Female doctor performing physical thyroid examination
Hashimoto’s disease is an autoimmune disorder the can cause hypothyroidism and damage the thyroid gland.

Everything You Need to Know About Hashimoto’s Disease

Hashimoto’s disease is a form of hypothyroidism, or underactive thyroid. It can cause a number of distressing symptoms, but with the right treatment, they can be successfully managed, and patients can live a relatively normal life.

Read on to find out more about Hashimoto’s disease and its causes, symptoms, and treatment.

What Is Hashimoto’s Disease?

The thyroid is a small gland located at the front of your neck, just beneath your Adam’s apple. It is an endocrine gland, meaning that it produces hormones that are necessary for a number of important bodily functions.

The thyroid gland converts iodine from food into hormones known as T3 and T4. These hormones are responsible for regulating your metabolism and energy production. The release of these hormones is controlled by another hormone called the thyroid stimulating hormone (TSH), which is released by the pituitary gland.


In patients with Hashimoto’s disease, this process is interrupted, and the thyroid cannot produce hormones as it should. It is an autoimmune disorder, meaning that the immune system does not recognize the thyroid as part of the body and begins to attack it. When the immune system attacks the thyroid gland, it becomes inflamed and damaged, which causes T3 and T4 production to stop.

Hashimoto’s disease is the most common form of hypothyroidism in areas where dietary iodine is sufficient. It is also known as Hashimoto’s thyroiditis, autoimmune thyroiditis, or chronic lymphocytic thyroiditis.

What Causes Hashimoto’s Disease?

As is the case with many autoimmune disorders, the exact cause of Hashimoto’s disease is still not fully understood.

It appears to have a genetic component, meaning that you are more likely to develop the condition if one of your close relatives has it. It is thought that in susceptible people, Hashimoto’s disease may be triggered by an infection such as a virus.

What we do know is that Hashimoto’s disease affects more women than men. This suggests that hormones may also play a part. The condition is usually diagnosed between the ages of 30 and 50, although it can develop at any time.

Symptoms of Hashimoto’s Disease

Thyroid hormones are responsible for providing energy for many of our biological processes. Therefore, Hashimoto’s disease can cause a wide variety of symptoms throughout the body.

One of the most distinctive symptoms of Hashimoto’s is goiter: a lump in the neck caused by a swollen thyroid gland. A goiter is usually not painful, but it can cause some discomfort or difficulty swallowing.

Other typical symptoms of Hashimoto’s disease include:

  • Fatigue
  • Unexplained weight gain
  • Sensitivity to cold
  • Joint or muscle pain
  • Dry, brittle hair and nails
  • Pale or puffy skin
  • Heavy or prolonged menstrual bleeding
  • Fertility problems
  • Slow heart rate
  • Depression
  • Poor memory
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In very severe cases, hypothyroidism can cause a condition called myxedema, which may lead to a potentially fatal coma. However, this is a rare occurrence and can be prevented with the right treatment.

Treatment of Hashimoto’s Disease

It is essential that hypothyroidism is treated correctly, both to relieve symptoms and prevent complications like myxedema.

The primary treatment for Hashimoto’s disease is medication, although this can be complemented with dietary changes.

Surgery for Hashimoto’s disease is not usually necessary. However, a goiter may be removed if it is causing severe discomfort, or if cancer is suspected.

Medication

Fortunately, Hashimoto’s disease can be treated effectively with a drug called levothyroxine. This medication is identical to the thyroid hormone T4 and can successfully control the symptoms of hypothyroidism.

However, the success of this medication depends on finding the correct dosage for each individual patient. Regular blood tests are also crucial, especially during the early stages. Even once an adequate dose has been achieved, close monitoring of thyroid hormone levels is required.

Levothyroxine does not normally cause any side effects, but it is important to take this medication correctly to ensure that it works as it should. Certain foods, drinks, and medicines can all affect the absorption of levothyroxine by the body. Therefore, it is usually recommended that this medication is taken first thing in the morning, at least an hour before any food, other medicine, or beverages other than water.

If you are taking levothyroxine and it is not helping your symptoms, you may need a higher dose. You should also check and ensure that you are taking it the right way, as perscribed. Symptoms such as chest pain, diarrhea, vomiting, and headaches could be a sign that your dosage is too high.

Another drug that may be used to treat Hashimoto’s disease is triiodothyronine (T3). However, there is little evidence that this works better than levothyroxine alone, so it is not usually prescribed.

Diet

In addition to medication, it is also important for people with Hashimoto’s disease to pay close attention to their diet. This condition can cause oversensitivity to iodine, and although a little iodine is beneficial for the thyroid, too much can be harmful for people with Hashimoto’s disease. Therefore, it is recommended that people with this form of hypothyroidism avoid eating too many iodine-rich foods such as seafood, seaweed, and table salt.

Another food group that should be limited is cruciferous vegetables such as cauliflower, broccoli, and Brussels sprouts. Although they are generally considered healthy, these vegetables contain compounds known as goitrogens which could make Hashimoto’s disease symptoms worse. These foods do not need to be cut out completely, but should only be eaten in moderation.


Some of the most beneficial nutrients for Hashimoto’s disease are selenium and zinc. Foods that are high in selenium include Brazil nuts, eggs, meat, and fish. Foods which are high in zinc include meat, cow’s milk, bread, cereals, and pulses.

If you have Hashimoto’s disease, talk to a qualified dietician to ensure that you are getting all the nutrients you need to properly manage your condition.