Launching September 2027

Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis At A Glance

  • Hashimoto’s thyroiditis is an autoimmune disorder in which the immune system mistakenly attacks the thyroid gland.
  • Over time, inflammation can damage the thyroid and reduce thyroid hormone production, often leading to hypothyroidism.
  • Symptoms usually develop gradually and may include fatigue, weight gain, cold intolerance, dry skin, constipation, depression, slow heart rate, hair thinning, and an enlarged thyroid.
  • Diagnosis commonly uses thyroid function blood tests along with thyroid antibody testing, especially TSH, free T4, and TPO antibodies.
  • When hypothyroidism develops, treatment usually involves thyroid hormone replacement, most commonly levothyroxine.
  • Hashimoto’s is usually lifelong, but with appropriate treatment and regular monitoring, most people achieve good symptom control and normal thyroid hormone levels.

Table of Contents

Table of Contents

What Is Hashimoto’s Thyroiditis?

Hashimoto’s thyroiditis, also called Hashimoto’s disease or chronic autoimmune thyroiditis, is an autoimmune disorder in which the body’s immune system mistakenly attacks the thyroid gland. Over time, this ongoing inflammation damages the thyroid and reduces its ability to produce thyroid hormone, often leading to hypothyroidism (underactive thyroid).

Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the United States. The condition usually develops gradually over many years, and many people do not notice symptoms until thyroid hormone levels become low. Although there is no cure for Hashimoto’s disease, it can usually be managed successfully with thyroid hormone replacement medication.

Learn More

Hashimoto’s Disease – NIH MedlinePlus
https://medlineplus.gov/hashimotosdisease.html

Provides easy-to-understand information about Hashimoto’s disease, including symptoms, diagnosis, treatment, and long-term management.

Hashimoto’s Thyroiditis – American Thyroid Association
https://www.thyroid.org/hashimotos-thyroiditis/

Explains what Hashimoto’s disease is, common symptoms, causes, diagnosis, and treatment.

How Common Is Hashimoto’s Thyroiditis?

Hashimoto’s thyroiditis is one of the most common autoimmune diseases and the leading cause of hypothyroidism in areas where iodine intake is adequate, including the United States. It is much more common in women than men and most often develops during middle adulthood, although it can occur at any age.

Learn More

American Thyroid Association – Hashimoto’s Thyroiditis
https://www.thyroid.org/hashimotos-thyroiditis/

Provides information about who is most likely to develop Hashimoto’s disease and common risk factors.

What Symptoms Might You Notice?

Many people have few or no symptoms early in the disease. As thyroid hormone levels decrease, symptoms of hypothyroidism gradually develop.

Common symptoms may include:

  • Fatigue
  • Weight gain
  • Feeling cold more easily
  • Dry skin
  • Constipation
  • Depression
  • Slow heart rate
  • Hair thinning or hair loss
  • Puffy face
  • Hoarse voice
  • Muscle aches or weakness
  • Joint pain
  • Memory problems or difficulty concentrating
  • Heavy or irregular menstrual periods
  • Enlarged thyroid gland (goiter)

How Is Hashimoto’s Thyroiditis Diagnosed?

Your healthcare provider will review your symptoms, perform a physical examination, and order blood tests to evaluate thyroid function and look for antibodies that indicate autoimmune thyroid disease.

A diagnosis is commonly made using thyroid hormone testing along with thyroid antibody testing.

Learn More

Hashimoto’s Disease – NIH MedlinePlus
https://medlineplus.gov/hashimotosdisease.html

Explains how Hashimoto’s disease is diagnosed and monitored.

Hashimoto’s Thyroiditis infographic – click to enlarge

What Causes Hashimoto’s Thyroiditis?

Hashimoto’s thyroiditis occurs when the immune system mistakenly attacks healthy thyroid tissue, causing chronic inflammation and gradual destruction of the thyroid gland.

Common risk factors include:

  • Family history of thyroid disease
  • Other autoimmune diseases
  • Female sex
  • Increasing age
  • Certain genetic factors
  • Previous radiation exposure involving the neck

Learn More

Hashimoto’s Disease – NIH MedlinePlus
https://medlineplus.gov/hashimotosdisease.html

Learn about the causes and risk factors associated with Hashimoto’s thyroiditis.

