What Is Hashimoto's Disease?

Medically Reviewed By Nancy Carteron, M.D., FACR
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Hashimoto’s disease is an autoimmune condition in which your body’s immune system attacks your thyroid gland. Your thyroid gland helps regulate your metabolism, body temperature, and energy level. Hashimoto’s disease can cause hypothyroidism and decrease your body’s circulating thyroid hormones.

This article explains what Hashimoto’s disease is. It also describes the symptoms, causes, and treatment options related to the condition.

What is Hashimoto’s disease?

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According to the National Health Service (NHS), Hashimoto’s disease — also known as Hashimoto’s thyroiditis — is an autoimmune condition associated with the thyroid gland. An autoimmune condition occurs when your body’s immune system does not recognize its own healthy tissue as “self.”

It attacks your healthy tissue, thinking it is an invading pathogen there to cause an illness. This leads to consequences in multiple systems throughout your body.

Read more about autoimmune conditions here.

What does Hashimoto’s disease do to your body?

Hashimoto’s disease specifically targets your thyroid gland. This butterfly shaped gland sits at the base of your neck and plays an important role. It is responsible for regulating several functions in your body. As a result, the symptoms of Hashimoto’s disease can be widespread.

When your thyroid gland can no longer regulate your body, you develop hypothyroidism.

Read more about hypothyroidism here.

How do thyroid disorders affect the body?

Your thyroid gland is responsible for managing several functions, including:

  • metabolism
  • body temperature
  • energy levels
  • heart rate
  • blood pressure

The thyroid gland accomplishes this by creating triiodothyronine (T3) and thyroxine (T4). These hormones work to balance your body in these areas.

Hyperthyroidism occurs when your thyroid gland makes too much of these hormones. Hypothyroidism happens when your body does not have enough thyroid hormones in circulation.

Read more about thyroid disorders here.

Is it common?

Up to 2% of people in the United States have Hashimoto’s disease, making it one of the most common causes of hypothyroidism.

Females are more likely to develop it, and it becomes more common with age. If a family member has Hashimoto’s disease, you are more likely to develop the condition as well. Also, when you have other autoimmune conditions, such as celiac disease and lupus, you have an increased risk of having Hashimoto’s disease.

What are the symptoms of Hashimoto’s disease?

The symptoms of Hashimoto’s disease usually develop slowly over time as the body attacks your thyroid gland.

Because hypothyroid causes a drastic decrease in thyroid function, many of the associated symptoms cause your body to slow down.

Hashimoto’s disease symptoms include:

  • fatigue
  • weight gain
  • thin, dry hair
  • constipation
  • depression
  • concentration issues
  • frequent coldness
  • a slowing of your heart rate
  • a puffy face
  • pale skin
  • goiter, or a visibly enlarged thyroid
  • swallowing issues

It is not uncommon for people to experience hyperthyroid symptoms 1–2 months before their hypothyroid symptoms. “Hashitoxicosis” is the clinical term for this phase. You may experience an increased heart rate, weight loss, and irritability before your hypothyroid symptoms.

What are the differences between Hashimoto’s disease and Graves’ disease?

The differences between Graves’ disease and Hashimoto’s disease relate to the effects of having too much or too little thyroid hormone circulating in your body.

Hashimoto’s disease is associated with hypothyroidism, or low levels of thyroid hormones. These conditions cause many of your bodily systems to slow down.

Graves’ disease is another autoimmune condition that attacks your thyroid. This disease is related to hyperthyroidism and causes your thyroid gland to produce too many thyroid hormones. If you have a hyperthyroid disease, you will experience symptoms that are the opposite of those of hypothyroidism. Many of your bodily systems will speed up.

The table below provides some key symptom differences between the two conditions.

Hashimoto’s disease symptomsGraves’ disease symptoms
cold intoleranceincreased sweating
fatigue increased metabolism
weight gainweight loss
a slow heart ratea racing heart
constipationanxiety and nervousness
depressionshort, light periods
thin, dry hairbulging eyes
a puffy faceinsomnia

Read more about Graves’ disease here.

Some symptoms, such as insomnia and fatigue, may overlap.

When should you contact a doctor?

You should seek medical advice from your doctor if you experience any of the above symptoms. They will be able to offer an official diagnosis and devise a treatment plan to manage your symptoms.

