What Medications Are Used To Treat Hashimoto's Thyroiditis?

Hashimoto’s disease is an autoimmune condition that causes the immune system to attack the thyroid gland. This may result in a low level of thyroid hormones and cause fatigue, weight gain, and other symptoms.

Several medications can help treat its symptoms, including prescription medications, over-the-counter supplements, and natural remedies. Read on to learn more about this condition and its treatment options.

Overview of Hashimoto’s thyroiditis

The thyroid gland is a small butterfly-shaped organ that releases hormones that help regulate and control various body functions. Hashimoto’s thyroiditis occurs when the thyroid gland starts producing insufficient hormones due to attacks from your immune system.

This hormone deficiency leads to hypothyroidism. Your body lacks the hormone levels necessary to convert food into energy, which slows down other metabolic and body functions.

In extreme cases, Hashimoto’s thyroiditis can lead to inflammation and swelling. It leads to your thyroid gland growing abnormally large, which is a condition called goiter.

Symptoms of Hashimoto’s thyroiditis

The following are the most common symptoms of Hashimoto’s thyroiditis. However, each person may experience symptoms differently.

Symptoms may include:

• Fatigue

• Weight gain

• Abdominal pain, nausea, and vomiting

• Constipation

• Hoarseness 

• Difficulty swallowing

• Dry skin and hair

• Hair loss

• Swelling of the face (moon face) due to fluid build-up in the tissues under the skin 

• Puffiness around the eyes (periorbital edema)

• Muscle weakness

• Muscle aches, joint pains, and stiffness

• Cold hands and feet, swelling in the feet, ankles, and legs (edema)

• Numbness or tingling in the hands and feet (peripheral neuropathy)

• Depression or mood swings

• Poor memory or concentration

• Dizziness or lightheadedness

• Menstrual irregularities in women (amenorrhea) 

• Infertility in women

• Loss of bone density (osteoporosis) and bone fractures

• Decreased perspiration

Risk factors of Hashimoto’s thyroiditis

Below are the risk factors associated with Hashimoto’s thyroiditis.

• Age (between 30 and 60 years old)

• Sex (women are at greater risk than men)

• Family history

• Autoimmune diseases

• Diet (being vegetarian or vegan)

Exposure to certain chemicals

Those who are regularly exposed to the following chemicals also have a higher risk of developing Hashimoto’s thyroiditis:

• Pesticides (insecticides, herbicides, and fungicides)

• Heavy metals (mercury, lead, and cadmium)

• Phenol compounds (used in the production of plastics and the dyeing and tanning industries)

• Dioxins (toxic chemicals found in manufacturing plastics, paper products, and other consumer goods)

• Polychlorinated biphenyls (PCBs)

• DDT

Exposure to radiation

You also have a higher risk of developing Hashimoto’s thyroiditis when exposed to radiation. This includes exposure to ionizing radiation in x-rays and gamma rays from medical procedures, accidents, or work-related exposures.

Exposure to non-ionizing radiation, such as electromagnetic fields from power lines, cell phones, and microwave ovens, can also be a risk factor.

Ingesting toxins

Ingesting toxins from the environment or your food and water can also increase your risk of developing the condition. These toxins include the following:

• Pesticides, including insecticides, herbicides, and fungicides

• Heavy metals such as mercury, lead, and cadmium 

• Phenol compounds found in the production of plastics, dyeing, and tanning industries

What medications treat Hashimoto’s?

Which Hashimoto’s thyroiditis medication to use depends on the cause of the disease and whether it has progressed to a stage that requires treatment.

If your condition is triggered by an overactive immune system, it may be treated with medications that target the immune system. These are called anti-thyroid medications.

On the other hand, if the condition occurs because of an underactive thyroid gland, it may be treated with medication that increases the organ’s hormone production. These medications are called thyroid hormone replacement medications.

Below are the widely used medications for treating and suppressing the condition’s symptoms.

Thyroid hormone replacement medications

Levothyroxine (T4) is a synthetic thyroid hormone used to treat hypothyroidism, the most common endocrine disease of the thyroid gland.

Levothyroxine is the most commonly prescribed medication for Hashimoto’s because it has the longest duration of action (30 to 90 days).

It can be given once a day or twice daily, depending on the doctor’s instructions.

