Despite its small size, the thyroid gland plays a major (and unsung) role in your body. Sitting just above your collar bones, the thyroid makes hormones that control your heart rate, the speed at which you burn calories (metabolism) and other important functions. Think of the thyroid as a factory that produces thyroid hormone. Hashimoto’s thyroiditis can lead to the slowing of the hormone assembly line. With treatment, however, a medicine takes the place of a thyroid-produced hormone to make up for the slowdown, giving you a chance to thrive.
When the Immune System Targets the Thyroid
Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis, is an autoimmune disorder, which means the immune system mistakenly identifies the thyroid as a threat. Why this occurs isn’t clear, but a family history of the condition and the presence of other autoimmune diseases, such as celiac disease or vitiligo, increases the risk of Hashimoto’s thyroiditis.
Believing the thyroid is a threat, the immune system makes antibodies that attack it. These antibodies can be detected with blood tests which helps diagnose Hashimoto’s thyroiditis. In many cases, the immune system attacking the thyroid leads to hypothyroidism (underactive thyroid). This occurrence is when the thyroid doesn’t produce enough hormones, which can lead to multiple symptoms. Hashimoto’s thyroiditis is the leading cause of underactive thyroid, according to the Office on Women’s Health.
Factors That Can Raise Your Risk for Hashimoto’s Thyroiditis
Hashimoto’s disease can affect anyone, but it’s more common in women. Additionally, if a parent or another family member had this condition, you’re more likely to have it. Other risk factors include:
- Getting older
- Having another autoimmune disorder, such as Type 1 diabetes, rheumatoid arthritis or lupus
- Recent pregnancy
Signs of an Underactive Thyroid
Not everyone notices symptoms of Hashimoto’s disease early on, but signs may appear over time. Keep a close eye on the lower-front part of your neck, just above where the collar bones meet. If it appears swollen, or you feel like something in your throat is making it difficult to swallow, you could have an enlarged thyroid called a goiter which can be a sign of Hashimoto’s thyroiditis. Despite feeling strange, goiters usually aren’t painful.
In addition to an enlarged thyroid, you may experience symptoms of hypothyroidism, including:
- Constipation
- Depression
- Dry skin
- Fatigue
- Feeling abnormally cold
- Heavier menstrual periods
- Joint or muscle aches
- Slower heart rate
- Weight gain
Diagnosing Hashimoto’s Thyroiditis
If you see or feel swelling in your neck or notice symptoms of an underactive thyroid, don’t shrug them off. Ignoring or delaying treatment for Hashimoto’s thyroiditis could lead to serious complications including, in rare cases, a type of coma known as myxedema coma. Without treatment, Hashimoto’s thyroiditis can also lead to heart disease, heart failure, high blood pressure, unhealthy cholesterol levels and problems during pregnancy, including preeclampsia and miscarriage.
See your primary care provider about Hashimoto’s thyroiditis-like symptoms. They may refer you to an endocrinologist, a physician who specializes in treating disorders of the thyroid and other glands of the endocrine system.
Your medical provider will ask about your symptoms and perform a physical exam to look for signs of Hashimoto’s thyroiditis, such as a goiter. You may need to provide a blood sample, which can shed light on thyroid function. Your medical provider may order tests to check the levels of certain thyroid hormones in your blood. These include thyroid-stimulating hormone (TSH), thyroxine (T4) and triiodothyronine (T3). Another type of blood test looks for antibodies that may indicate Hashimoto’s thyroiditis. These include Thyroid peroxidase antibody (TPO) and Anti-Thyroglobulin antibody (anti-TG).
In most cases, medical providers don’t need imaging to diagnose Hashimoto’s thyroiditis. In certain situations, however, an ultrasound exam may be helpful. Ultrasound can show whether your thyroid is enlarged and whether a thyroid nodule is present.
Replacement Plan: How Medical Providers Treat Hashimoto’s Thyroiditis
Having Hashimoto’s disease doesn’t automatically mean you’ll need treatment. If your thyroid function is normal, your medical provider may simply want to see you regularly to monitor for progression of the disease or to look for an enlarged gland. If you have an underactive thyroid, especially those with symptoms, you’ll need thyroid hormone replacement, which is a prescription medicine that takes the place of the hormone thyroxine.
Each day, you’ll take medication, such as levothyroxine to replace the function of the underactive thyroid gland. You’ll work closely with your medical provider to get the dosage just right. This is important because if you take too much or too little of the medication, you’ll have symptoms of an overactive or underactive thyroid. Once you find the appropriate dosage, you can control an underactive thyroid. You’ll continue to see your medical provider regularly to ensure levothyroxine is still working and to assess if your symptoms are improving.
Give Hashimoto’s Thyroiditis Treatment a Helping Hand
If you’re taking thyroid medication such as levothyroxine, you want it to be as effective as possible. You can help by taking the medicine as prescribed. Don’t take more or less than your medical provider instructed, and don’t miss or skip doses.
Other steps you can take to support treatment involve adjusting your eating habits, including:
- Time when you take your medicine carefully. Your provider may recommend taking levothyroxine at least 30 minutes before eating breakfast to prevent certain foods and supplements, such as grapefruit juice or multivitamins with iron or calcium, from interfering with the medicine, according to the NIDDK.
- Notify your provider if you are taking medication that can affect your thyroid blood test result. These include supplements that contain biotin, high-dose iodine, and prescription medications such as amiodarone, lithium, and certain types of cancer immunotherapy.
Doing your part to increase the chances of an effective treatment can help you control Hashimoto’s thyroiditis and hypothyroidism for years to come.
Medically reviewed by Medha Satyarengga, MD.
