Learn Everything You Need To Know About Living With Hashimoto's Disease

Hashimoto's disease is the most common type of thyroid disease in the United States, with one in five people suffering from this condition. Diagnosing and treating this disease can be challenging as there is no known cure, and its signs and symptoms are often confused with other conditions. If you have Hashimoto’s disease, it’s important to learn how to live with it.

What is Hashimoto's disease?

Hashimoto's disease, or Hashimoto's thyroiditis, is an autoimmune disease that affects the thyroid gland. It occurs when your body's antibodies attack your thyroid gland. As a result, the thyroid gland doesn't make enough thyroid hormones, leading to a condition known as hypothyroidism. 

Who is at risk of developing Hashimoto's disease?

There is a range of factors that make you more likely to get Hashimoto's disease, including:

• Being female: Women are four times more likely¹ to have Hashimoto's disease than men.

• Genetics: Having a family history of this disease increases your risk.

• Autoimmune diseases: Having other autoimmune diseases like type 1 diabetes, celiac disease, rheumatoid arthritis, and lupus increases your likelihood of having Hashimoto’s disease.

Why is it hard to diagnose Hashimoto's disease?

Hashimoto's disease is the most undiagnosed thyroid-related disease, despite being the most common autoimmune disease in the US. Here are some reasons why it's challenging to diagnose Hashimoto's disease. 

Signs and symptoms

The signs and symptoms of Hashimoto's disease can be vague, making them difficult to identify and diagnose. For instance, stress and fatigue are common symptoms of Hashimoto’s disease, but they are also common to other diseases. The fatigue can even be mistaken for iron deficiency.

Since Hashimoto's disease is common among women, signs and symptoms might be considered normal due to menstrual cycle changes.

If you're suffering from another autoimmune disease, like lupus or celiac disease, the symptoms could be similar to Hashimoto’s disease, and so it might take time to diagnose Hashimoto’s disease. 

Tests

 For an accurate diagnosis, your doctor should order the following three tests:

• Thyroid-stimulating hormone test

• Free T3 test 

• Thyroid peroxidase antibodies test

How does Hashimoto's disease affect your life?

Living with Hashimoto's disease can be difficult due to its unpleasant signs and symptoms. Some studies² indicate that people with Hashimoto's are more likely to suffer from anxiety disorders and depression.

Signs and symptoms of Hashimoto’s disease include:

• Depression 

• Anxiety

• Difficulty concentrating 

• Lack of interest in activities you used to enjoy

• Memory problem 

• Mood swings 

• Irritability

• Fatigue

• Constipation

• Menstrual disorders or changes

Myths and misconceptions about Hashimoto's disease

There are many myths and misconceptions, including those mentioned below, about Hashimoto's disease since it is commonly confused with other thyroid-related disorders.

Your symptoms will disappear once you start taking medication

False. It takes time for your symptoms to improve once you start taking medication for Hashimoto's disease. Some symptoms, like severe cold intolerance and joint pain, might improve relatively quickly, but for others, like fatigue and anxiety, it will likely take at least a month before you start to see results.

Hashimoto’s disease has clear signs and symptoms

False. The signs and symptoms of Hashimoto's can be subtle and easily overlooked, especially if they are mild.

It is also tricky to differentiate Hashimoto’s from other diseases because signs and symptoms like fatigue, irritability, weight loss, and sensitivity to hot or cold are common across most conditions.

Therefore, you might be misdiagnosed until a significant sign, like goiter, is noticed, followed by other signs and symptoms of hypothyroidism once the condition presents itself.

Hormonal issues after age 40 are a sign of menopause

False. Many women with Hashimoto's disease start experiencing menopause-like symptoms in their 40s, such as mood fluctuations, irregular menstrual periods, heat sensitivity, and sleep disturbance. These symptoms are associated with Hashimoto's hypothyroidism.

One study³ found that women with Hashimoto's hypothyroidism were found to have less frequent menstrual disturbances. However, researchers found that those with severe hypothyroidism had frequent irregularities.

You will be on medication for the rest of your life

This one is actually true. Medications for Hashimoto's disease, such as levothyroxine, are taken for a lifetime. 

