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Hashimoto’s Thyroiditis

What is Hashimoto’s Thyroiditis?

What is Hashimoto’s thyroiditis? This is a condition affecting the thyroid which is a gland, small, and located at the base of the neck. This gland is part of the endocrine system which creates hormones that direct most of the activities of the body. This gland is butterfly-shaped and releases 2 hormones, thyroxine or T4 and triiodothyronine or T3.


This condition is also known as “chronic lymphocytic thyroiditis” and develops when the immunity system attacks the thyroid gland resulting in inflammation and in some cases causes a thyroid gland to be underactive or hypothyroidism. This condition of Hashimoto’s disease is the most common reason for the development of hypothyroidism in the United States. It usually affects women in middle age but can also develop in women and men of any age as well as children. Medical researchers have found Hashimoto’s disease to often run in families.

Hashimoto’s Thyroiditis Symptoms

In the beginning of this condition, Hashimoto’s disease doesn’t have any symptoms or signs that are unique. The condition normally develops slowly over numerous years and creates chronic damage to the thyroid gland leading to the thyroid hormone levels in the blood continuing to drop. At a point the symptoms and signs become those of hypothyroidism.

Hypothyroidism has symptoms and signs that widely vary, dependent on the how severe the hormone drop is. In the beginning the symptoms will not be noticeable, such as little energy as well as chronic fatigue but most individuals just believe that these are only part of growing older. But, the disease will continue to progress until the individual develops symptoms and signs that are more noticeable.

A unique problem with this disease is that there can be time periods when the thyroid might start working again even to the point of causing short-term hyperthyroidism, then reverting back to hypothyroidism. These periods of back and forth between hyper and hypothyroidism are quite distinctive of this disease. As an example, cycling between periods of anxiety, diarrhea, insomnia, weight loss might be followed by periods of depression, constipation, fatigue, weight gain.

Symptoms and signs of hypothyroidism can include:

  • Low energy
  • Chronic fatigue
  • Sensitivity to cold
  • Constipation
  • Dry, pale skin
  • Puffy face
  • Voice that is hoarse
  • Cholesterol level that is elevated
  • Weight gain that is unexplained (occurs rarely and usually is only 10 to 20 pounds, the majority which is fluid)
  • Shoulder muscle aches and stiffness
  • Hip muscle aches and tenderness
  • Weakness in lower extremities muscles
  • Menorrhagia – prolonged or excessive bleeding during menstrual period
  • Depression
  • Forgetfulness
  • Hair loss
  • Problems concentrating
  • Late in the disease small or shrunken thyroid gland

Left untreated, symptoms and signs will grow more severe and the thyroid gland itself might grow to be very large which is called a goiter. If the goiter becomes too large the individual might feel discomfort in the throat or neck region. The area might feel swollen or sore. Often the neck or throat can cause the individual to have problems swallowing or breathing due to blockage of the esophagus or windpipe.

Hashimoto’s Thyroiditis Causes

Hashimoto’s disease is actually an autoimmune condition where the immune system produces antibodies that damage the thyroid gland. Medical researchers do not know what causes the immunity system to attack and damage the gland but some researchers believe it could be triggered by a bacterium or virus, while other medical professionals believe a genetic flaw is the reason. Others believe that it is a combination of issues, such as heredity, sex as well as age.

Continued research is being done in the form of clinical trials to aid in the improvement of diagnosis, prevention and treatment for those individuals with this disease. Some studies are being done to look at control of this disease and how to improve the individual’s quality of life. Other trials are being done to look at how this disease affects other systems of the body, the relationship to other conditions as well as studying advancements in diagnostic and monitoring aids.

Hashimoto’s Thyroiditis Treatment

The treatment for this disease at first might only include observation especially if there is no evidence of deficiency of hormones and the gland is working normally. If an individual does need medication it will probably be needed for the rest of the individual’s life.

Medication for this disease involves synthetic hormones used as replacement therapy for the hormone deficiency. This means daily doses of the synthetic hormone levothyroxine under the names of Levoxyl, Levothroid, and Synthroid. Synthetic levothyroxine is the same as thyroxine which is the natural version of this hormone made by the gland. This is an oral medication taken daily and restores hormones to adequate levels reversing all the symptoms of hypothyroidism.

After beginning drug treatment the individual will notice less fatigue and the medication will also lower gradually any cholesterol levels that were elevated. It might also reverse any gaining of weight. Treatment is usually lifelong but since the dosage might need changed, the individual will have to have TSH levels checked every six to twelve months.

To initially determine the correct dosage, the physician will generally check levels of TSH after a couple of weeks of therapy. Amounts of the hormone that are excessive can speed up loss of bone and might make osteoporosis worse or add to the individual’s risk of osteoporosis. Overtreatment with synthetic thyroid can also cause disorders of heart rhythm called arrhythmias. For these reasons, if an individual has coronary artery disease or hypothyroidism that is severe, the physician will begin treatment with a small amount and increase the dosage gradually. This method of progressive hormone replacement will allow the heart to better adjust to the increase in metabolism.

Levothyroxine has little or no side effect when the correct dose is used and is a medication that is very inexpensive. It is also important not to miss doses or discontinue taking this medication just because symptoms are gone – if you do, symptoms and signs will return.

Hashimoto’s Thyroiditis Diet

Some supplements, medications and some foods might affect the body’s ability to absorb levothyroxine. An individual should speak to their physician if they consume large amounts of products with soy or have a diet that is high in fiber or if any of the below are being used:

  • Iron supplements or multivitamins containing iron
  • Calcium supplements
  • Cholestyramine called Questran which is a drug for lower blood cholesterol levels
  • Sodium polystyrene sulfonate under the name of Kayexalate that is used to stop high blood potassium levels
  • Aluminum hydroxide that is in some antacids
  • Sucralfate that is an ulcer drug

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