How to Know If You Have Hashimoto’s Disease (& What to Do)

There are symptoms that a lot of us might chalk up as just “part of life,” but nothing is normal about chronic fatigue, acid reflux, achy joints, inability to lose weight, hair falling out in clumps, and depression. In fact, these symptoms are usually telling us that there is something going on inside our bodies that we need to address.

I have Hashimoto’s thyroiditis, an autoimmune condition where the body mistakenly attacks the thyroid. My path to diagnosis was long and frustrating. I even had symptoms for a long time that I didn’t even know were associated with thyroid problems.

I get questions daily relating to what I do for my thyroid, how I got diagnosed with Hashimoto’s Disease and hypothyroidism, and how to find answers so you can start feeling better.

This post is a collection of all I’ve learned about Hashimoto’s in the last several years. I’ve written this post to give you resources so that you can find your own answers.

While I’m not a doctor and this isn’t medical advice, hopefully sharing this will save you a few bumps along the way and speed up the process of finding the right doctor/solution for you.

What Is Hashimoto’s Thyroiditis?

You’ve probably heard of Hashimoto’s thyroiditis, as I’ve written about it in the past. Hashimoto’s is one of the world’s most common autoimmune disorders. It is also known as autoimmune thyroiditis or chronic lymphocytic thyroiditis. What it really is, though, is a literal pain in the neck!

The thyroid is a butterfly-shaped gland that sits at the base of the neck. It makes hormones that regulate metabolism. This is why thyroid problems can result in weight gain or loss, as well as feeling too hot (overactive thyroid) or too cold (underactive thyroid).

Out of Hashimoto’s cases in the United States, women are impacted 10 times more than men. While most women will be diagnosed between ages 30 to 50, women of any age can develop thyroid problems.

While Hashimoto’s is different from hypothyroidism, the autoimmune disease is the most common cause of hypothyroidism in the U.S., according to the American Thyroid Association.

Conservative estimates say that 1 in every 5 women will suffer from Hashimoto’s or another type of thyroid disease at some point during their life. Women are more prone to thyroid problems, and autoimmune disease in general, thanks to a combination of hormones, how our bodies respond to the environment, and genetics.

This might sound like a bold statement, but when you’re so exhausted that it literally hurts to get out of bed, or you’re so anxious you think you’re going crazy, or your hair literally won’t stay on your head—you can see how this disease puts life on hold while you struggle to get through each day.

Signs & Symptoms of Hashimoto’s

Hashimoto’s shares a lot of the symptoms of hypothyroidism. Having an underactive thyroid leads to shared symptoms like fatigue, hair loss, and dry skin. But when you also have an autoimmune component, you might be more likely to have chronic pain or related autoimmune disorders.

Signs or symptoms that are common with Hashimoto’s are:

• Goiter, or swelling of the neck
• Weight gain
• Dry skin
• Difficulty swallowing
• Frequent sore throat
• Hair loss
• High cholesterol
• Muscle weakness
• Tiredness and fatigue
• Low heart rate
• Low basal body temperature
• Sensitivity to cold
• Constipation
• Joint pain and feelings of stiffness
• Depression and mood changes
• Memory lapses and poor cognitive ability
• Heavy menstrual periods
• Infertility or miscarriage
• Reduced exercise or activity tolerance

Talk about an awful list! While most people with Hashimoto’s won’t have every symptom on that list, even just one or two are enough to make you feel terrible.

I had trouble losing weight and felt tired all the time. I chalked these up to being a mom of young kids and sleeping poorly. Unfortunately, new moms are at higher risk for developing something known as postpartum thyroiditis. It can be a temporary form of autoimmune thyroid disease, or it can turn permanent.

Differences Between Hashimoto’s & Hypothyroidism

If you have symptoms of low thyroid, how can you tell the difference between whether it’s hypothyroidism or Hashimoto’s? Hashimoto’s is the most common cause of hypothyroidism, but that doesn’t mean you’re guaranteed to have it.

The best way to understand what’s causing your symptoms is to get the proper testing. It took a long time for me to get diagnosed because I didn’t really know what I was looking for. If you have signs of hypothyroidism, getting the right labs done can rule out the cause and get you answers faster.

