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Hashimoto’s 101: Understanding Autoimmune Thyroid Disease

Hashimoto’s - Autoimmune Thyroid Disease

An autoimmune disorder is one of the more challenging conditions to correctly diagnose and treat. Most autoimmune conditions result in a wide array of symptoms and disruption throughout the body. However, few have as significant an effective on the thyroid as Hashimoto’s thyroiditis.

As one of the causes of hypothyroidism, Hashimoto’s is an incredibly impactful condition that should be understood by all.

The primary difficulties associated with autoimmune disorders, including Hashimoto’s are expedient diagnosis and effective treatment. Being aware of the symptoms and appropriate treatment methods can help reduce the widespread influence of this autoimmune thyroid condition.

What is Hashimoto’s?

Hashimoto’s thyroiditis is an autoimmune condition that causes the body’s defenses to turn on itself and begin attacking the thyroid.

The immune system relies on reliable identification of harmful substances to work correctly. If the immune system incorrectly marks a beneficial system or substance as harmful, antibodies can attack critical systems leaving the body in a state of disarray. In the case of Hashimoto’s, the immune system perceives proteins located in the thyroid gland as a threat resulting in an outright assault on the gland.

Lymphocytes are one of the tools used by the immune system to eliminate threats. When the body’s defenses begin attacking the thyroid, lymphocytes enter the thyroid and destroy tissue, cells and blood vessels contained therein.

Typically, thyroid damage caused by Hashimoto’s accrues slowly over a long period of time. This means that symptoms may not be noticed for years. Furthermore, many go undiagnosed because the majority of doctors rely on the thyroid stimulating hormone (TSH) test to assess their patients (find out what’s wrong with the TSH test here), TSH and thyroid levels generally change only after irreparable damage has been done. This means that by the time most physicians are able to identify Hashimoto’s it is already too late to prevent thyroid degradation.

Signs and Symptoms

Hashimoto’s causes patients to experience typical hypothyroid symptoms such as fatigue, weight gain, and difficulty thinking clearly. However, as the thyroid is damaged, clusters of thyroid hormone are released from the destroyed tissue resulting in temporary elevation of thyroid hormone levels. This can trigger symptoms more often associated with hyperthyroidism such as anxiety, diarrhea, increased heart rate and sudden weight loss. Hashitoxicosis is the term used to describe the occurrence of this sudden shift in thyroid hormones resulting in hyperthyroid-like symptoms.

Depending on how far Hashimoto’s has progressed, different symptoms may develop. Early stage Hashimoto’s generally causes few hypothyroid symptoms at mild intensity. As the condition advances and more thyroid cells are destroyed, symptoms can worsen, and you may experience additional symptoms with occasional bouts of Hashitoxicosis.

Symptoms present themselves differently for each person. Patients may suffer from some or all of the following symptoms with varying degrees of intensity.

Those with early stage Hashimoto’s may experience the following symptoms:

  • Acid reflux
  • Bloating
  • Constipation
  • Diarrhea
  • Irritable bowel syndrome

More established Hashimoto’s is associated with a broader range of symptoms:

  • Brain fog
  • Difficulty swallowing
  • Fatigue
  • Hair loss
  • Hair loss
  • Hoarseness
  • Inability to regulate temperature (in heat or cold)
  • Irregular periods
  • Joint and muscle pain
  • Low libido
  • Memory loss
  • Swelling in the hands, feet or face
  • Tightness in the throat
  • Weakness
  • Weight gain

Thyroid tissue destruction resulting in Hashitoxicosis can induce the following symptoms:

  • Anxiety
  • Diarrhea
  • Panic attacks
  • Quickened heartbeat
  • Rapid weight loss
  • Shaking hands
  • Sweating

In some cases, patients may develop a goiter, or enlarging of the thyroid gland, that can cause tenderness and soreness around the neck and may obstruct airways. In addition to physical discomfort, a goiter may cause an undesired aesthetic change appearing as a large growth or protuberance of the neck area.

