Symptoms of Hashimoto's Disease

Table of ContentsView AllTable of ContentsSymptomsComplicationsWhen to See a ProviderNext in Hashimoto’s Disease GuideCauses and Risk Factors of Hashimoto’s Disease

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Table of Contents

Symptoms

Complications

When to See a Provider

Next in Hashimoto’s Disease Guide

Hashimoto’s symptoms aren’t obvious in the early stages of the disease. People may live for years withHashimoto’s disease(Hashimoto’s thyroiditis) before symptoms emerge that lead to a diagnosis.

These common symptoms include fatigue, sensitivity to cold, hair loss, and constipation. The symptoms are consistent withhypothyroidism, or low thyroid function. But even when Hashimoto’s is already at work, symptoms go unnoticed until inflammation of the thyroid gland—known as chroniclymphocytic thyroiditis—advances.

This article explains what Hashimoto’s feels like and its common symptoms and complications. It also discusses when the symptoms mean you should see a healthcare provider.

Verywell / Emily Roberts

Hashimoto’s vs. Hypothyroidism: Understanding the Difference

Hashimoto’s Symptoms

Hashimoto’s symptoms in the early stages may include fatigue and weight gain. This is because Hashimoto’s disease affects thethyroid gland’s ability to produce hormones that the body needs to maintain normal metabolism. It limits the ability to convert oxygen and calories into energy.

Hashimoto’s disease typically worsens slowly over many years and causes progressive damage to the thyroid gland, leading to a decline in the production of key thyroid hormones.

Hashimoto’s Symptoms vs. HypothyroidismSome people use the terms Hashimoto’s disease and hypothyroidism synonymously, but there is a difference between hypothyroidism and Hashimoto’s. Hashimoto’s is more aptly characterized as the most common of the disorders that can produce hypothyroidism.

Hashimoto’s Symptoms vs. Hypothyroidism

Some people use the terms Hashimoto’s disease and hypothyroidism synonymously, but there is a difference between hypothyroidism and Hashimoto’s. Hashimoto’s is more aptly characterized as the most common of the disorders that can produce hypothyroidism.

Hashimoto’s eventually may cause the typical symptoms of hypothyroidism. The most common include:

Who’s at Risk for Hashimoto’s Disease?Hashimoto’s disease affects both biological males and females with many of the same symptoms. However, it affects females seven to 10 times more often than males.Most cases emerge in people between 40 and 60 years old.It’s also more common in people with other autoimmune disorders, includingtype 1 diabetes.

Who’s at Risk for Hashimoto’s Disease?

Hashimoto’s disease affects both biological males and females with many of the same symptoms. However, it affects females seven to 10 times more often than males.Most cases emerge in people between 40 and 60 years old.It’s also more common in people with other autoimmune disorders, includingtype 1 diabetes.

An Overview of Endocrine Issues and Autoimmune Diseases

Hashimoto’s Complications

Hashimoto’s symptoms don’t always appear immediately but as the disease progresses, it can cause permanent damage to the thyroid gland. In an effort to produce more thyroid hormone, the gland itself will start to enlarge, leading to the development of a goiter.

There are different types of goiter:

Goiter TreatmentWhile smaller goiters may not requiretreatment, radioactive iodine (RAI) may be needed to reduce the size of larger ones. Retrosternal goiters occasionally require surgical removal if they interfere with breathing or swallowing.

Goiter Treatment

While smaller goiters may not requiretreatment, radioactive iodine (RAI) may be needed to reduce the size of larger ones. Retrosternal goiters occasionally require surgical removal if they interfere with breathing or swallowing.

The progressive metabolic disruptions and hormonal imbalances can begin to affect multiple organ systems, leading to a cascade of complications that extend well beyond the thyroid gland itself.

What Is a Goiter?

Infertility

If thyroid hormone levels are too low, they can affect the hormonal mechanisms that regulate the menstrual cycle and trigger ovulation. This can lead to infertility in some cases.

Heart Disorders

Even mild hypothyroidism can have a profound effect on heart health.The dysregulation of thyroid hormones can instigate increases in “bad"LDL (low-density lipoprotein) cholesterol, leading to the hardening of arteries (atherosclerosis) and increasing the risk of heart attacks and stroke.

Pericardial effusion, the buildup of fluid around the heart, can affect up to 37% percent of people who have hypothyroidism.

While most cases are mild, severe hypothyroidism can lead topericardial tamponade, a condition in which the heart is less able to pump blood. In some cases, it can lead to a potentially fatal drop in blood pressure.