Another medication used is desiccated thyroid, and it is given to people with no symptoms and is only mildly hypothyroid. The drug helps address low thyroid-stimulating hormone (TSH) levels.

Antithyroid medications

Antithyroid medications are used to treat the symptoms of hypothyroidism and may be given together with levothyroxine to treat the symptoms of Hashimoto’s.

The most common anti-thyroid drug is methimazole, which treats Graves’ disease and hyperthyroidism.

Anti-inflammatory medicines

These are drugs that contain substances that reduce the inflammatory response. They include tricyclic antidepressants (TCAs), such as amitriptyline and nortriptyline, which are commonly used to treat hypothyroidism symptoms and burn patients with thyroiditis.

Ibuprofen (Motrin) and naproxen can also relieve pain and reduce inflammation and swelling.

Anti-cretin medications

These drugs prevent the production of thyroid hormones by blocking TSH receptors on the pituitary gland. The most commonly used anti-cretin drug is propylthiouracil (PTU).

Propylthiouracil is used to treat hyperthyroidism and Graves’ disease, but clinicians also use it to treat Hashimoto’s disease if the TSH level is low and the T3 and T4 levels are high.

Beta-blockers

Beta-blockers are used to treat angina, high blood pressure, or heart arrhythmias. They are also used to treat hyperthyroidism if the TSH level is low and the T3 and T4 levels are high.

In addition, beta-blockers may help prevent future episodes of hyperthyroidism by reducing thyroid hormone production in people with a previous episode of hyperthyroidism.

Calcium channel blockers

Calcium channel blockers (CCBs) reduce blood pressure by blocking calcium channels in heart cells. They are also used to treat hyperthyroidism if the TSH level is low and the T3 and T4 levels are high.

Some CCBs, such as verapamil, may help prevent future episodes of hyperthyroidism by reducing thyroid hormone production in people with a previous episode of hyperthyroidism.

Thyroid supplements

These supplements help promote thyroid health, especially in people who experience challenges with following a balanced diet. They include the following:

Armour thyroid

Armour thyroid contains T3 and T4 thyroid hormones in capsule form. The thyroid hormones are absorbed into the bloodstream quickly and help restore the body’s natural production of thyroid hormones.

Armour thyroid HBI

This supplement contains T3 and T4 thyroid hormones in a capsule form with a longer release time than armour thyroid. It helps restore the natural production of thyroid hormones in the body.

Niacinamide

This vitamin is essential in producing thyroid hormones, regulates energy levels, and helps support the immune system in your body.

Selenium

Selenium plays a vital role in producing thyroid hormones and is needed to maintain healthy levels of these hormones in your body. Selenium deficiency can lead to a decrease in thyroid hormone production, which may cause hypothyroidism.

Thiamine and folic acid

Thiamine plays a vital role in producing thyroid hormones needed for proper metabolism and growth.

Vitamin A

Your body requires vitamin A to produce thyroid hormones, which regulate energy levels and metabolism. It also helps to maintain healthy skin and eyesight.

Vitamins B12 and D

Both of these vitamins are used by your body to produce thyroid hormones. They help regulate several functions, such as energy levels, metabolism, and muscle growth.

Vitamin C

Vitamin C is a powerful antioxidant that helps the body fight infections, strengthens the immune system, and improves white blood cells’ function while boosting the production of thyroid hormones.

It is also used to slow down or prevent further damage to your thyroid gland.

Zinc

Zinc is an essential mineral needed for the thyroid gland’s proper functioning, and it helps regulate the production of thyroid hormones. Zinc supplementation may also help improve symptoms in adults with hypothyroidism, such as fatigue and weight gain.

Antidepressants

Antidepressants are used to treat depression and other mood disorders. They may also effectively treat autoimmune thyroid disease because they may reduce some of the symptoms associated with autoimmunity, including fatigue and trouble sleeping.

Common antidepressants used include tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

Immunosuppressants

Immunosuppressants are used to suppress the immune system, and they are used to treat the autoimmune thyroid disease. However, their effectiveness is limited because they do not stop the body’s production of autoantibodies or reverse damage caused by them.

The most commonly used immunosuppressants include azathioprine (AZA) and cyclophosphamide.

Immunomodulators

Immunomodulators are medications that decrease the immune system’s activity. They are used to reduce the number of antibodies produced by the body, which is a reaction that can occur in Hashimoto’s thyroiditis.

