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Hashimoto’s disease is an autoimmune disorder that can cause hypothyroidism, or underactive thyroid. Rarely, the disease can cause hyperthyroidism, or overactive thyroid.
The thyroid is a small, butterfly-shaped gland in the front of your neck. In people with Hashimoto’s disease
Thyroid hormones control how your body uses energy, so they affect nearly every organ in your body—even the way your heart beats.
Hashimoto’s disease is also called Hashimoto’s thyroiditis, chronic lymphocytic thyroiditis, or autoimmune thyroiditis.
The number of people who have Hashimoto’s disease in the United States is unknown. However, the disease is the most common cause of hypothyroidism, which affects about 5 in 100 Americans.1
Hashimoto’s disease is 4 to 10 times more common in women than men.2 Although the disease may occur in teens or young women, it more often develops in women ages 30 to 50.3 Your chance of developing Hashimoto’s disease increases if other family members have the disease.
You are more likely to develop Hashimoto’s disease if you have other autoimmune disorders, including4
Many people with Hashimoto’s disease develop hypothyroidism. Untreated, hypothyroidism can lead to several health problems, including5
Left untreated, hypothyroidism can also cause problems during pregnancy.
Many people with Hashimoto’s disease have no symptoms at first. As the disease progresses, you may have one or more of the symptoms of hypothyroidism.
Some common symptoms of hypothyroidism include
Hashimoto’s disease causes your thyroid to become damaged. Most people with Hashimoto’s disease develop hypothyroidism. Rarely, early in the course of the disease, thyroid damage may lead to the release of too much thyroid hormone into your blood, causing symptoms of hyperthyroidism.3
Your thyroid may get larger and cause the front of the neck to look swollen. The enlarged thyroid, called a goiter, may create a feeling of fullness in your throat, though it is usually not painful. After many years, or even decades, damage to the thyroid may cause the gland to shrink and the goiter to disappear.
Researchers don’t know why some people develop Hashimoto’s disease, but a family history of thyroid disease is common. Several factors may play a role, including2
Hypothyroidism can also be caused by
Doctors diagnose Hashimoto’s disease based on
You probably won’t need other tests to confirm you have Hashimoto’s disease. However, if your doctor suspects Hashimoto’s disease but you don’t have antithyroid antibodies in your blood, you may have an ultrasound of your thyroid. The ultrasound images can show the size of your thyroid and other features of Hashimoto’s disease. The ultrasound also can rule out other causes of an enlarged thyroid, such as thyroid nodules—small lumps in the thyroid gland.
How your doctors treat Hashimoto’s disease usually depends on whether the thyroid is damaged enough to cause hypothyroidism. If you don’t have hypothyroidism, your doctor may choose to simply check your symptoms and thyroid hormone levels regularly.
The medicine levothyroxine, which is identical to the natural thyroid hormone thyroxine (T4), is the recommended way to treat hypothyroidism. Prescribed in pill form for many years, this medicine is now also available as a liquid and in a soft gel capsule.2 These newer formulas may be helpful to people with digestive problems that affect how the thyroid hormone pill is absorbed.
Some foods and supplements can affect how well your body absorbs levothyroxine. Examples include grapefruit juice, espresso coffee, soy, and multivitamins that contain iron or calcium.1,6 Taking the medicine on an empty stomach can prevent this from happening. Your doctor may ask you to take the levothyroxine in the morning, 30 to 60 minutes before you eat your first meal.
Your doctor will give you a blood test about 6 to 8 weeks after you begin taking the medicine and adjust your dose if needed. Each time you change your dose, you’ll have another blood test. Once you’ve reached a dose that’s working for you, your doctor will likely repeat the blood test in 6 months and then once a year.
Never stop taking your medicine or take a higher dose without talking with your doctor first. Taking too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation or osteoporosis.5
Your hypothyroidism can be well-controlled with thyroid hormone medicine, as long as you take the medicine as instructed by your doctor and have regular follow-up blood tests.
The thyroid uses iodine, a mineral in some foods, to make thyroid hormones. However, if you have Hashimoto’s disease or other types of autoimmune thyroid disorders, you may be sensitive to harmful side effects from iodine. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed, and certain iodine-rich medicines—may cause hypothyroidism or make it worse. Taking iodine supplements can have the same effect.
Talk with members of your health care team about
However, if you are pregnant, you need to take enough iodine because the baby gets iodine from your diet. Too much iodine can cause problems as well, such as a goiter in the baby. If you are pregnant, talk with your doctor about how much iodine you need.
Researchers are looking at other ways in which diet and supplements—such as vitamin D and selenium—may affect Hashimoto’s disease.2 However, no specific guidance is currently available.3
The NIDDK conducts and supports clinical trials in many diseases and conditions, including endocrine diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life.
Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about Hashimoto’s disease and improve health care for people in the future.
Find out if clinical studies are right for you.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
You can find clinical studies on Hashimoto’s disease at www.ClinicalTrials.gov. In addition to searching for federally funded studies, you can expand or narrow your search to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Leonard Wartofsky, M.D., M.A.C.P., MedStar Georgetown University Hospital