Pregnancy Complications

Because a pregnant person’s thyroid hormones are vital to fetal development, untreated hypothyroidism during pregnancy can lead to potentially serious complications for both the parent and child.

According to research, untreated hypothyroidism significantly increases the risk of:

With these complications is a greatly increased risk of premature birth, between two and four times that of typical pregnancies.

Hashimoto’s in PregnancyEven with subclinical hypothyroidism (in which there are no observable symptoms), pregnant people are at greater risk ofpreeclampsia,gestational diabetes, post-delivery hemorrhage, andpostpartum depressionthan those without thyroid disease.

Hashimoto’s in Pregnancy

Even with subclinical hypothyroidism (in which there are no observable symptoms), pregnant people are at greater risk ofpreeclampsia,gestational diabetes, post-delivery hemorrhage, andpostpartum depressionthan those without thyroid disease.

What to Know About Hashimoto’s Disease and Pregnancy

Hashimoto’s Encephalopathy

Hashimoto’s encephalopathyis a rare complication in which the swelling of the brain can cause profound and debilitating neurological symptoms. The condition only affects around two of every 100,000 people each year, usually, those who are between the ages of 41 and 48.Females are affected four times more often than males.

Hashimoto’s encephalopathy typically manifests in one of two ways:

Hashimoto’s encephalopathy is usually treated with intravenous corticosteroid drugs likeprednisoneto quickly bring down the inflammation and swelling of the brain.

Myxedema

Other symptoms of myxedema include:

Myxedema is considered a medical emergency requiring immediate medical assistance.

Symptoms of a Hashimoto’s Flare-Up

When to See a Healthcare Provider

As a largely “invisible” disease in the early stages, Hashimoto’s is often first discovered during a routine exam when thyroid hormone levels are found to be abnormally low.

As Hashimoto’s disease tends to run in families, it’s a good idea to get tested if someone in your family has the disease.

Talk to your healthcare provider if you begin to experience the classic signs of hypothyroidism, including persistent tiredness, facial puffiness, dry skin, hair loss, abnormal periods, and unexplained weight gain. Early diagnosis and treatment will improve your outcome.

Summary

Symptoms of Hashimoto’s disease include fatigue, hair loss, constipation, and sensitivity to cold temperatures. People with Hashimoto’s may also gain weight.

Untreated Hashimoto’s can cause permanent damage to the thyroid gland. This can cause a goiter to develop. Other complications can include infertility, heart disorders, and pregnancy complications. In rare cases, swelling of the brain or coma can occur.

Causes and Risk Factors of Hashimoto’s Disease

9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Hashimoto’s disease.Klubo-Gwiezdzinska J, Wartofsky L.Hashimoto thyroiditis: An evidence-based guide to etiology, diagnosis and treatment.Pol Arch Intern Med. 2022;132(3):16222. doi:10.20452/pamw.16222Johns Hopkins Medicine.Hashimoto’s thyroiditis.American Thyroid Association.Hashimoto’s thyroiditis (lymphocytic thyroiditis)Quintino-moro A, Zantut-wittmann DE, Tambascia M, Machado Hda C, Fernandes A.High prevalence of infertility among women with Graves' disease and Hashimoto’s thyroiditis.Int J Endocrinol. 2014;2014:982705. doi:10.1155/2014/982705Harvard Medical School.Thyroid hormone: How it affects your heartChahine J, Ala CK, Gentry JL, Pantalone KM, Klein AL.Pericardial diseases in patients with hypothyroidism.Heart. 2019;105(13):1027-1033. doi:10.1136/heartjnl-2018-314528Chaudhuri J, Mukherjee A, Chakravarty A.Hashimoto’s encephalopathy: case series and literature review.Curr Neurol Neurosci Rep. 2023;23(4):167-175. doi:10.1007/s11910-023-01255-5Wiersinga WM.Myxedema and coma (severe hypothyroidism).Additional ReadingMaraka S, McCoy R, Sangaralingham L, et al.Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment.BMJ.2017;356:i6865. doi:10.1136/bmj.i6865U.S. National Library of Medicine.Hashimoto thyroiditis.