Levothyroxine will continue to replace your thyroid hormone due to having an underactive thyroid. If you have surgery to remove your thyroid, you will be required to take hormone replacement medication for the rest of your life to sustain normal thyroid functioning.

It's okay to skip your medication once symptoms improve

False. Your signs and symptoms might start to improve once you start taking your medication, but this doesn't necessarily mean that you should stop. It's recommended to continue taking your medication as prescribed.

Because Hashimoto’s disease is an autoimmune disease, not taking your medication regularly can result in complications such as goiter, poor pregnancy outcomes, and in rare cases, myxedema (severely advanced hypothyroidism).

You can treat Hashimoto's disease with over-the-counter supplements

False. An accurate diagnosis and prescription medication are important for treating Hashimoto's disease.

Some over-the-counter drugs are made out of synthetic thyroxine extracted from pigs, which is not currently approved for use in treating Hashimoto’s disease. The risk is that taking them without a prescription might lead to a long-term impact on your thyroid or other health problems.

Hashimoto's disease is common in women

True. However, it can affect either gender, especially if you live in a place with sufficient iodine in your diet rather than not enough.

Complications

If Hashimoto's disease is left untreated, several complications can arise, including:

Goiter

Untreated Hashimoto's disease can lead to permanent damage to your thyroid gland. To compensate for an underactive thyroid gland, the thyroid gland swells, causing a goiter to form. There are different types of goiter that you can suffer from, including:

• Diffuse type, characterized by a smooth and generalized swelling  

• Nodular type that appears as a lump

• Multiple lumps 

• Retrosternal type that presents as a lump that extends back towards the windpipe 

Infertility

When your thyroid hormone levels are too low, this can affect your menstrual cycle and ovulation. Insufficient production of thyroid hormones due to Hashimoto's disease leads to changes in prolactin levels⁴ which can completely stop your periods.

In another study, out of the 100 women participants aged between 15 to 45 who had menstrual disorders, 30% were found to have autoimmune thyroid antibodies present. This indicates that many women experiencing infertility have Hashimoto's disease.

Heart disorders

Mild hypothyroidism can significantly affect your heart health⁵. There have been cases where Hashimoto's hypothyroidism has led to heart disorders.

Low thyroid hormone production triggers the production of "bad" (LDL) cholesterol, hardening the arteries and increasing the chances of a heart attack.

Even though most heart disorders related to Hashimoto's disease are mild, severe Hashimoto's hypothyroidism can cause pericardial tamponade⁶, a condition in which the heart pumps less blood. This can significantly lower your blood pressure, eventually resulting in death if not treated.

Pregnancy-related complications

As the thyroid hormone is vital for fetal development, Hashimoto's hypothyroidism can lead to pregnancy-related complications if left untreated. It can also double the risk of:

• Fetal respiratory issues 

• Fetal heartbeat irregularities 

• Low birth weight 

• Rupture of the uterine membrane 

Hashimoto's encephalopathy

Hashimoto's encephalopathy is a rare complication that causes the brain to swell, resulting in significant negative neurological effects. This condition can manifest itself in the following two ways:

• Seizure and stroke-like attacks

• A steady decline in cognitive function (causing dementia, hallucination, tremors, sleepiness, and in rare cases, coma)

Myxedema

Myxedema is a rare and severe type of Hashimoto's hypothyroidism that slows down your metabolism to the point of causing you to enter a coma. It is usually associated with severe untreated hypothyroidism if you get an infection.

The following signs and symptoms characterize myxedema:

• Swollen and puffy skin 

• Severe cold intolerance 

• Hypothermia or reduction in body temperature

• Slowed movement 

• Psychosis

• Confusion 

• Shock 

Dietary changes

It is recommended that you eat a nutrient-dense diet⁷ to reduce the severity of your Hashimoto’s disease symptoms and improve your overall health. Try to incorporate the following foods into your diet:

• Fruits such as apples, pineapples, citrus fruits, pears, and peaches 

• Non-starchy vegetables like tomatoes, asparagus, broccoli, mushrooms, carrots, and pepper 

• Starchy vegetables like acorn, butternut squash, potatoes, sweet potatoes, and peas 