What Can Make Hashimoto’s Thyroiditis Worse?

Several factors may worsen symptoms or interfere with thyroid hormone treatment.

Common factors include:

  • Missing thyroid medication doses
  • Taking thyroid medication incorrectly
  • Calcium or iron supplements taken too close to thyroid medication
  • Certain medications that interfere with thyroid hormone absorption
  • Untreated autoimmune diseases
  • Pregnancy, which may increase thyroid hormone requirements

Learn More

American Thyroid Association
https://www.thyroid.org/

Provides practical guidance on taking thyroid medications correctly and managing Hashimoto’s disease.

Prevention

Hashimoto’s thyroiditis cannot currently be prevented because it is an autoimmune disease. However, early diagnosis, regular monitoring, and appropriate treatment can help prevent complications related to hypothyroidism.

Helpful prevention tips include:

  • Take thyroid medication exactly as prescribed.
  • Attend regular healthcare appointments.
  • Have routine thyroid blood tests as recommended.
  • Inform your healthcare provider about new or worsening symptoms.
  • Follow recommendations for monitoring thyroid nodules if present.
  • Eat a balanced diet with adequate iodine intake.
  • Discuss new medications or supplements with your healthcare provider before starting them.

Learn More

American Thyroid Association
https://www.thyroid.org/

Provides practical information about thyroid health, medication management, and long-term care.

Learn More About Hashimoto’s Thyroiditis

The following video content is provided to help you better understand this condition. These resources are intended for educational purposes and should not replace personalized medical advice from your healthcare provider.

Labs

Laboratory testing is essential for diagnosing and monitoring Hashimoto’s thyroiditis.

Common laboratory tests may include:

  • Thyroid-Stimulating Hormone (TSH): The primary screening test for hypothyroidism.
  • Free T4 (Free Thyroxine): Measures active thyroid hormone levels.
  • Thyroid Peroxidase (TPO) Antibodies: The most common antibody found in Hashimoto’s disease.
  • Thyroglobulin Antibodies (TgAb): May also be elevated in autoimmune thyroid disease.
  • Complete Blood Count (CBC): May evaluate for anemia contributing to fatigue.
  • Lipid Panel: Cholesterol levels may be elevated in untreated hypothyroidism.

Learn More

TSH Test – NIH MedlinePlus
https://medlineplus.gov/lab-tests/tsh-thyroid-stimulating-hormone-test/

Explains how TSH testing is used to diagnose and monitor Hashimoto’s thyroiditis.

Diagnostics

Most people with Hashimoto’s disease do not require extensive imaging. However, additional testing may be recommended if thyroid enlargement or nodules are present.

Common diagnostic tests include:

  • Thyroid Ultrasound: Evaluates the thyroid gland for enlargement, inflammation, or nodules.
  • Fine-Needle Aspiration (FNA) Biopsy: May be recommended if a thyroid nodule appears suspicious.
  • Physical Examination: Helps evaluate for thyroid enlargement (goiter).

Learn More

American Thyroid Association – Thyroid Function Tests
https://www.thyroid.org/thyroid-function-tests/

Provides information about thyroid blood tests, ultrasound, and thyroid nodule evaluation.

Treatment & Management

Treatment Options

Treatment focuses on replacing thyroid hormone when the thyroid is no longer able to produce enough on its own.

Treatment options may include:

  • Thyroid hormone replacement therapy
  • Regular laboratory monitoring
  • Medication dose adjustments based on blood test results
  • Monitoring thyroid nodules if present
  • Surgery in rare situations involving large goiters or suspicious nodules

Learn More

Hashimoto’s Thyroiditis – American Thyroid Association
https://www.thyroid.org/hashimotos-thyroiditis/

Provides information about treatment options and long-term management of Hashimoto’s disease.

Lifestyle Changes

Healthy lifestyle habits can support thyroid health and improve your overall well-being.

Helpful lifestyle changes include:

  • Take thyroid medication exactly as prescribed.
  • Take levothyroxine on an empty stomach if instructed.
  • Wait the recommended amount of time before eating after taking your medication.
  • Eat a balanced diet.
  • Stay physically active.
  • Maintain a healthy weight.
  • Get enough sleep.
  • Keep regular healthcare appointments.
  • Report new or worsening symptoms to your healthcare provider.

