speech and intellectual delays, and other developmental problems.
  • Heart problems – People with hypothyroidism may experience high cholesterol, putting them at risk for heart disease or heart failure. They also may have an enlarged heart.
  • Sexual issues – Men with hypothyroidism could suffer from erectile dysfunction and a low sperm count, and women could experience heavy periods or an inability to ovulate.

How to treat Hashimoto’s disease

Fortunately, when doctors catch Hashimoto’s disease early, they can treat it quickly and reverse its effects. The body cannot distinguish between the thyroid hormone it makes by itself and thyroid hormone that it receives through medication, so a synthetic hormone called levothyroxine is the easiest way to remedy the problem.

The challenge is finding the right medication dosage. If your doctor suspects you have Hashimoto’s disease, they will order a blood test that measures the amount of thyroid stimulating hormone (TSH) and thyroxine (T-4) in your blood. Once they make a diagnosis, they will start you on medication, checking your hormone levels every few weeks to make sure that the medicine is doing its job.

They may change your dosage several times while determining the amount of extra thyroid hormone your body needs. The good news is, once you find the right dosage of medication, you should start to see a reversal of symptoms.

In very rare cases, doctors may need to remove the thyroid gland if it becomes so large that it makes breathing difficult.

Hashimoto’s disease is a serious autoimmune disorder that requires immediate treatment. It’s important to find the right doctor who is willing to take the time to determine the best way to remedy it.

Find a doctor

If you think you might have Hashimoto’s disease or another thyroid condition, our endocrinology experts can help. You can find a provider using our provider directory. 

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Related resources

How to spot and treat thyroid disease

Hormones and mental health

Thyroid diet myths and truths

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.


About the Author

The Providence Health Team brings together caregivers from diverse backgrounds to bring you clinically-sound, data-driven advice to help you live your happiest and healthiest selves.

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