Hashimoto’s Disease

Novaendocenter Hashimoto's diseaseHashimoto’s disease is an autoimmune disease that affects your thyroid gland. Autoimmune means that, for one reason or another, your own antibodies attack your thyroid gland. This leads to inflammation and eventually below normal thyroid function (hypothyroidism). Other names for Hashimoto’s disease are Hashimoto’s thyroiditis and chronic lymphocytic thyroiditis.

Symptoms of Hashimoto’s Disease

The symptoms of Hashimoto’s disease usually do not occur suddenly. The inflammation gradually affects your thyroid until it becomes underactive. The resulting hypothyroidism can then produce symptoms such as:

  • Tiredness and fatigue
  • Less tolerance to cold temperatures
  • Constipation
  • Skin dryness and pale complexion
  • Facial puffiness
  • Hoarseness of the voice
  • High cholesterol
  • Weight gain
  • Aches and pain in the muscles (shoulders and hips)
  • Stiff, painful joints (knees, hands, feet)
  • Weakness in the legs
  • Heavy or prolonged menstrual bleeding
  • Depressed mood
  • Swelling of the thyroid gland (goiter)

If you have any of these symptoms, you should consult with you doctor as soon as possible.

Causes of Hashimoto’s Disease

Hashimoto’s disease is an autoimmune disease where your own body does harm to your thyroid gland leading to inflammation and eventual under-activity. The exact cause of the disorder is not known. Some theories suggest that an infection by a virus or bacteria could be the cause. Other evidence shows that there might be a hereditary component. Women in middle age are at highest risk for developing this disease; however, it can occur in any person at any age.

Complications of Hashimoto’s Disease

Hashimoto’s disease leads to hypothyroidism. If left untreated this state of thyroid under-activity can lead to:

  • Goiter: This is an enlargement of the thyroid gland. Since there is not enough thyroid hormone in your blood, the pituitary tries to stimulate the thyroid leading to gland enlargement. In severe cases this could affect swallowing or breathing.
  • Heart Disease: The hypothyroidism associated with Hashimoto’s disease can lead to increased levels of “bad” or LDL cholesterol.
  • High cholesterol is associated with an increased risk of heart attacks. Also, long term hypothyroidism can lead to heart enlargement and, rarely, heart failure.
  • Depression: An underactive thyroid gland can lead to a depressed mood or even clinical depression. It can also lead to a decreased sexual desire.
  • Myxedema: This is a rare complication of hypothyroidism, but it can be life-threatening. If the illness has gone undetected for a long time, hypothyroidism can lead to severe cold intolerance, lethargy and unconsciousness. This is a medical emergency.
  • Birth Defects: Pregnant women with hypothyroidism caused by Hashimoto’s disease have an increased risk of giving birth to a child with birth defects including: mental retardation, cleft palate and heart and kidney problems.

Diagnosing Hashimoto’s Disease

If you show any of the signs or symptoms listed above, your doctor should evaluate you for Hashimoto’s disease. The initial testing involves blood tests to measure your thyroid function and how much your pituitary is stimulating your thyroid. These tests are:

  • Thyroxine or T4 (a thyroid hormone)
  • Triiodothyronine or T3 (a thyroid hormone)
  • TSH (thyroid stimulating hormone made by the pituitary gland)

Your doctor might also order an antibody test to check for levels of antibodies produced by your body. Antibodies against thyroid peroxidase are often present in Hashimoto’s disease.

Treating Hashimoto’s Disease

Treatment of this disorder depends on your symptoms and blood test results. If your thyroid tests are normal, your doctor might choose to just follow your symptoms and not use any medication. Otherwise, some treatment options are:

  • Thyroid Hormone Replacement: If you develop hypothyroidism due to Hashimoto’s disease the best treatment is synthetic thyroid hormone replacement. Doctors use the medication levothyroxine (Synthroid, Levoxyl, Levothyroid) to treat hypothyroidism. Usually this medication must be taken for life. Its effectiveness is measured by checking TSH levels in the blood and by following your symptoms.
  • Surgery: This would only be indicated in very rare cases where thyroid enlargement is interfering with breathing or swallowing. In most cases the disease is detected before these symptoms occur.


Hashimoto’s disease is an autoimmune disorder that affects the thyroid gland and can lead to hypothyroidism. Typical symptoms of hypothyroidism are fatigue, dry skin, weight gain, constipation and hoarseness of the voice. The diagnosis is made by physical exam and blood testing. Hashimoto’s disease is usually treated with thyroid hormone replacement for life.