What Is Hashimoto’s Disease? Overview, Symptoms, and Treatment

Types of Hypothyroidism

It is estimated that hypothyroidism affects around 1–5% of people under 60. Among those over 60, the risk increases significantly, with prevalence rising to 10–15%. Statistics show that women suffer from thyroid underactivity several times more often than men (2).

Primary and Secondary Hypothyroidism

Hypothyroidism can be divided into:

• Primary – caused by direct damage to the thyroid gland,

• Secondary – resulting from dysfunctions in other areas such as the pituitary gland or hypothalamus, which are responsible for stimulating the thyroid.

The main primary causes include:

• congenital absence of the thyroid,

• Hashimoto’s disease,

• thyroidectomy (surgical removal of the gland),

• damage due to radiation,

• damage from iodine deficiency or excess, or from radioactive iodine therapy (3).

Secondary hypothyroidism occurs due to inadequate or absent secretion of thyroid-stimulating hormone (TSH) by the pituitary or thyrotropin-releasing hormone (TRH) by the hypothalamus. This impairs the thyroid’s ability to produce key hormones such as triiodothyronine (T3) and thyroxine (T4).

Symptoms of Hypothyroidism

Triiodothyronine has broad and multidirectional effects on the body. Therefore, symptoms of hypothyroidism may involve various organs and systems, including the cardiovascular, respiratory, digestive systems, and the skin.

Hypothyroidism can develop gradually over many years with nonspecific symptoms. The symptoms depend on how long the condition has lasted and the degree of hormone deficiency.

The most common symptoms include:

• dry and thickened skin – especially on the elbows and knees,

• myxedema (swelling) – particularly in the jaw, hands, and eyelids,

• bradycardia – a slow heart rate,

• shallow breathing,

• slow intestinal motility,

• muscle weakness,

• hoarseness due to vocal cord changes,

• hair loss and brittleness,

• fatigue,

• sensitivity to cold.

Early diagnosis and treatment help prevent late-stage complications of hypothyroidism. One of the most serious complications is myxedema coma, which can be fatal.

What Is Hashimoto’s Disease?

Hashimoto’s disease is a type of hypothyroidism and one of the leading causes of decreased thyroid hormone secretion.

As with other forms of hypothyroidism, Hashimoto’s incidence increases after the age of 60. However, it is also frequently diagnosed in younger individuals and even in children.

It often co-occurs with other autoimmune diseases, including:

• type 1 diabetes,

• celiac disease,

• pernicious anemia (Addison-Biermer anemia),

• rheumatoid arthritis (RA) (4).

Hashimoto’s Disease – Characteristics

Hashimoto’s disease is characterized by chronic lymphocytic infiltration in the thyroid, which leads to fibrosis (scarring) of the gland. This impairs or completely halts its hormonal activity.

The inflammation results from the immune system mistakenly recognizing thyroid cells as “foreign.” The body produces antibodies that attack and destroy the thyroid tissue.

Causes of Hashimoto’s Disease

The exact causes of Hashimoto’s disease remain unclear. Researchers have observed that the condition often runs in families and is associated with other autoimmune diseases. Therefore, genes related to immune function are thought to play a key role.

Some studies suggest that bacterial and viral infections can trigger antibody production that mistakenly targets the thyroid. Associations have been noted between Hashimoto’s and infections such as mumps, rubella, enteroviruses, and Epstein-Barr virus.

Environmental factors also contribute to the development of thyroid disorders. One of the main factors is iodine availability. Both deficiency and excess of iodine can affect thyroid function.

Insufficient iodine intake is associated with hypothyroidism, while excessive or careless iodine supplementation can damage the gland.

Moreover, the immune system is constantly responding to external threats. Poor diet, chronic stress, and lack of physical activity may dysregulate immune responses and trigger autoimmune attacks against the thyroid.

Diagnosis and Treatment of Hashimoto’s

Diagnosing Hashimoto’s disease, like other types of hypothyroidism, involves assessing hormone and antibody levels in the blood, along with thyroid ultrasound.

Due to its autoimmune nature, diagnosis often includes screening for other autoimmune conditions such as celiac disease, rheumatoid arthritis, or diabetes.

The mainstay of treatment is thyroid hormone replacement therapy to restore proper hormone levels. Dosage is tailored by a physician based on current lab results.

Diet in Hashimoto’s Disease

The role of diet in managing Hashimoto’s is receiving growing attention. Research indicates that dietary interventions may help alleviate symptoms.

Key nutrients for individuals with Hashimoto’s include:

• iodine,

• selenium,

• zinc,

• omega-3 and omega-6 fatty acids,

• antioxidants.

Patients often wonder whether they need to avoid dairy, gluten, or foods containing antinutrients (e.g., cabbage, soy). Current guidelines do not recommend routine elimination of these foods. Gluten and lactose should only be excluded if there is a confirmed intolerance. Cruciferous and legume vegetables can be eaten in moderation and preferably cooked.

Proper food choices and an appropriate energy balance can help reduce inflammation, support a healthy body weight, and improve skin and hair condition.

Additionally, a well-structured diet enhances medication absorption and may prevent disease complications.

Hashimoto’s – From Diagnosis to a Healthy Lifestyle

If you are experiencing concerning symptoms and suspect hypothyroidism, consider getting tested for Hashimoto’s. The disease is becoming increasingly common, so it is worth consulting a physician and performing the necessary diagnostics.

If you are diagnosed, don’t panic. Early identification and a holistic treatment approach can help reduce inflammation and improve quality of life.

Diet plays a significant role in managing Hashimoto’s. It can support pharmacological treatment and help relieve symptoms. If you want to ensure your nutrition plan is balanced and appropriate, explore a Hashimoto-specific diet from Peater. It’s designed especially for individuals with thyroid underactivity.