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.Hashimoto’s disease.Klubo-Gwiezdzinska J, Wartofsky L.Hashimoto thyroiditis: An evidence-based guide to etiology, diagnosis and treatment.Pol Arch Intern Med. 2022;132(3):16222. doi:10.20452/pamw.16222Johns Hopkins Medicine.Hashimoto’s thyroiditis.American Thyroid Association.Hashimoto’s thyroiditis (lymphocytic thyroiditis)Quintino-moro A, Zantut-wittmann DE, Tambascia M, Machado Hda C, Fernandes A.High prevalence of infertility among women with Graves' disease and Hashimoto’s thyroiditis.Int J Endocrinol. 2014;2014:982705. doi:10.1155/2014/982705Harvard Medical School.Thyroid hormone: How it affects your heartChahine J, Ala CK, Gentry JL, Pantalone KM, Klein AL.Pericardial diseases in patients with hypothyroidism.Heart. 2019;105(13):1027-1033. doi:10.1136/heartjnl-2018-314528Chaudhuri J, Mukherjee A, Chakravarty A.Hashimoto’s encephalopathy: case series and literature review.Curr Neurol Neurosci Rep. 2023;23(4):167-175. doi:10.1007/s11910-023-01255-5Wiersinga WM.Myxedema and coma (severe hypothyroidism).Additional ReadingMaraka S, McCoy R, Sangaralingham L, et al.Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment.BMJ.2017;356:i6865. doi:10.1136/bmj.i6865U.S. National Library of Medicine.Hashimoto thyroiditis.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institute of Diabetes and Digestive and Kidney Diseases.Hashimoto’s disease.Klubo-Gwiezdzinska J, Wartofsky L.Hashimoto thyroiditis: An evidence-based guide to etiology, diagnosis and treatment.Pol Arch Intern Med. 2022;132(3):16222. doi:10.20452/pamw.16222Johns Hopkins Medicine.Hashimoto’s thyroiditis.American Thyroid Association.Hashimoto’s thyroiditis (lymphocytic thyroiditis)Quintino-moro A, Zantut-wittmann DE, Tambascia M, Machado Hda C, Fernandes A.High prevalence of infertility among women with Graves' disease and Hashimoto’s thyroiditis.Int J Endocrinol. 2014;2014:982705. doi:10.1155/2014/982705Harvard Medical School.Thyroid hormone: How it affects your heartChahine J, Ala CK, Gentry JL, Pantalone KM, Klein AL.Pericardial diseases in patients with hypothyroidism.Heart. 2019;105(13):1027-1033. doi:10.1136/heartjnl-2018-314528Chaudhuri J, Mukherjee A, Chakravarty A.Hashimoto’s encephalopathy: case series and literature review.Curr Neurol Neurosci Rep. 2023;23(4):167-175. doi:10.1007/s11910-023-01255-5Wiersinga WM.Myxedema and coma (severe hypothyroidism).

National Institute of Diabetes and Digestive and Kidney Diseases.Hashimoto’s disease.

Klubo-Gwiezdzinska J, Wartofsky L.Hashimoto thyroiditis: An evidence-based guide to etiology, diagnosis and treatment.Pol Arch Intern Med. 2022;132(3):16222. doi:10.20452/pamw.16222

Johns Hopkins Medicine.Hashimoto’s thyroiditis.

American Thyroid Association.Hashimoto’s thyroiditis (lymphocytic thyroiditis)

Quintino-moro A, Zantut-wittmann DE, Tambascia M, Machado Hda C, Fernandes A.High prevalence of infertility among women with Graves' disease and Hashimoto’s thyroiditis.Int J Endocrinol. 2014;2014:982705. doi:10.1155/2014/982705

Harvard Medical School.Thyroid hormone: How it affects your heart

Chahine J, Ala CK, Gentry JL, Pantalone KM, Klein AL.Pericardial diseases in patients with hypothyroidism.Heart. 2019;105(13):1027-1033. doi:10.1136/heartjnl-2018-314528

Chaudhuri J, Mukherjee A, Chakravarty A.Hashimoto’s encephalopathy: case series and literature review.Curr Neurol Neurosci Rep. 2023;23(4):167-175. doi:10.1007/s11910-023-01255-5

Wiersinga WM.Myxedema and coma (severe hypothyroidism).

Maraka S, McCoy R, Sangaralingham L, et al.Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment.BMJ.2017;356:i6865. doi:10.1136/bmj.i6865U.S. National Library of Medicine.Hashimoto thyroiditis.

Maraka S, McCoy R, Sangaralingham L, et al.Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment.BMJ.2017;356:i6865. doi:10.1136/bmj.i6865

U.S. National Library of Medicine.Hashimoto thyroiditis.

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