Hashimoto's Disease (Hashimoto’s Thyroiditis) Treatment in Fairfax, VA
Hashimoto’s disease, also called Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis, is an autoimmune condition that affects your thyroid gland. In autoimmune disease, your own antibodies attack healthy tissue. In Hashimoto’s, that attack causes inflammation in the thyroid and, over time, can lead to an underactive thyroid (hypothyroidism). It is the most common cause of hypothyroidism in the United States.
At The Endocrine Center in Fairfax, Virginia, endocrinologists Dr. Denise Armellini and Dr. Romona Satchi provide concierge endocrine care, including thyroid care, to patients throughout Northern Virginia. This page explains the symptoms, causes, diagnosis and treatment of Hashimoto’s disease, and how our membership practice can help.
Hashimoto’s Disease Symptoms
Symptoms of Hashimoto’s disease usually do not appear suddenly. Inflammation gradually affects your thyroid until it becomes underactive, and the resulting hypothyroidism can cause:
- 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, see your doctor as soon as possible. Many of them are common and can have other causes, which is why blood testing is the only way to know for sure.
What Causes Hashimoto’s Disease?
Hashimoto’s disease is an autoimmune disorder in which the body harms its own thyroid gland, leading to inflammation and eventual underactivity. The exact cause is not known. Some theories suggest an infection with a virus or bacteria could play a role, and other evidence points to a hereditary component.
Who Is at Risk?
Women in middle age are at the highest risk, but Hashimoto’s can occur in anyone at any age. Risk is also higher if you have:
- A family history of thyroid disease or other autoimmune conditions
- Another autoimmune condition, such as type 1 diabetes
Complications of Untreated Hashimoto’s Disease
Hashimoto’s disease leads to hypothyroidism. If it is left untreated, this thyroid underactivity can lead to:
- Goiter: An enlarged thyroid gland. When there is not enough thyroid hormone in your blood, the pituitary gland keeps stimulating the thyroid, which can cause it to enlarge. In severe cases, a goiter can affect swallowing or breathing.
- Heart disease: Hypothyroidism can raise “bad” LDL cholesterol, which is linked to a higher risk of heart attack. Long-term untreated hypothyroidism can also lead to an enlarged heart and, rarely, heart failure. Learn more about high cholesterol.
- Depression: An underactive thyroid can cause low mood or even clinical depression, and can also decrease sexual desire.
- Myxedema: A rare but life-threatening complication of severe, long-undetected hypothyroidism, causing extreme cold intolerance, lethargy and loss of consciousness. This is a medical emergency; call 911.
- Pregnancy complications: Untreated or poorly treated hypothyroidism during pregnancy raises the risk of complications for both mother and baby and can affect the baby’s development. If you are pregnant or planning to be, tell your physician.
How Hashimoto’s Disease is Diagnosed
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.
Hashimoto’s Disease Treatment
If your thyroid tests are normal, your doctor may choose to follow your symptoms and repeat your blood tests over time, rather than starting medication right away.
Thyroid Hormone Replacement
If you develop hypothyroidism because of Hashimoto’s disease, the best treatment is synthetic thyroid hormone replacement. Doctors use the medication levothyroxine, sold under brand names such as Synthroid, Levoxyl and Unithroid. It usually must be taken for life. Effectiveness is measured by checking your TSH level in the blood and by following your symptoms, and your dose may be adjusted over time.
Levothyroxine is typically taken once a day on an empty stomach, and some supplements, such as calcium and iron, can interfere with absorption. Taking too much can cause symptoms of an overactive thyroid and can affect bone health, which is why regular follow-up testing matters.
Surgery
Surgery is needed only in very rare cases, such as when thyroid enlargement interferes with breathing or swallowing. In most cases Hashimoto’s disease is detected before that happens.
Hashimoto’s Disease and Your Overall Health
Because thyroid hormone affects nearly every system in the body, Hashimoto’s disease is often connected to other health concerns. Your endocrinologist can look at the full picture, including:
- Cholesterol and heart health: Hypothyroidism can raise LDL cholesterol. See our page on high cholesterol and metabolic syndrome.
- Bone health: Both untreated hypothyroidism and too much thyroid medication can affect bones. See our page on osteoporosis.
- Other autoimmune conditions: Hashimoto’s can occur alongside other autoimmune diseases, such as type 1 diabetes.
- Pregnancy planning: Thyroid levels matter before and during pregnancy.