Testing for Hashimoto’s Thyroiditis

In order to get the full picture of your thyroid health, you need several thyroid tests. Some doctors will only run TSH, which gives an incomplete picture of what the thyroid is doing. This is why it took so long for me to get a proper diagnosis. To avoid a lengthy time of diagnosis limbo, the following tests should be run:

• TSH (Thyroid Stimulating Hormone): This test shows how hard the pituitary gland is having to work to tell the thyroid to make more hormone. Elevated levels would indicate hypothyroidism. In early stages of Hashimoto’s, TSH might be normal.
• Free T3 and Free T4: These are the active versions of your thyroid hormones. By testing the free forms, your doctor gets to see how much hormone you have available to use. Suppressed levels would indicate a struggling thyroid. Free T3 and Free T4 may be elevated or suppressed in Hashimoto’s patients, depending on where you are in the disease process. T3 is considered the active thyroid hormone.
• Reverse T3: This lab helps to assess why your T3 or T4 levels may not be optimal. In times of stress (for example starvation) or hyperthyroidism, the body stores excess T3 as Reverse T3.
• Thyroid Peroxidase Antibody and Thyroglobulin Antibodies: These measure the level of antibodies that your body has made to attack your thyroid. Normal levels, or having none, show that you don’t have Hashimoto’s. Elevated levels could indicate Hashimoto’s or Graves’ disease (the hyperthyroid version of autoimmune thyroid disease).
• Thyroid Ultrasound: Some doctors will also check your thyroid via ultrasound, especially if you’ve had symptoms for a long time or have an enlarged thyroid gland. It’s important to tell your doctor if you have pain at the base of your neck or it hurts to swallow, as these could also be signs of a swollen thyroid gland.

How to Get the Right Diagnosis

After you get lab work and tests done, working with a doctor to get an official diagnosis is important. The thing you need to know is that not every doctor is a thyroid expert, and some of them might write off your symptoms as normal. But if you don’t feel normal, you need to find someone who will take you seriously.

I struggled to get a diagnosis. It finally happened after I was at a conference and a dear friend heard about my symptoms, immediately knew what it was, and connected me with Dr. Alan Christianson, a thyroid expert. He reached out and felt my thyroid. He also ran some labs, but based on those things, he rather quickly diagnosed me with Hashimoto’s.

I felt so much relief at finally having an answer for feeling so terrible! A diagnosis can feel overwhelming, but it also gives some clear direction for a way to feel better. If your doctor says your TSH levels are “normal” and won’t run other blood tests, it’s probably time to get a second opinion.

What Causes Hashimoto’s Thyroiditis?

Hashimoto’s happens when the body’s immune system mistakenly targets the thyroid for attack. This can happen for one or more reasons, but these risk factors are the most common:

• Genetics or family history
• Environmental triggers (diet, stress, toxins, chemicals, air pollution, etc.)
• Leaky gut (including certain trigger foods like dairy, gluten, and soy)
• Hormone triggers (having a baby, entering menopause)
• Having another autoimmune disorder (type 1 diabetes, celiac disease, rheumatoid arthritis, etc.)
• Certain viral infections (such as Epstein Barr, enterovirus, rubella, mumps, herpes simplex, and parvovirus)
• Graves’ disease, or autoimmune hyperthyroidism, can also “burn out” the thyroid and lead to Hashimoto’s

Alessio Fasano is an expert on leaky gut and autoimmunity. His research has found that while the above triggers, especially leaky gut, can be involved in the cascade that sets off autoimmunity, you don’t have to fix everything before you start to feel better. Of course you can’t control your genes! But you do have the ability to address the other elements, and I want to discuss how I did that in my own life.

There isn’t a cure for Hashimoto’s. Autoimmune diseases don’t go away once you develop them, but you can enter remission. It’s possible to be symptom-free and have your antibodies down to zero. But this process takes time. You can’t expect to feel completely normal after just a few days or weeks.

Still, the changes you make to address Hashimoto’s will benefit the rest of your life!

How to Start Feeling Better From Hashimoto’s

I’ve joked before that I created the perfect recipe for causing autoimmune disease. I was not sleeping, eating really bad food, and stressed out all the time. With a genetic disposition, that lifestyle can easily trigger autoimmunity.

But if you can live a lifestyle that makes you prone to disease, you can also live a lifestyle that helps to address it! Part of working toward feeling better from Hashimoto’s is addressing the areas that can improve your disease: diet and nutrients, environment (like personal care products), gut health, stress, and other lifestyle factors.

