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Living with Autoimmune Conditions: Hashimoto’s Disease

Molly Downey, RDN, LDN

Published in Health & Wellness

8 min read

December 9, 2021
a person touching their neck
a person touching their neck

Living with an autoimmune disease isn’t easy, but according to the National Institutes of Health, a significant amount of Americans live with one—up to 23.5 million, in fact. The same report also found that they disproportionately affect women and that (for unknown reasons) their prevalence is rising. So, before we dive in to tell you more about this specific one, let’s spend a little time on what autoimmune diseases are.

Simply put, these diseases occur when your immune system begins to attack the organs, tissues, and cells in your body. It can be because of genetics or other underlying causes. And while some of these, like Kawasaki disease, are pretty rare, others are more common. Type 1 diabetes, Graves’ disease, Rheumatoid arthritis, and Celiac disease are some you may recognize. 

Because autoimmune diseases affect everything from blood glucose levels and thyroid glands to insulin levels and obesity, it’s worth spending some time understanding the specifics of a few common autoimmune conditions. We’re going to start with one that affects thyroid function, called Hashimoto’s disease. 

What is Hashimoto’s Disease?

a person's neck being examined

Hashimoto’s thyroiditis, or Hashimoto’s disease, is an autoimmune condition that affects your thyroid health. Just in case you don’t already know: your thyroid is a gland that’s part of your endocrine system. The endocrine system is made up of glands that control hormone function. 

Hashimoto’s disease is one of the most commonly diagnosed forms of hypothyroidism. When you have hypothyroidism, the secretion and production of thyroid hormones in your body begin to decrease. Your thyroid eventually begins to under-produce and release these thyroid hormones into your bloodstream. Essentially, if you have a form of hypothyroidism, you have an underactive thyroid. 

Hashimoto’s leads to white blood cells and antibodies attacking your thyroid and healthy tissues instead of defending them like it is supposed to. This causes inflammation in the thyroid. If left untreated, Hashimoto’s may damage your thyroid health enough for you to develop a more permanent form of hypothyroidism. Your thyroid then begins to cease producing enough thyroid hormones for your body to function, and you will need medication to make up for that lack.

Although endocrinology and functional medicine researchers are still studying the autoimmune condition, there’s currently no cure. So healthcare providers will usually focus on disease management here as they do for most thyroid disorders. In some (rare) cases, Hashimoto’s disease can also lead to hyperthyroidism, or an overactive thyroid. 

12 Common Symptoms of Hashimoto’s Disease

a person looking tired

Hashimoto’s and hypothyroidism can cause many, many symptoms. Every case is different, which is why hypothyroidism is often misdiagnosed. One of the overarching issues of thyroid dysfunction is that it affects adrenal glands, causing everything from fatigue to brain fog and cravings. It can also increase cortisol levels in your blood. Here are some of the most common symptoms found in those suffering from Hashimoto’s disease:

  1. Inflammation or Goiter: One of the most telling symptoms of Hashimoto’s is a goiter. A goiter is basically an irregular swelling of your thyroid gland. This is at the front of your throat, just below the Adam’s apple.
  2. Fatigue: People who suffer from hypothyroidism or any thyroid problems that are left untreated are highly likely to feel fatigued even when they are getting a healthy amount of sleep. This can lead to oversleeping and difficulty waking up in the mornings. 
  3. Brain Fog: Brain fog is essentially a mental “fuzziness” that makes it difficult to concentrate or commit any information to memory. When you experience brain fog, you may not be able to think clearly or make decisions easily. 
  4. Constipation: Hashimoto’s can cause digestive issues and slow down the digestion of food moving through your intestines, causing constipation. 
  5. Weight Gain: Hypothyroidism causes your metabolism to slow down, resulting in weight gain if you don’t adjust your diet and exercise to make up for the lethargy your body feels, thanks to your thyroid condition. 
  6. Joint Pain: Joint pain caused by Hashimoto’s is most often found in the wrists and ankles. 
  7. Sensitivity to Cold: Feeling cold even on a relatively warm day? Because your metabolism is slowing down, Hashimoto’s can also cause sensitivity to cold. 
  8. Thinning Hair and Brittle Nails: Hypothyroidism may cause your hair to start thinning [all over your body] and make your nails brittle. 
  9. Mental Health Problems: This autoimmune thyroid disease causes dips in your hormone levels, which can often lead to depression, anxiety, sadness, and mood swings. 
  10. Bloating: Food moving more slowly through your stomach and intestinal tract can lead to bloating and discomfort in your stomach.
  11. Weakness: When thyroid hormone production dips, it can lead to muscle weakness and other aches and pains. This may lead to difficulty completing daily tasks.