• Healthy fats like coconut oil, olive oil, avocado oil, and avocado

• Animal proteins like chicken, turkey, salmon, and turkey 

• Seeds, nut butter, and nuts like almonds, cashew nuts, sunflower seeds, almond butter, pumpkin seeds, and almond butter 

• Beans and lentils kike black beans, lentils, and chickpeas 

• Non-lactose or non-dairy substitutes like coconut yogurt, coconut milk, cashew milk, goat’s milk, and goat’s cheese 

• Beverages like sparkling water, unsweetened tea, and water 

You should also avoid specific foods to improve Hashimoto's signs and symptoms, including:

• Foods with added sugar

• Sweets such as cake, ice cream, candy, sugar cereals, table sugar, and pastries 

• Fast food and fried foods like hot dogs, fried chicken, and French fries 

• Refined grains like bagels, white flour tortillas, and pasta 

• Highly processed meats and other foods like margarine, frozen dinners, bacon, microwave dinners, and sausages 

• Grains and foods containing gluten such as rye, bread, wheat, and barley 

As everyone is different, you should work with a dietician or nutritionist specializing in autoimmune disorders to work out what diet best helps you manage your symptoms.

Lifestyle changes

A range of lifestyle factors can improve your ability to manage Hashimoto’s disease. These include getting enough sleep, reducing stress, and practicing self-care.

Research⁸ has shown that participating in stress reduction practices can reduce symptoms such as anxiety and depression and improve your overall quality of life.

It is also recommended that medication for Hashimoto's disease be taken on an empty stomach, preferably 30 to 60 minutes before breakfast and three to four hours before dinner. You should also avoid consuming coffee at least thirty minutes before taking your medicine.

Supplements

In addition to dietary changes, several supplements can reduce the effects of Hashimoto's disease⁹. These supplements decrease thyroid antibodies and inflammation and replenish nutrients that become depleted in your body due to Hashimoto's disease.

It is essential to discuss any supplements with your doctor before taking them.

Helpful supplements include:

• Selenium — Taking at least 200mcg of selenium daily can reduce your antithyroid peroxidase antibodies¹⁰.

• Zinc — Studies have shown that taking zinc supplements¹¹ alongside selenium can improve thyroid function.

• Curcumin — Curcumin is a powerful antioxidant and anti-inflammatory compound¹² that protects the thyroid gland and can also treat autoimmune disorders like lupus and celiac disease.

• Magnesium — Low magnesium levels can lead to an increased risk of Hashimoto's disease, so correcting magnesium deficiencies¹³ can improve thyroid health.

Medications

Levothyroxine is the most common treatment for Hashimoto's disease. While it does not provide a cure, it can help you to keep your condition under control in the long term.

Levothyroxine is sold using different brand names, such as:

• Unithroid

• Synthroid

• Levoxyl

• Unithroid direct

Levothyroxine is a synthetic form of T4. This means it maintains your thyroxine levels, which are usually low when you have Hashimoto's hypothyroidism.

Your levothyroxine dosage depends on your weight, age, and thyroid hormone levels. Older people tend to start with a small dose, which can be increased as necessary.

After six weeks, your doctor should retest your hormone levels and review your symptoms. They may decide to change your medication dosage. Once your hormonal levels stabilize, the doctor will recommend a six-month or a yearly visit to monitor your hormonal levels on an ongoing basis.

Please note that for your treatment to be effective, you should use the same brand of medication, follow a strict schedule of taking your medication at the same dosage and time, and avoid skipping doses.

Clinical trials

If you are living with Hashimoto's disease, you can participate in a clinical trial to help medical researchers and doctors learn more about this disease and how to manage it.

You can find Hashimoto's disease clinical trials in your local area by searching here.

The lowdown

Hashimoto's disease can have a range of negative signs and symptoms, but the disease can be difficult to diagnose as many of these symptoms are shared with other conditions.

By getting an accurate diagnosis and learning more about managing the condition, such as medication, diet, and lifestyle changes, you can improve your symptoms and avoid complications.

Your doctor, dietician, and endocrinologist can help treat your Hashimoto’s disease to enable you to live comfortably with the disease and improve your quality of life.