Hashimoto's Disease

The thyroid gland has a huge impact on your overall health. This small gland, located in the front of the throat, makes hormones that influence energy use and metabolism throughout the whole body. When the levels of thyroid hormones are too high or too low, then symptoms may result.

The most common cause of hypothyroidism, or low thyroid hormone levels, is Hashimoto’s disease. 

What is Hashimoto disease?

In people with Hashimoto’s disease, the body makes antibodies against the thyroid gland. These attack the cells of the thyroid and interfere with thyroid function. Patients with Hashimoto’s disease are said to go through 5 stages of Hashimoto’s, including having a genetic predisposition, immune cells infiltrating the thyroid, subclinical hypothyroidism (where the patient doesn’t yet have symptoms), and then overt hypothyroidism. The last stage is the development of other autoimmune diseases, like lupus or psoriasis. While not all patients with Hashimoto’s will develop these other diseases, it does increase the risk.

There is another autoimmune disease called Graves’ disease. In patients with this disease, the body also makes antibodies against the thyroid gland. However, instead of interfering with its function, these antibodies stimulate the thyroid gland to make more thyroid hormones, leading to hyperthyroidism.

What are the Hashimoto symptoms?

People with Hashimoto’s disease tend to experience the same symptoms that other patients with hypothyroidism experience, including low energy and fatigue, weight gain, cold intolerance (feeling cold when others are comfortable), constipation, and depression.

There is also a link between Hashimoto’s and heart rate. People with Hashimoto’s or another cause of hypothyroidism may have a slower than normal heart rate. This can contribute to feeling lethargic and fatigued.

For premenopausal women, there is a link between Hashimoto’s and menstrual cycle irregularities. Some women with hypothyroidism have heavier than normal periods. The periods may also become very irregular or even stop altogether.

Can you have Hashimoto’s with normal TSH?

Thyroid stimulating hormone, or TSH, is made by the pituitary gland, and stimulates the thyroid gland to make thyroid hormones. In Hashimoto, TSH levels are most commonly high. This is because when thyroid hormone levels are low, the pituitary gland is triggered to make extra TSH to try to get the thyroid gland to make more thyroid hormones.

However, it’s also possible to have normal levels of TSH, and still be suffering from symptoms of hypothyroidism. Treatment with thyroid hormones will generally reverse the symptoms.

Can you get rid of Hashimoto disease?

Although there’s no known way to completely get rid of Hashimoto’s disease, it can be successfully treated. Patients take replacement thyroid hormones to get their thyroid hormone levels into the normal range. It’s important to monitor the treatment to ensure that you’re getting the right dose. If you don’t get enough replacement thyroid hormone, then you’ll still have symptoms. If you get too much, then you may develop hyperthyroidism, which causes different symptoms.

How to prevent Hashimoto’s disease

There is no scientifically proven way to prevent Hashimoto’s disease. If you have a genetic predisposition, then you may develop this disease. If there are others in your family who have Hashimoto’s disease or another autoimmune disease, then you should be watchful for signs of hypothyroidism so that you can be tested if you develop any of the possible signs of Hashimoto’s.

FAQs

Is there a link between Hashimoto and coronavirus?

Studies have indicated that being infected with COVID-19 can raise the risk of developing an autoimmune condition, such as Hashimoto’s disease. In addition, people who have hypothyroidism are at an increased risk for developing complications from COVID-19 if they become infected.

Is there a link between Hashimoto’s and osteoporosis?

In people with hyperthyroidism, or high thyroid hormone levels, bone mineral density may be decreased, and osteoporosis becomes more likely. For people with Hashimoto’s disease or another cause of hypothyroidism, overtreatment (giving too high of a dose of replacement thyroid hormones) may lead to the same problem, increasing the risk of osteoporosis. This is why it’s very important for a doctor to monitor your treatment and ensure that you’re getting the right dose.

Is there a link between Hashimoto’s and insomnia?

Hyperthyroidism is typically associated with difficulty sleeping. People with Hashimoto’s who receive too much thyroid hormone may develop insomnia, just as they may develop osteoporosis. There have been some studies that show that hypothyroidism is also associated with sleep problems, although this has not been found in every study, so it’s hard to be sure.

What are the Hashimoto symptoms with normal TSH?

Patients with Hashimoto’s disease who have normal TSH generally have the same symptoms as those with high TSH. The changes in the TSH level are an indication of the disease, but this isn’t what causes the symptoms. Instead, the low levels of T4 and T3 are the cause of the symptoms of hypothyroidism.

Is there a link between Hashimoto disease and weight change?

There’s a strong link between Hashimoto’s and weight gain. Just as with other types of hypothyroidism, Hashimoto’s reduces the body’s energy usage, so there’s extra energy that the body then needs to store. Because many people with hypothyroidism are in older age groups, it’s common for people to attribute weight gain and other symptoms to aging, rather than recognizing that they have a thyroid issue.

Because the symptoms of hypothyroidism are so similar to other types of conditions (including aging), the only way to be sure whether you have this condition is to get a blood test. Thyroid tests can be conducted in a laboratory, or a home testing kit can be used. If you use a home testing kit, then you’ll be connected with a medical professional to discuss treatment options via telemedicine if your levels are abnormal. 

Sources

Damara FA, Muchamad GH, et al. Thyroid disease and hypothyroidism are associated with poor COVID-19 outcomes: A systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2021 November-December;15(6):102312. doi: 10.1016/j.dsx.2021.102312

Delitala AP, Scutala A, et al. Thyroid Hormone Diseases and Osteoporosis. J Clin Med. 2020 Apr; 9(4):1034. doi: 10.3390/jcm9041034.

Knack RF, Hanada T, et al. Hashimoto’s thyroiditis following SARS-CoV-2 infection. BMJ Case Rep 2021 Aug 9;14(8):e244909. doi: 10.1136/bcr-2021-244909.

Ling C, Sun Q, et al. Does TSH Reliably Detect Hypothyroid Patients? Ann Thyroid Res. 2018;4(1):122–125.

Song L, Lei J, et al. The Association Between Subclinical Hypothyroidism and Sleep Quality: A Population-Based Study. Risk Manag Healthc Policy. 2019;12:369–374. doi: 10.2147/RMHP.S234552