Your doctor will put you on a personalized plan, but these are the basics of wellness for thyroid disease.

Diet & Nutrients

Many experts recommend beginning with nutrition, and I certainly agree that this is an important first step! Start by removing gluten, dairy, and soy from your diet. You may find that paleo or autoimmune paleo options are the best diets to use while you’re trying to get your health back.

You guys know how I feel about gluten, dairy, and soy, so when I found out these are the recommended steps to be proactive about preventing thyroid disease, it was a no-brainer! You may find my Wellness Mama Cookbook helpful because it’s full of great recipes to support your gut and fill you and your family with delicious nutrients.

Make sure to get the proper amount of vitamins and minerals to give the body a fighting chance to combat disease and illness. A lot of times, people suffering from thyroid disease and especially Hashimoto’s are nutrient deficient. Loading up on selenium, zinc, vitamin D, and even magnesium will drastically improve the way that you feel.

Eating plenty of vegetables—any and all vegetables—is a great way to pack your diet with vitamins and minerals. Some fear cruciferous vegetables with thyroid disease, but if they’re cooked, you avoid any potential complications. So you don’t have to avoid broccoli, cabbage, and Brussels sprouts. In fact, these are packed with healing nutrients!

Don’t go low-carb, either. The thyroid needs carbohydrates to make and convert hormones. Dr. Alan Christianson, a thyroid expert, recommends consuming carbs at night though, which goes against normal advice. Carbs at night helps to regulate your cortisol and other hormones, promoting better sleep, and also helping you avoid feeling hungry!

Supplements can also aid in healing, but make sure your healthcare provider recommends them and knows what you’re taking. Iodine and other “thyroid support” supplements might worsen Hashimoto’s. Dr. Alan Christianson has a line of products that have had a tremendous impact on those suffering with thyroid conditions.

Personal Care Products

Our environment is what we live in, but it’s also the things that we breathe in and that we take in through our skin. If you have Hashimoto’s, consider doing a clean out of your personal care products.

Skincare, make-up, lotions, perfumes, hair care, and other products tend to make women more susceptible to thyroid-related conditions than men. Women use an estimated 12 personal care products with 168 ingredients on a daily basis. Compare this to a man using 6 products with 85 ingredients. Both numbers are high, but 168 is nearly double!

When we slather lotions and creams all over our faces, necks, and bodies, it seeps into our bloodstreams and deposits right into other organs, especially the thyroid. The thyroid is like a hoarder, and instead of releasing the toxins, it just holds onto them. Over time, this builds into a toxic environment. If they’re not released properly, they can wreak havoc on your thyroid gland, triggering autoimmunity.

It has never been easier to replace toxic personal care ingredients with natural ones. I’ve made it my mission to do this for my family, and I even started a product line to make it easier for others. There are many companies out there doing the same thing!

Gut Health

In addition to dietary changes, helping repair gut health comes down to giving your body the tools it needs. Amino acids are the building blocks of protein, and they are also important for repairing things like the tight junctions in your gut wall. Gelatin found in bone broth can help promote a healthy gut lining. Collagen supplementation can help, too.

Probiotics are another important part of gut health. Your microbiome is always a mix of good and bad bacteria, but the bad guys are hardier than the good ones. Your good bacteria need to be replaced often, especially when you have autoimmune disease. You can do this by eating fermented foods and by taking a daily probiotic supplement.

Stress

It’s nearly impossible to never stress, I get that. But working to help your body process stress in a healthier way is really essential to recovering from Hashimoto’s.

Creating a healthy sleep routine, where you have a regular bedtime that you try to stick to is a big part of it. If you have small kids, it might be hit or miss, but it’s about valuing it. The more you try to make sleep a priority, the better it will get.

Exposing yourself to morning sunlight is also great for regulating cortisol and your circadian rhythm. It doesn’t have to be on your skin, and you don’t have to try to get a tan. Just be in the morning light as soon as possible after you wake up for at least 30 minutes. This will help balance cortisol, melatonin, and work to lower inflammation in the body.

How Long Does It Take to Feel Better From Hashimoto’s?

