Hashimoto’s Disease: All You Need To Know About This Common Thyroid Condition

Hashimoto’s disease is the most common cause of hypothyroidism, but what does it entail, and how is it treated?

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You might have heard of Hashimoto’s disease, an endocrine disease that’s become more visible in the media over the past few years. Recently, celebrities like model Gigi Hadid and Jane the Virgin actress Gina Rodriguez have spoken up about the realities of life with Hashimoto’s. Rodriguez in particular has spoken about how she’s struggled with depression, forgetfulness, fatigue, and fluctuating weight—all of which are symptoms of Hashimoto’s disease. Hadid has also shared on social media how difficult it is to live with Hashimoto’s while working in the modeling industry, where her weight is constantly under scrutiny. Hadid and Rodriguez are not alone. According to Andres Palacio, MD, an endocrinologist with Tenet Florida Physician Services, Hashimoto’s disease can be found in up to 10 percent of the population. Studies indicate that Hashimoto’s may be up to eight times more common in women than in men. But despite the fact that the condition is fairly common, many of us aren’t familiar with the signs and symptoms of Hashimoto’s. If you think you could potentially have Hashimoto’s disease, or if you’re simply curious and want to learn more, read on.

What is Hashimoto’s disease?

Hashimoto’s disease is an autoimmune disease, meaning that the body’s immune system attacks the bodily tissues. It’s also recognized as a chronic illness. Hashimoto’s specifically affects the thyroid gland, which is a part of the endocrine system. The endocrine system is responsible for regulating the hormones throughout the body. According to Palacio, other than in cases caused by an iodine deficiency, Hashimoto’s disease is the most common cause of hypothyroidism. Hashimoto’s disease can also cause thyroiditis, which is an inflammation of the thyroid. Because of this, Hashimoto’s disease might also be called Hashimoto’s thyroiditis. It’s important to note that thyroiditis isn’t always caused by Hashimoto’s disease, nor is it only linked to hypothyroidism. “[Thyroiditis] can be caused by viruses or autoimmune processes. It can present both as hyperthyroidism [producing too much hormone] or hypothyroidism [producing too little hormone],” Palacio notes. Hashimoto’s disease is most likely to appear in people between the ages of 40 and 60. You’re also more likely to have Hashimoto’s disease if you have other health conditions such as Addison’s disease, rheumatoid arthritis, lupus, autoimmune hepatitis, vitiligo, pernicious anemia, and type 1 diabetes.

What are the symptoms of Hashimoto’s disease?

Because the disease attacks the thyroid gland, people with Hashimoto’s have low levels of thyroxine, a hormone made in the thyroid that is essential for many bodily functions such as digestion and brain development.   Palacio notes that Hashimoto’s can sometimes include the development of a goiter. According to the American Thyroid Association, a goiter occurs when the thyroid swells, making it look like a large mass in the neck near the Adam’s apple. It’s important to note that a goiter could be caused by hypothyroidism or hyperthyroidism. As such, it can be caused by Hashimoto’s disease, but it can also be caused by conditions, such as Graves’ disease, that cause hyperthyroidism. According to Mayo Clinic and the American Thyroid Association, the symptoms of Hashimoto’s disease include:

  • Sore, stiff, or weak muscles
  • Weight gain
  • Fatigue
  • Pale, dry skin
  • Constipation
  • A puffy face
  • Menorrhagia (excessive or prolonged menstrual bleeding)
  • Depression
  • Brittle nails and hair loss
  • Memory loss

Because hypothyroidism affects thyroid levels, Hashimoto’s can also lead to high cholesterol, which can in turn cause heart conditions.

How is Hashimoto’s disease diagnosed?

Hashimoto’s disease is diagnosed by measuring thyroid-stimulating hormone (TSH) along with thyroid peroxidase (TPO) antibodies, Palacio says. Since Hashimoto’s is an autoimmune disorder, it’s usually accompanied by a high amount of TPO antibodies. Unfortunately, getting a diagnosis isn’t always easy. Kathryne struggled to find a diagnosis for her extreme fatigue for 18 years before she was finally diagnosed with Hashimoto’s disease just three years ago. The 52-year-old strategist and mother says that It became so extreme that I could barely walk up a short flight of stairs. At that time, I was only being seen by regular, general practice doctors. I didn’t have any idea what was going on, so I didn’t know that I should have pushed harder for answers. It was many, many months before they even thought to do a thyroid test,” she recalls. For the next 10 years, she was treated for hypothyroidism. Despite the fact that her other symptoms seemed like Hashimoto’s disease, her doctors dismissed it. During this period, she developed a bald patch, found her hair thinning, and had a rash. When her rash flared up, she would experience extreme fatigue and pain. Yet she still couldn’t find someone who could provide her with effective treatment. Both naturopaths and traditional medicine failed to help her. Eventually, she found a functional medicine doctor who ordered a full thyroid panel and confirmed that she had Hashimoto’s disease. Since then, she’s been able to find an effective form of treatment.

How can Hashimoto’s disease be treated?

Hashimoto’s is a chronic illness, meaning there is no cure. But it can be effectively treated with medication. “The main recommendation for patients when they have Hashimoto’s is to take their medication appropriately—on an empty stomach, with water, and at least 60 minutes before having any food,” Palacio says. The medication often prescribed for Hashimoto’s is levothyroxine, a synthetic version of thyroxine that ensures that hormones are at an optimum level. Palacio notes that people being treated will also have to have their hormone and antibody levels checked every six to 12 months. Kathryne says that her doctor, a practitioner of functional medicine, has taken a different approach to her medication. Her doctor has reduced her levothyroxine dosage, prescribed liothyronine, and adjusts her medication based on both her lab results and symptoms. “My doctor recently started me on LDN (‘low dose’ micro doses of naltrexone), and she is carefully monitoring my thyroid panel, including TPO, to make adjustments to my dosages of levothyroxine and liothyronine as necessary,” Kathryne explains. Naltrexone is an opiate antagonist, and LDN is a fairly common treatment for people with autoimmune disorders such as Hashimoto’s disease. Many people try gluten-free diets if they have disorders like Hashimoto’s disease. This is because various studies suggest celiac disease is prevalent in people who have endocrine autoimmune disorders. While many people believe that a change in diet can help them, that’s not something Palacio personally recommends to his patients. “There is no scientific evidence that there is a need to change the diet if the patient has hypothyroidism,” Palacio explains. That said, certain lifestyle changes could help manage the symptoms of Hashimoto’s disease. Healthy lifestyle changes are never a bad idea, but they’re especially imperative with a chronic illness such as Hashimoto’s disease. Kathryne says she feels best when she eats a Whole30 diet, practices yoga daily, gets regular exercise, and sleeps well. As mentioned earlier, Hashimoto’s is linked to depression. Lifestyle changes might be necessary to address any mental health difficulties experienced as a result of Hashimoto’s. For those who do experience depression, psychotherapy (also known as talk therapy) might be useful. Although Kathryne struggled to find an effective approach, she finally found a form of treatment that’s right for her. “I haven’t had a serious flare-up since then. My energy level is much better,” she says. “I still have to be careful about overexertion. I work very hard at maintaining a healthy balance of diet, exercise, and especially rest. I now feel better than I have in almost 20 years,” she says. If you suspect you have Hashimoto’s disease, don’t let healthcare providers dismiss your symptoms without offering any explanation. It might take awhile to find a doctor who takes your symptoms seriously, as Kathryne’s case shows, but her story also shows that persevering is worth it. Don’t stop looking until you find a healthcare provider who really listens to you and looks at a wide array of test results,” Kathryne says. “Healing can take a long time, so don’t give up.”