Hashimoto's Thyroiditis

What is Hashimoto's thyroiditis?

Hashimoto's is an autoimmune disease in which the immune system mistakenly attacks the thyroid gland. Over time this can damage the thyroid and reduce hormone production, leading to hypothyroidism.

It is the most common cause of hypothyroidism in the United States and is much more common in women.

Common symptoms

Many people with Hashimoto's have no symptoms at first. When hypothyroidism develops, symptoms include fatigue, weight gain, cold intolerance, dry skin, hair thinning, constipation, low mood and brain fog.

The thyroid may also be enlarged, sometimes causing a feeling of fullness in the neck.

Possible causes

Hashimoto's results from a combination of genetic predisposition and environmental triggers that are not fully understood. Family history, other autoimmune conditions, pregnancy and certain infections or stressors may play a role.

The exact trigger for each person is usually unknown, and the condition is managed rather than 'fixed.'

How it is evaluated

Evaluation includes a full thyroid panel with TSH, free T4, free T3 and reverse T3, plus thyroid antibodies such as TPO and thyroglobulin antibodies to confirm the autoimmune pattern.

Nutrient markers such as iron, vitamin D and selenium may be checked because they affect thyroid function.

Care options that may be considered through telehealth

When hypothyroidism is present, thyroid hormone replacement such as levothyroxine is the mainstay, with combination T4 and T3 considered when appropriate. Dosing is individualized and monitored.

Nutrient support and lifestyle planning are added when testing shows a need, and complex cases are coordinated with endocrinology.

Lifestyle factors

Consistent medication timing, adequate sleep, stress management and balanced nutrition support thyroid health. Supplements such as selenium are only used when testing shows a need, not routinely.

When to seek urgent care

Hashimoto's is not usually an emergency, and telehealth is not for emergencies. A rapidly enlarging neck with trouble swallowing or breathing, chest pain, or stroke symptoms warrant immediate care: call 911 or go to the emergency room.