Your journey in developing Hashimoto’s is different from mine and from someone else’s. There isn’t a specific length of time you’re guaranteed to feel better in. But taking the long view is important. It may take weeks or even months to notice a huge difference, but because the changes are happening over time, they’ll last.

Addressing underlying causes versus just treating symptoms takes more work, but the payoff is so much better. Getting to remission was very much a decade-long journey for me. But if you get diagnosed sooner than I did, you may also feel better faster.

Should You Take Medication for Hashimoto’s?

Some people who have Hashimoto’s do need thyroid hormone replacement. There’s no shame in this! Levothyroxine is a common one, but there are several options. The medication that works for someone else may not be the one that helps you the most.

I try to avoid medication whenever possible, but there’s absolutely a time and place for conventional medicine. If your thyroid has been damaged and can’t make its own hormone, or if you just need a temporary boost while your body is healing from Hashimoto’s, thyroid hormone replacement can make a huge difference in how you feel.

I found success with Nature Throid, a natural desiccated version of thyroid hormone. There are many different kinds and your doctor should work with you to determine the best fit for your needs. This often means checking your thyroid levels a few times a year to make sure your dose is right. Too much thyroid hormone can make you feel every bit as bad as too little!

What Not to Do for Hashimoto’s

If you have Hashimoto’s, addressing lifestyle and diet to help promote healing is important. It’s also every bit as critical that you avoid things that could make your thyroid disease worse.

Avoid Iodine for Thyroid Disease

The thyroid needs iodine to make hormones. However, this small amount can be obtained through dietary sources. Supplementing with iodine on its own can be bad for Hashimoto’s and can set off a firestorm of symptoms, worsening the autoimmune attack.

I learned this the hard way. After taking iodine at the recommendation of a chiropractor, I started feeling a lot worse. Research backs this up, too. Countries who add iodine to salt to avoid hypothyroidism also have higher rates of Hashimoto’s! This was evidenced by studies in Sri Lanka, Brazil, China, Greece, and India.

Iodine worsens the autoimmune attack on the thyroid because it slows the activity of thyroid peroxidase, an enzyme that is needed for making thyroid hormones.

Dr. Terry Wahls, an expert on autoimmunity, notes that iodine is worse when selenium levels are also too low. Antibodies should be tested periodically to see if they are increasing or decreasing based on your treatment plan.

Don’t Skip Doctor Visits

Speaking of doctors, following through with regular appointments and lab work is important when it comes to addressing Hashimoto’s. You need to see how your thyroid levels and antibodies are responding. You may also need to adjust medication doses or make other changes over time, and it’s hard to do this if you don’t have regular check-ins.

About Remission from Hashimoto’s

Many have asked questions about how I got to remission, so I want to really make it clear that the process of getting there is a marathon, not a sprint. Since autoimmune diseases can’t be cured, getting to remission means no antibodies present. It is possible! But it takes the combination of everything I discussed in this post, plus time, plus addressing your unique factors, to get there.

Once I got into remission, I could stop being as strict with my diet. Addressing emotional triggers, for me, was also part of getting to this place. I eat more food now than I’ve ever been able to as an adult—including the occasional gluten or sugar, as well as dairy. They don’t bother me now that I am not inflamed and flared up with autoimmunity.

For two years after being diagnosed, I was very strict with my diet and highly regimented. While that was happening, I was not losing weight. It took years after that to be able to lose the weight and enter remission. It is a process that takes time.

Build habits that let you implement healing protocols and track what you’re doing. This way, you’ll be able to see what’s working, and what helps improve your energy and sleep. I saw improvements in these far before I lost weight or achieved remission. You will start to feel better, but to be fully better, it’s a journey.

Shifting my mindset and addressing the emotional factors behind my weight loss, which were related with Hashimoto’s, was also something different that I had to focus on. I was mad at my body. It’s understandable, when your body attacks itself, to feel angry. But those feelings have to be resolved to help you move forward.

This article was medically reviewed by Dr. Jennifer Pfleghaar, D.O., FACEP, ABOIM. Dr Jennifer is a double board certified physician and is now working in Emergency Medicine and has an office in Ohio practicing Integrative Medicine. As always, this is not personal medical advice and we recommend that you talk with your doctor.

What are your thoughts about Hashimoto’s? Do you or someone you know suffer from some form of thyroid disease? I’d love to hear your thoughts in the comments!