Learn More

American Thyroid Association
https://www.thyroid.org/

Provides practical guidance for living well with Hashimoto’s thyroiditis.

Medications

Most people with Hashimoto’s thyroiditis who develop hypothyroidism are treated with thyroid hormone replacement.

Common medications include:

  • Levothyroxine: The standard treatment for hypothyroidism caused by Hashimoto’s disease.
  • Liothyronine (T3): May be prescribed in selected situations, although it is not routinely used.
  • Combination T4/T3 Therapy: Occasionally recommended for selected patients under the guidance of an endocrinologist.

Learn More

Levothyroxine – NIH MedlinePlus
https://medlineplus.gov/druginfo/meds/a682461.html

Provides information about levothyroxine, proper use, side effects, and monitoring.

Procedures

Most people with Hashimoto’s thyroiditis do not require surgery or invasive procedures. Treatment usually involves monitoring thyroid function with regular blood tests and taking thyroid hormone replacement medication if hypothyroidism develops. However, certain procedures may be recommended if thyroid nodules, an enlarged thyroid (goiter), or thyroid cancer is suspected.

Common procedures may include:

  • Thyroid Ultrasound: Uses sound waves to evaluate the thyroid gland for enlargement, inflammation, or thyroid nodules.
  • Fine-Needle Aspiration (FNA) Biopsy: A small needle is used to collect cells from a thyroid nodule to determine whether it is benign or cancerous.
  • Thyroidectomy: Surgical removal of part or all of the thyroid gland. This is uncommon for Hashimoto’s disease but may be recommended for a large goiter causing difficulty swallowing or breathing, suspicious thyroid nodules, or thyroid cancer.
  • Regular Thyroid Function Testing: Routine blood tests help monitor thyroid hormone levels and determine whether medication adjustments are needed.

Learn More

American Thyroid Association
https://www.thyroid.org/

Learn about thyroid ultrasounds, biopsies, surgery, and long-term monitoring for Hashimoto’s thyroiditis.

What Should You Expect Long-Term?

Hashimoto’s thyroiditis is usually a lifelong condition. Most people gradually develop hypothyroidism over time and require lifelong thyroid hormone replacement therapy. With proper treatment and regular monitoring, most people experience excellent symptom control and live healthy, active lives.

Your healthcare provider will monitor your thyroid hormone levels regularly and adjust your medication if needed.

What Can You Do At Home?

Daily self-care is an important part of managing Hashimoto’s thyroiditis.

Helpful tips include:

  • Take your thyroid medication exactly as prescribed.
  • Take levothyroxine on an empty stomach with water unless instructed otherwise.
  • Wait at least 30–60 minutes before eating after taking your medication.
  • Avoid taking calcium or iron supplements within 4 hours of your thyroid medication unless directed otherwise.
  • Eat a balanced diet.
  • Stay physically active.
  • Maintain a healthy weight.
  • Get enough sleep.
  • Keep regular healthcare appointments.
  • Report new or worsening symptoms to your healthcare provider.

Learn More

American Thyroid Association – Hashimoto’s Thyroiditis
https://www.thyroid.org/hashimotos-thyroiditis/

Provides practical guidance for managing Hashimoto’s disease and taking thyroid medication correctly.

Frequently Asked Questions

Is Hashimoto’s disease the same as hypothyroidism?

No. Hashimoto’s thyroiditis is an autoimmune disease that damages the thyroid gland. Over time, it commonly leads to hypothyroidism, but they are not the same condition.

Will I need thyroid medication forever?

Many people with Hashimoto’s disease eventually require lifelong thyroid hormone replacement because the thyroid gradually loses its ability to produce enough hormone.

Can Hashimoto’s disease cause weight gain?

Yes. Weight gain may occur as thyroid hormone levels decrease and metabolism slows. Treating hypothyroidism often improves metabolism, although healthy eating and regular exercise remain important.

Can Hashimoto’s disease cause fatigue?

Yes. Fatigue is one of the most common symptoms, particularly when hypothyroidism develops.