Identifying Immune Dysfunction

The process for diagnosing autoimmune thyroid issues should include tests for thyroid peroxidase antibody (TPO) and antithyroglobulin. Increased levels of these substances strongly indicate the presence of an autoimmune issue. Up to 95% of those with Hashimoto’s have elevated levels of TPO and about 80% of cases show increased antithyroglobulin. However, even if these elements are not increased, a patient may still have Hashimoto’s.

To fully assess thyroid function and autoimmunity a comprehensive approach is best. This should include testing of Free T4, Free T3, Reverse T3, sex hormone binding globulin (SHGB) and basal metabolic rate. Testing each of these areas provides a better picture of thyroid function and allows for more accurate diagnosis of your condition regardless if it is related to autoimmune function or not.

What Contributes to Autoimmune Thyroid Disease?

Although there is no singular definitive cause of Hashimoto’s there are various contributing factors that may increase the likelihood of developing an autoimmune condition.

Approximately one in every thousand people will develop Hashimoto’s with the majority of them being between the ages of 45 and 65. Additionally, thyroid disease, including Hashimoto’s, is more likely to develop in women.

Those with a family history of thyroid disease, specifically Hashimoto’s, are more likely to develop an autoimmune thyroid disorder. Pregnancy may also be a major contributor to Hashimoto’s as child birth puts additional stress on the immune system. Some believe that low levels of thyroid-related nutrients such as selenium, zinc and iron are associated with Hashimoto’s because a deficiency can contribute to thyroid inflammation.

Chronic disease and infection can also contribute to the development of autoimmune disorders because they tax the immune system. Conditions such as Epstein Barr, Lyme disease and mycoplasma further increase the likelihood of immune dysfunction. Furthermore, long term emotional or physical stress can disrupt the immune system and trigger significant inflammation. Additional stress placed on an already exhausted immune system and causes further dysfunction and increases the risk of developing an autoimmune disorder.

Treating the Thyroid and Immunity

Treatment of Hashimoto’s almost always involves thyroid hormone replacement therapy to balance the deficit caused by reduced thyroid production. After significant thyroid cell destruction, the patient enters a hypothyroid state and will require lifelong medication with a thyroid replacement drug. Regardless of thyroid health, Hashimoto’s it still an autoimmune condition and must be treated as such – learn about treating the immune component here.

Frequently, those with Hashimoto’s have reduced levels of various hormones that help regulate immune function and antibody activity. Rebalancing hormones such as DHEA and testosterone through supplementation can help normalize immune response and reduce continued thyroid damage.

Resolving deficiencies of important nutrients such as selenium and iodine may also prove highly beneficial. It is always best to speak with a physician prior taking supplements.

Halting the Advance of Hashimoto’s

Even though Hashimoto’s is a common cause of thyroid disease it frequently goes undiagnosed until it is too late. Being informed of the condition, its symptoms and the various methods of treatment can help reduce the life changing impact of Hashimoto’s for yourself and possibly others.

If you think you may have Hashimoto’s but are not suffering from hypothyroid-like symptoms, seek out a physician that will take the appropriate steps to fully assess immune function and thyroid health.








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SusanJAAIréne mulder Recent comment authors
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Iréne mulder
Iréne mulder

I’ve been diagnosed with Hashimoto’s thyriditis/encephalopathy 3 weeks ago,. Attacking my brain cells. I had 5 days of 1000ml of steroids and I was given meds which did not agree with me and I’ve had a allergic reaction and back in hospital since yesterday. I am now going to get radium iodine capsule treatment. My question …why don’t the Drs remove the thyroid? Or is it more complicated than just removing a thyroid?


My TSH has risen 2 points in 9 months (it is out of a functional range but still within conventional range) and my TPO antibodies came back at 99, negative for anti-thyroglobulin antibodies. The only symptoms I experience are occasional diarrhea, anxiety, and bloating but over the last couple months I’ve noticed heartburn that was never present before. Would you classify this as hashimotos?


Are those who went through chemo to beat cancer more susceptible to developing this thyroid disease?

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