The common immunomodulators include corticosteroids and cyclosporine.

Holistic remedies used to treat Hashimoto’s thyroiditis

There are several non-pharmacological remedies used to treat symptoms of Hashimoto’s thyroiditis, including herbal remedies. 

Herbal remedies

Herbal remedies are natural substances that have been used for centuries to treat conditions such as Hashimoto’s thyroiditis. The most popular ones include the following:

Ashwagandha

Ashwagandha is a medicinal herb with several health benefits. Among others, it helps improve thyroid function for hypothyroid patients.

Black cohosh (Actaea racemosa)

The herb black cohosh is used to treat menopause and menstrual problems. It contains anti-inflammatory properties, making it helpful in treating Hashimoto’s thyroiditis, primarily when used with other natural remedies.

Black walnut (Juglans nigra)

Black walnut contains a substance called juglone, which has been beneficial in treating hypothyroidism. It helps the body produce more thyroid hormones and reduces inflammation.

Blueberry (Vaccinium corymbosum)

Blueberries contain a phytochemical called anthocyanin. It is beneficial in treating hypothyroidism by helping the body produce more thyroid hormones and reducing inflammation.

Dandelion (Taraxacum officinale)

Dandelions contain isoflavonoids, which are beneficial in treating hypothyroidism by reducing inflammation.

Echinacea

Echinacea, a group of flowering plants known for its herbal use, has been used for centuries to treat colds, fevers, and infections. It helps reduce inflammation, which may help treat Hashimoto’s thyroiditis or other autoimmune diseases.

Fennel seed (Foeniculum vulgare)

Fennel seed is beneficial in treating hypothyroidism because it helps the body produce more thyroid hormones. It also helps balance your hormone levels.

Garlic (Allium sativum)

It is believed that garlic contains sulfur compounds that help the liver metabolize thyroxine and triiodothyronine, two thyroid hormones.

Gum guggul

Gum guggul helps in converting inactive T4 to active T3.

Kelp

This is a type of seaweed that contains anti-inflammatory properties, and it reduces inflammation caused by Hashimoto’s thyroiditis.

Korean herbal medicine

Korean herbal medicine is also used for the treatment of Hashimoto’s thyroiditis¹. It significantly normalizes free thyroxine levels and thyroid-stimulating hormone levels for patients with hypothyroidism.

Milk thistle (Silybum marianum)

Milk thistle aids in the removal of toxins from the body, including free radicals that cause inflammation in the body and the thyroid gland. It also aids in supporting your immune system and helping it function properly.

Parsley (Petroselinum crispum)

Fresh parsley or flat-leaf parsley is a good source of vitamins C and A. These are both needed for optimal thyroid function and general health maintenance of the body.

Acupuncture

Acupuncture is a form of treatment that involves the insertion of very fine needles into specific points on your body that are the hubs of specific meridians or energy channels.

These points are believed to have particular healing properties, and when stimulated, they release chi or energy, which helps restore balance and harmony in your body.

Massage therapy

Massage therapy is a physical therapy that uses the hands, fingers, elbows, and knees to stimulate your body’s muscles, tendons, ligaments, and tissues.

What happens if Hashimoto’s thyroiditis is not treated?

If Hashimoto’s thyroiditis is left untreated, you may develop more symptoms of the disease. These include the following:

• Weight loss and fatigue

• Severe depression and anxiety

• Hair loss

• Hypothyroidism

• Constipation/irritable bowel syndrome (IBS)

In addition to these symptoms, you may also be at a higher risk of developing other autoimmune diseases such as rheumatoid arthritis, lupus, or psoriasis if Hashimoto's thyroiditis is left untreated.

Can Hashimoto’s thyroiditis be cured?

No, Hashimoto’s thyroiditis cannot be cured. However, it is possible to manage the disease through lifestyle changes.

With proper medications tailored to regulate the hormone levels, your metabolic functions can also be restored to their optimal levels.

The lowdown

Even though Hashimoto’s thyroiditis is incurable, proper management of the condition can significantly alleviate the symptoms and improve your quality of life.

Before taking any medication, whether it’s pharmaceutical or herbal, consult a medical professional. Your doctor will test your thyroid function and, once the test results are out, determine the best treatment options based on the causes and severity of your condition.