How to Detect Hashimoto’s Disease

Hashimoto’s is one of the most common causes of hypothyroidism in the U.S. But, if you detect it early enough, you can prevent the development of symptoms that accompany the condition. If you think you may have Hashimoto’s symptoms, your next step is to consult with a healthcare professional and run some blood tests.

The blood tests that need to be run examine the TSH levels and your TPOab [or thyroid peroxidase antibodies] in your bloodstream. When Hashimoto’s begins to progress, the thyroid peroxidase antibodies are the ones that attack your thyroid gland. If the antibodies are found in your blood along with high TSH levels and low thyroid hormone levels, you likely have Hashimoto’s disease.

The leading causes of developing Hashimoto’s are pre-existing autoimmune disorders, including type 1 diabetes and Celiac disease. Some genes may also be risk factors for the autoimmune condition. 

Some Facts About Hashimoto’s Disease

a person examining their neck

Are there risk factors? Are some people more likely to develop this thyroid condition than others? Here’s what you need to know:

  1. Women are seven times more likely to develop Hashimoto’s than men. 
  2. Selenium has been linked to thyroid peroxidase antibody reduction. 
  3. Radiation exposure can make you more prone to developing Hashimoto’s disease.
  4. Hashimoto’s is most commonly diagnosed in middle-aged people but is found in people of all ages. 
  5. Hashimoto’s can be passed down hereditarily. You are more likely to develop the condition if it’s in your family and should notify your doctor if that is the case. 
  6. Undiagnosed Hashimoto’s disease has been linked to birth defects. Doctors have linked developmental problems to children born to undiagnosed mothers. If you’re pregnant or planning to become pregnant, it may be wise to check your levels if you have any symptoms that suggest thyroid dysfunction. 
  7. Too much iodine consumption may lead to developing Hashimoto’s.
  8.  Thyroid disorders like Hashimoto’s can increase your risk of developing other conditions like coronary heart disease

How to Treat Hashimoto’s Disease

a doctor examining patient's neck

There is no known cure for Hashimoto’s disease, but some treatments prevent worsening symptoms and treat current symptoms. Once a healthcare professional has reviewed your symptoms and bloodwork, they may prescribe a hormone replacement pill that must be taken daily on an empty stomach. There are different strengths of these medications, and what you’re prescribed will depend on your blood levels, age, the severity of Hashimoto’s, your weight, and other health conditions that you may have.

Even after you are diagnosed with this autoimmune condition and prescribed medication, you will need regular blood work. Monitoring your symptoms and visiting your doctor regularly to discuss your treatment is also a good idea, as you may have to change the dose of your hormone replacement several times throughout your life. Remember that it will take time for your body to readjust to having the right level of hormones to work with, and you will need to be patient as your symptoms begin to subside. 

Can Blood Sugar Affect Hashimoto’s Disease?

a person applying CGM on their uper arm

Blood sugar imbalances are associated with thyroid disorders, and chronically high blood sugar levels can lead to inflammation. Abnormal inflammatory responses have been associated with many autoimmune diseases.  Low blood sugar or hypoglycemia may also occur

Your diet is an excellent way to help regulate and manage the symptoms of Hashimoto’s. While everyone’s body is different and diets to treat Hashimoto’s can vary from person to person, some of these dietary changes can help improve your condition. 

  1. Talk to your doctor about reducing or removing gluten from your diet. Hashimoto’s disease has been linked to Celiac disease, so even if you don’t have Celiac disease, a gluten-free diet may help reduce symptoms in the digestive tract for some people. It may help boost metabolism for these people as well. 
  2. Avoid dairy products. Many people diagnosed with Hashimoto’s disease have also been diagnosed with lactose intolerance. Removing or reducing your intake of dairy products may help your symptoms if you have symptoms affecting your digestive system.
  3. Anti-inflammatory diets have been found to improve Hashimoto’s symptoms. 
  4. Reduce your carbohydrate consumption. Carbohydrates are what your body breaks down into sugar, and overconsumption can often cause high blood sugar levels and blood sugar spikes. Avoiding a primarily high-carb diet may reduce inflammation for some people.
  5. Use caution when consuming foods rich in iodine. Consuming too much iodine may make hypothyroid conditions worse.
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Kara Collier, RDN, LDN, CNSC

Reviewed by: Kara Collier, RDN, LDN, CNSC

Kara Collier is the co-founder and VP of Health at Nutrisense, one of America’s fastest-growing wellness-tech startups, where she leads the health team. She is a Forbes 30 under 30 recipient, frequent podcast guest & conference speaker.

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