If Hashimoto’s disease is not treated, people may experience significant complications.

What causes Hashimoto’s disease?

Researchers have identified some possible causes of Hashimoto’s disease, but they are unsure why some people develop the condition while others do not.

Some potential causes of Hashimoto’s disease include:

  • genetics
  • environmental factors, particularly exposure to toxins or nuclear radiation
  • viruses, such as hepatitis C
  • medications containing iodine

Your genetics and environment play a significant role in whether or not you develop Hashimoto’s disease.

Potential triggers for Hashimoto’s disease

Hashimoto’s disease may happen when a person is genetically predisposed to thyroid conditions and then an environmental event triggers the condition.

Such triggers can include:

  • pregnancy
  • stress
  • menopause
  • contracting a virus
  • consuming artificial sweeteners
  • excessive iodine consumption
  • consuming animal protein in large amounts

How do doctors diagnose Hashimoto’s disease?

If you report symptoms that sound like those of hypothyroidism to your doctor, they may order blood tests to check how well your thyroid gland is functioning.

Specifically, your doctor may order a thyroid-stimulating hormone test. They may also order a T3 and a T4 test. These are all hormones associated with your thyroid. If they are outside the typical range, it may indicate that you have hypothyroidism due to Hashimoto’s disease.

Your doctor may also order an additional antibody test. This will help reveal if Hashimoto’s disease is causing your hypothyroidism. Most people with Hashimoto’s disease have these antibodies present in their bodies, but not everyone does.

If you test positive for antibodies, it does not necessarily mean that you have the condition. If this is the case, your doctor may request an ultrasound scan to visualize the characteristics of your thyroid that may indicate Hashimoto’s disease.

Occasionally, a biopsy is needed to exclude thyroid cancer.

How do you treat Hashimoto’s disease?

You may visit an endocrinologist. These are doctors who are trained to treat hormone-related conditions. Your endocrinologist will manage your treatment depending on your symptoms.

If you have no symptoms of hypothyroidism and you have antibodies in your system, they may simply monitor your condition. They may regularly test your thyroid hormones to track your progression.

Medications

Levothyroxine is the medication used to treat Hashimoto’s disease. This drug mirrors T4, which is a natural thyroid hormone your body already makes. Your doctor may recommend taking this medication in the morning on an empty stomach to maximize absorption and minimize side effects.

Your doctor may monitor your thyroid levels with regular blood tests. You can expect to take levothyroxine every day for the rest of your life. If you have Hashimoto’s disease and are pregnant, you may need a higher dose of levothyroxine to prevent issues during pregnancy.

Diet and lifestyle

Having Hashimoto’s disease does not mean that you need to change your current diet. However, you may want to limit your iodine intake, as it may make hypothyroidism worse. Fish and seaweed products are worth avoiding, as they contain iodine.

Living a relatively healthy life by quitting smoking, managing stress, and exercising can also help you manage the condition.

What are the complications of Hashimoto’s disease?

Getting treatment is important. There are many possible complications of Hashimoto’s disease, which include:

Another major complication is myxedema coma. In this case, the thyroid gland is critically stagnant. It may cause coma, seizures, and death.

Read more about myxedema coma here.

What are the risk factors for Hashimoto’s disease?

There are many risk factors associated with Hashimoto’s disease. For example, you have a higher risk of developing this condition if you have radiation exposure. Hashimoto’s disease is also more likely to occur as people get older.

Scientists have pinpointed several genes that may have variations responsible for Hashimoto’s disease symptoms. Many genes play a role in your body’s immune system.

Genetic factors can play a small role in whether or not you develop Hashimoto’s disease.

When there are deviations, your immune system struggles to distinguish its own protein from the protein of invading pathogens.

Summary

Hashimoto’s disease is an autoimmune condition that affects the thyroid gland. The thyroid gland regulates many functions in the body, such as metabolism and temperature.

Symptoms of Hashimoto’s disease can include a slow heart rate and weight gain. It is important to seek medical care if you believe that you have any symptoms relating to Hashimoto’s disease, as there can be severe complications without treatment.

Treatment for Hashimoto’s disease involves taking synthetic hormone medications, such as levothyroxine.

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Medical Reviewer: Nancy Carteron, M.D., FACR
Last Review Date: 2022 May 17
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