Can You Die From Hashimoto's Disease?

Hashimoto's disease, also known as chronic lymphocytic thyroiditis, is an autoimmune condition that affects the thyroid gland and can cause underactive thyroid or hypothyroidism. In rare cases, it can also lead to hyperthyroidism or overactive thyroid. 

Under Hashimoto’s disease, the immune system makes antibodies that attack the butterfly-shaped thyroid gland found at the bottom of the neck. 

With Hashimoto’s, vast amounts of white blood cells that form part of the immune system build up within the thyroid, affecting thyroid hormone production. Thyroid hormones regulate the metabolic activity, meaning they affect almost every organ in the body.  

The exact number¹ of people with Hashimoto's disease is not known. However, it is the most common cause of hypothyroidism, affecting about 5 in 100 Americans.

Hashimoto’s is four to ten times more prevalent among women than men, and it might also appear in young women or teens, increasing in prevalence with age. 

Hashimoto's disease has hereditary risks, which means you are more likely to develop the condition if a family member has genes associated with the disease. 

Additionally, an individual is more likely to have Hashimoto’s disease if they have other autoimmune disorders, such as 

• Celiac disease: which is a digestive disorder that damages the small intestine

• Lupus: a long-term, chronic disorder that can affect the whole body

• Rheumatoid arthritis: a condition that affects the joints

• Sjogren’s syndrome: usually associated with dry mouth and eyes

• Type 1 diabetes: a condition marked by high blood sugar levels

Symptoms of Hashimoto’s disease

Hashimoto’s disease usually progresses slowly for years with gradual loss of thyroid function until you notice symptoms of the disease. Most people miss the signs and symptoms during the initial stages of the disease. 

As thyroid hormone production declines, the first sign you might experience is goiter, an enlarged thyroid. Goiter is characterized by a swollen area in front of the neck, making it a challenge to swallow. 

Other symptoms of Hashimoto's disease are similar to other medical conditions, so it is critical to see a physician for a diagnosis. 

Here are some of the signs and symptoms associated with the disease:

• Metabolic: Less ability to tolerate cold, modest weight gain (due to fluid retention and decreased metabolism), hypothermia

• Neurologic: Forgetfulness, tingling, or prickling in the hands and feet

• Psychiatric: Personality changes, depression, dull facial expression, dementia or frank psychosis (myxedema madness)

• Dermatologic: Facial puffiness, myxedema (swelling of skin or tissues), sparse, coarse, and dry hair, rough, dry, scaly, and thick skin, yellowish skin hue (particularly notable on the palms and soles of feet)

• Ocular: Swollen or puffy area around the eyes, droopy eyelids

• Gynecologic: Changes in menstruation

• Cardiovascular: Slow heart rate, enlarged heart shown on examination and imaging

Diagnosis and treatment options for Hashimoto’s disease

Unfortunately, there is no known cure for Hashimoto's thyroiditis, but replacing hormones with medication can help manage the hormone levels and restore normal metabolism. 

Levothyroxine (Synthroid®, Levothyroid®, Levoxyl®), or T4, is the most common medication used to treat this condition.

The recommended prescription dose depends on age, weight, the severity of hypothyroidism, underlying health condition, or other medications that could interact with synthetic thyroid hormones. 

Before treatment, the physician will ensure the proper diagnosis of Hashimoto’s disease based on:

Physical exam and medical history

The physician will check the individual's medical record and perform physical exams. Apart from exams and history, the doctor will also check your neck for goiter, a common disease symptom.

Blood tests

The doctor could also request blood tests to confirm hypothyroidism and its possible cause. Some of the tests include measuring levels of the thyroid hormones T4 (thyroxine) and T3 (triiodothyronine), thyroid-stimulating hormone (TSH), antithyroglobulin antibodies (AB), and thyroid peroxidase antibodies (TPO), a type of thyroid antibody that is present in most individuals with the disease.

Most diagnoses only need two tests (T4 and TSH/TPO) and a physical exam to confirm Hashimoto's disease. Still, if a physician suspects you have the condition but cannot spot any antithyroid antibodies in your blood, they might request an ultrasound of your thyroid. 

The ultrasound images show the size of the thyroid and other features of Hashimoto's disease. It is also great at ruling out other causes of an enlarged thyroid, such as small lumps in the thyroid gland (thyroid nodules).   

After diagnosis, the physician will prescribe treatment depending on whether the thyroid is damaged and causing hypothyroidism. If not currently hypothyroid, the doctor will typically check your thyroid hormone levels and symptoms regularly. 

The most commonly prescribed medication for managing Hashimoto's disease is levothyroxine which is similar to the thyroid hormone thyroxine.    

The physician will conduct a blood test about six to eight weeks after you start taking levothyroxine and adjust the dose as needed. 

Note that you have to have a blood test every time you change the dosage. Once a perfect balanced dose is reached, the rate of blood tests slows down. 

Before stopping or increasing your dose, consult with your doctor to avoid complications. 

What happens if Hashimoto’s disease isn’t treated?

The issue with Hashimoto's disease is that it has no obvious symptoms in the initial stages. Therefore, regular diagnostic testing is recommended, especially if your physician suspects you might have the condition or there is a family history of Hashimoto’s.

Over time, if Hashimoto's disease goes untreated, it can cause several additional health problems. 

Complications

Subclinical hypothyroidism/thyroid antibodies² are linked to increased risks during pregnancy, particularly high blood pressure, miscarriage, and congenital disabilities. 

Here are more potentially severe conditions resulting from untreated Hashimoto's disease:

• Heart disease: The condition could either lead to high blood pressure or congestive heart failure

• Kidney disease: People with hypothyroidism have a high increase in kidney dysfunction  

• Peripheral neuropathy: Untreated Hashimoto’s disease could damage your peripheral nerves because of excess pressure

• Myxedema coma: This life-threatening condition can occur when the levels of thyroid hormones get too low and symptoms get worse

• Hashimoto encephalopathy: A rare disease that involves impaired brain function

The lowdown

So, can you die from Hashimoto's disease? It is possible but a rare outcome. However, Hashimoto’s is a risk factor for some severe conditions that are among the leading causes of death in America. 

Women are more likely to suffer from Hashimoto's disease, mainly due to hormones. It’s important to seek medical attention if you develop any symptoms such as goiter or if there is a strong family history of Hashimoto’s disease.