Hashimoto Thyroiditis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hashimoto Thyroiditis?
An endocrinologist, a doctor who treats hormone and gland problems such as thyroid disease, usually treats Hashimoto thyroiditis. A primary care doctor can often check thyroid blood tests first. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Hashimoto thyroiditis?
Hashimoto thyroiditis is an autoimmune disorder. This means the immune system attacks the body's own tissue. It can cause hypothyroidism, or an underactive thyroid.
The thyroid is a small, butterfly-shaped gland in the front of the neck. Thyroid hormones control how your body uses energy. In this disease, the immune system makes antibodies that attack the thyroid. The thyroid gets damaged. It cannot make enough hormone.
It is also called Hashimoto's disease, chronic lymphocytic thyroiditis, or autoimmune thyroiditis. It is the most common cause of hypothyroidism in the United States, and it affects 1 to 2 percent of people there.
Symptoms
Many people have no symptoms at first. The disease begins slowly. As it goes on, you may have signs of hypothyroidism, such as:
- Fatigue, or feeling very tired.
- Weight gain.
- Trouble tolerating cold.
- Joint and muscle pain.
- Constipation.
- Dry skin, or dry and thinning hair.
- Heavy or irregular periods, or fertility problems.
- A slowed heart rate.
The thyroid may get larger. This is called a goiter. It can make the front of the neck look swollen and may cause a feeling of fullness in the throat. A goiter is usually not painful. Depending on its size, it may interfere with breathing and swallowing.
Untreated hypothyroidism can lead to high cholesterol, heart disease and heart failure, and high blood pressure. It can also cause problems in pregnancy.
Causes and who gets it
Experts do not know why some people get Hashimoto thyroiditis. A family history of thyroid disease is common. Genes and viruses, such as hepatitis C, may play a role. Other possible triggers include certain medicines, radiation, and too much iodine.
The disease is 4 to 10 times more common in women than in men. It may occur in teens or young women, but it more often develops in women ages 30 to 50.
You are more likely to get it if you have another autoimmune disorder. Examples are celiac disease, lupus, rheumatoid arthritis, Sjogren's syndrome, and type 1 diabetes.
How doctors diagnose it
Doctors start with your medical history and a physical exam. They check your neck for a goiter. Then they order blood tests. These check the thyroid hormones T4 and T3 and thyroid-stimulating hormone (TSH). They also check thyroid peroxidase antibodies (TPO).
You probably will not need other tests. If you have no antithyroid antibodies, your doctor may order an ultrasound of your thyroid. It can show the size of the thyroid and rule out other causes of a large thyroid, such as nodules.
Treatment
Treatment depends on whether the thyroid is damaged enough to cause hypothyroidism. If you do not have hypothyroidism, your doctor may just check your symptoms and thyroid hormone levels regularly.
For hypothyroidism, the recommended medicine is levothyroxine. It is identical to the natural thyroid hormone T4. Some foods and supplements can change how well your body absorbs it. Examples are grapefruit juice, espresso coffee, soy, and multivitamins with iron or calcium. Follow your doctor's instructions on when to take it.
Your doctor will check your blood and adjust your dose if needed. Never stop taking your medicine or take a higher amount without talking with your doctor first. Too much thyroid hormone medicine can cause serious problems, such as atrial fibrillation (an irregular heartbeat) or osteoporosis (weak bones).
Foods with large amounts of iodine, such as kelp or other seaweed, may cause hypothyroidism or make it worse. Ask your health care team what to limit. No specific guidance is available yet on vitamin D or selenium.
When to see a doctor
Contact your doctor if you have symptoms of chronic thyroiditis or hypothyroidism.
Severe untreated hypothyroidism can lead to a change in consciousness, coma, and death. This usually happens if people get an infection, are injured, or take medicines such as opioids. Call 911 or go to the emergency room if someone with thyroid disease has a change in mental state, is hard to wake up, or has severe trouble breathing.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can order thyroid blood tests and follow your results over time. They can also help you find an endocrinologist when needed.
Common questions
Is Hashimoto thyroiditis the same as hypothyroidism?
No, but the two are linked. Hashimoto's disease is an autoimmune disorder that can cause hypothyroidism, or an underactive thyroid. It is the most common cause of hypothyroidism in the United States.
Can Hashimoto thyroiditis be prevented?
No, there is no known way to prevent it. Knowing the risk factors may allow earlier diagnosis and treatment.
Does everyone with Hashimoto thyroiditis need medicine?
No. If you do not have hypothyroidism, your doctor may simply check your symptoms and thyroid hormone levels regularly. Levothyroxine is the recommended treatment once hypothyroidism develops.
Does diet matter with Hashimoto thyroiditis?
Yes, mainly because of iodine. Large amounts of iodine, such as from kelp or seaweed, may cause hypothyroidism or make it worse. Iodine supplements can have the same effect.
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) - Hashimoto's Disease
- MedlinePlus - Chronic thyroiditis (Hashimoto disease)
- MedlinePlus - Hashimoto's disease (MedlinePlus Genetics)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
