What Is Hashimoto’s Disease?

Hashimoto’s Disease is the most common cause of hypothyroidism in the United States.
What Is Hashimoto’s Disease?

Hashimoto's Thyroiditis is an autoimmune disorder that damages the thyroid gland. With this condition, antibodies directed against the thyroid gland lead to chronic inflammation. It is the most common cause of hypothyroidism in the United States, affecting roughly 5% of the population.

Symptoms of Hashimoto’s Disease

The early stages of Hashimoto’s disease may not cause noticeable symptoms. As the disease progresses and more of the thyroid is damaged, the drop in thyroid hormone levels may cause symptoms like:

・ Enlarged thyroid gland (goiter)

・ Increased sensitivity to cold/inability to get warm

・ Fatigue

・ Hoarse voice

・ Sluggishness

・ Dry, pale skin

・ Constipation

・ Hair loss

・ Brittle nails or hair

・ Difficulty getting pregnant

・ Puffy face

・ High cholesterol

・ Unexplained weight gain

・ Enlargement of the tongue

・ Slowed heart rate

・ Joint or muscle pain or stiffness

・ Muscle weakness or tenderness

・ Depression

・ Lapses in memory

・Prolonged or excessive menstrual bleeding

Causes of Hashimoto’s Disease

Hashimoto’s is caused by your immune system attacking your thyroid gland. Research is inconclusive about why some people make these antibodies. Studies point to nutritional deficiencies, damage to the pituitary gland, certain medications, pregnancy, large hormonal events, or most probably, family history.

Risk Factors of Hashimoto’s Disease

Without treatment, the reduced levels of thyroid hormone caused by Hashimoto’s can lead to many health complications, including:

Age. Hashimoto’s disease is more common in middle age.

Sex. Women are seven to eight times more likely than men to develop Hashimoto’s.

Radiation exposure. People who have been exposed to high levels of radiation are more prone to developing Hashimoto’s.

Heredity. If other family members have Hashimoto’s or other autoimmune disorders, the risk of developing Hashimoto’s increases.

Other autoimmune diseases. People who have other autoimmune diseases like type 1 diabetes, lupus, or rheumatoid arthritis are more likely to develop Hashimoto’s.

Complications of Hashimoto’s Disease

Without treatment, the reduced levels of thyroid hormone caused by Hashimoto’s can lead to many health complications, including:

Heart problems. People with an underactive thyroid gland, like those with Hashimoto’s disease, are more prone to high levels of low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol), which can contribute to an enlarged heart and an increased risk of heart disease, including heart failure.

Goiter. An enlargement of the thyroid gland is called a goiter, and hypothyroidism, like Hashimoto’s disease, is one of the most common causes of goiters. While goiters usually aren’t painful, they can alter your appearance or cause breathing or swallowing problems.

Myxedema (miks-uh-DEE-muh). Long-term untreated hypothyroid disease can cause drowsiness that progresses to profound lethargy, unconsciousness, and even coma, which can be triggered by sedatives, infection, cold, or other types of stress on the body. Myxedema can be life-threatening and requires emergency medical attention.

Mental health issues. Depression can start in the beginning stages of Hashimoto’s disease and may progress and become more severe with the illness. Decreased libido and cognitive functioning may also occur.

Birth defects. Children born to mothers with an untreated hypothyroid disease like Hashimoto’s are at increased risk for many birth defects such as cleft palates, intellectual and developmental disabilities, and heart, brain, or kidney problems.

If doctors take a little time to understand their patients and address their frustrations, they can take steps to relieve the unhappiness of their patients and potentially improve their quality of life.

Stages of Hashimoto’s Disease

Hashimoto’s disease has 7 stages:


Here, your thyroid is still close to fully functional, and you will likely experience few to no symptoms. It could take several years before symptoms appear, so following a healthy lifestyle helps to prevent disease progression.


At this stage, you might start to feel a few early symptoms as your immune cells start working faster to destroy your thyroid gland. If your doctor runs the standard Thyroid Stimulating Hormone (TSH) test at this stage, likely alarm bells won't sound, as there won't be much of a difference. You may want to get tested for Free Thyroxine (fT4) to see if your T4 levels are low. Maintain a healthy lifestyle here to slow disease progression.

Full blown disease

It's in this stage that you may see notable change in your blood values, and your doctor may prescribe thyroid hormone replacement supplements, or beginning regular monitoring to watch for TSH deviating from the normal range. Most commonly, pure synthetic thyroxine (T4), taken once daily by mouth, fully replaces the thyroid gland and successfully treats the symptoms of hypothyroidism in most patients. For the few patients who do not feel completely normal taking a synthetic preparation of T4 alone, the addition of synthetic T3 may be of benefit.

Medicated Hashimoto’s

To compensate for the loss of thyroid function, your doctor will likely increase your dosage at this stage. Work with your doctor to find the right treatment for you. We are all unique with individual sensitivities, so our bodies will not all react the same way to a specific medication.

We advise the slow, step-by-step method of reaching your optimal dose, which is easier on the body than the "sock it to me" approach so characteristic of our fast paced culture. The goal is to get you feeling your best while managing symptoms.

Lifestyle-managed Hashimoto’s

At this stage, nutrition matters. What you eat may affect your thyroid disease, including the absorption of your thyroid medication. Nutrition, supplements, and lifestyle optimization have been shown to make a difference in certain cases and can be personalized to you.

Talk to your Paloma practitioner for more details about how personalized dietary guidance and health coaching might benefit you.


While an autoimmune disease cannot be reversed, it can be blocked. Healthy diet and exercise routine can halt further progression of the disease, but going back tot bad habits will trigger the condition again.


Maintain, maintain, maintain. There is no cure for Hashimoto's, so proactively monitoring and adjusting your treatment plan is critical to feeling your best each day.

Getting a Diagnosis

If you are experiencing symptoms of Hashimoto’s like fatigue, dry skin, constipation, or a goiter, a blood test can help you understand how your thyroid is working and if there is need for further evaluation of your thyroid function.

You can get started with a Paloma at-home test kit. While many labs only look only at Thyroid Stimulating Hormone (TSH) to assess thyroid health, we believe it's critical to also measure Free Triiodothyronine (fT3), Free Thyroxine (fT4), and TPO antibodies. The antibody test is used to determine whether or not you are producing antibodies against thyroid peroxidase.

Click here to get started.

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Hypothyroidism is a long-term commitment and we’re committed to you. Schedule a free, no-obligation phone consultation with one of our intake specialists to find out more.

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