Hashimoto Thyroiditis

What is Hashimoto thyroiditis?

Thyroiditis is when your thyroid gland becomes irritated or inflamed. Hashimoto thyroiditis is the most common type of this health problem. It may also be called chronic autoimmune thyroiditis. This thyroiditis is an autoimmune disease. It occurs when your body makes antibodies that attack the cells in your thyroid. The thyroid gland becomes overrun with white blood cells and becomes scarred. This makes the gland feel firm and rubbery. The thyroid then can’t make enough of the thyroid hormone.

Many people with this problem have an underactive thyroid gland or hypothyroidism. They have to take medicine to keep their thyroid hormone levels normal.

What causes Hashimoto thyroiditis?

Hashimoto thyroiditis is an autoimmune disorder. Normally, your immune system protects your body by attacking bacteria and viruses. But with this disease, your immune system attacks your thyroid gland by mistake. Your thyroid then can’t make enough thyroid hormone, so your body can’t work as well.

Who is at risk for Hashimoto thyroiditis?

Things that may make it more likely for to get Hashimoto thyroiditis are:

• Being a woman. Women are more likely to have the disease. Hashimoto thyroiditis sometimes begins during pregnancy. The condition may get better in some women during pregnancy. But then it may return after delivery.

• Being middle age. Most cases happen between ages 30 and 60. But it has been seen in younger people.

• Having a family member with the disease (heredity). The disease tends to run in families. But no gene has been found that carries it.

• Having other autoimmune diseases. These health problems raise a person’s risk. Some examples are rheumatoid arthritis, Addison disease, and type 1 diabetes. Having Hashimoto thyroiditis also increases your risk for other autoimmune illnesses.

What are the symptoms of Hashimoto thyroiditis?

Each person’s symptoms may vary. Symptoms may include:

Underactive thyroid

When your thyroid doesn’t make enough thyroid hormone, it can cause these symptoms:

• Tiredness

• Muscle weakness and joint pain

• Constipation

• Weight gain

• Not being able to handle cold

• Depression

• Hair and skin changes

Overactive thyroid

When the thyroid is attacked by antibodies, it may at first release more thyroid hormone. This is called thyrotoxicosis. It does not happen to everyone. But it can cause these symptoms: 

• Not being able to handle heat

• Fast heart rate

• Sweating

• Weight loss

• Tremors

• Anxiety

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is Hashimoto thyroiditis diagnosed?

Your healthcare provider will ask about your health history and give you a physical exam. You will also have blood tests. These can measure your thyroid hormone levels and check for certain antibodies that form against proteins in the thyroid.

How is Hashimoto thyroiditis treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

You will not need treatment if your thyroid hormone levels are normal. But Hashimoto thyroiditis can cause an underactive thyroid gland. If so, it can be treated with medicine. The medicine replaces lost thyroid hormone. That should stop your symptoms. Some people with Hashimoto's develop an enlarged thyroid gland called a goiter. Others develop an atrophic, or shrunken, thyroid gland. If the goiter grows quickly or is large, surgical removal of the goiter may be recommended to avoid problems with swallowing, speaking, or even breathing.

When should I call my healthcare provider?

Tell your healthcare provider if your symptoms get worse or you have new symptoms.

Key points about Hashimoto thyroiditis

• Hashimoto thyroiditis can cause your thyroid to not make enough thyroid hormone.

• It's an autoimmune disease. It occurs when your body makes antibodies that attack the cells in your thyroid.

• Symptoms may include an enlarged thyroid gland (goiter), tiredness, weight gain, and muscle weakness.

• You don’t need treatment if your thyroid hormone levels are normal. If you have an underactive thyroid, medicine can help.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.