Should I avoid certain foods?

Most people do not need a special diet. Eating a balanced diet and discussing supplements or major dietary changes with your healthcare provider is recommended.

Questions To Ask Your Provider

Consider asking your healthcare provider:

  • What is causing my Hashimoto’s thyroiditis?
  • Have I developed hypothyroidism?
  • Will I need thyroid medication for life?
  • How often should my thyroid levels be checked?
  • Do I have thyroid nodules that need monitoring?
  • Should I see an endocrinologist?
  • When should I schedule my next follow-up appointment?

Specialist Referrals

Many people with Hashimoto’s thyroiditis receive care from their primary care provider. Depending on your condition, your provider may recommend seeing a specialist.

You may be referred to:

  • Endocrinologist: Specializes in thyroid disorders, autoimmune diseases affecting the thyroid, and hormone-related conditions.
  • Endocrine Surgeon: Evaluates thyroid nodules, large goiters, or thyroid cancer that may require surgery.
  • Registered Dietitian: Provides nutrition guidance to support a healthy weight and overall wellness.
  • Otolaryngologist (ENT Surgeon): May perform thyroid surgery when indicated.

Learn More

American Thyroid Association
https://www.thyroid.org/

Provides patient education about thyroid disorders, specialty care, and treatment options.

Is Hashimoto’s Thyroiditis Curable?

There is currently no cure for Hashimoto’s thyroiditis because it is an autoimmune disease. However, it is highly treatable. Most people who develop hypothyroidism can successfully manage their condition with daily thyroid hormone replacement medication.

With appropriate treatment and routine follow-up, most people maintain normal thyroid hormone levels and enjoy an excellent quality of life.

Emergency Symptoms / When To Seek Immediate Help

Call 911 or seek emergency medical care immediately if you experience:

  • Severe difficulty breathing
  • Chest pain
  • Loss of consciousness
  • Severe confusion
  • Very low body temperature
  • Extreme drowsiness or inability to wake up
  • Slow heart rate with severe weakness

These symptoms may be signs of myxedema coma, a rare but life-threatening complication of severe untreated hypothyroidism.

Seek prompt medical evaluation if you notice:

  • A rapidly enlarging neck mass
  • Difficulty swallowing
  • Persistent hoarseness
  • Significant neck swelling
  • New or worsening symptoms despite treatment

Learn More

Hashimoto’s Disease – NIH MedlinePlus
https://medlineplus.gov/hashimotosdisease.html

Learn about Hashimoto’s disease, possible complications, and when emergency medical care is needed.

CALL 911

APNS does not provide emergency medical services. If you believe you are experiencing a medical emergency, including (but not limited to) chest pain, difficulty breathing, stroke symptoms, severe allergic reactions, anaphylaxis, uncontrolled bleeding, seizures, loss of consciousness, or any other potentially life-threatening condition, you are instructed to call 911 immediately or go immediately to the nearest emergency department.

Official Resources / External Links

Hashimoto’s Disease – NIH MedlinePlus
https://medlineplus.gov/hashimotosdisease.html

Easy-to-understand information about Hashimoto’s disease, including symptoms, diagnosis, treatment, and long-term management.

American Thyroid Association – Hashimoto’s Thyroiditis
https://www.thyroid.org/hashimotos-thyroiditis/

Comprehensive patient education about Hashimoto’s disease, hypothyroidism, thyroid hormone replacement, and follow-up care.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
https://www.niddk.nih.gov/health-information/endocrine-diseases

Reliable information about thyroid disease and other endocrine disorders.

Hormone Health Network
https://www.hormone.org/

Evidence-based patient education about thyroid disorders, autoimmune thyroid disease, and endocrine health.

This guide is intended for educational purposes only and should not replace medical advice, diagnosis, or treatment from your healthcare provider. Always follow the recommendations of your healthcare team regarding your individual health needs. Contact your healthcare provider if your symptoms worsen, new symptoms develop, or your medication is no longer controlling your thyroid condition. Call 911 immediately if you experience severe difficulty breathing, chest pain, loss of consciousness, severe confusion, or symptoms of myxedema coma or another medical emergency.

Get personalized care for Hashimoto’s Thyroiditis

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