Also Known As
Chronic Thyroiditis
Autoimmune Thyroiditis
Lymphocytic Thyroiditis
This article was last reviewed on
This article waslast modified on
November 27, 2017.
What is Hashimoto thyroiditis?

Hashimoto thyroiditis is the most common form of thyroid gland inflammation (thyroiditis) and the most frequent cause of decreased thyroid hormone production (hypothyroidism). It results from an autoimmune disorder, an attack on the thyroid gland by a person's own immune system.

The thyroid gland is a butterfly-shaped organ that lies flat against the windpipe in the throat. It produces the hormones thyroxine (T4) and triiodothyronine (T3) and plays an important role in controlling the body's metabolism.

With Hashimoto thyroiditis, the thyroid becomes enlarged (called a goiter), firm, and rubbery but not usually tender. Thyroid gland tissue is slowly destroyed by white blood cells called lymphocytes that move into the thyroid gland and by one or more thyroid autoantibodies. This causes a progressive decrease in the production of thyroid hormones.

About 1 in 1,000 people are diagnosed annually with Hashimoto thyroiditis, and the number has been increasing over time due to improvements in diagnostic techniques. This disorder can affect anyone at any age but occurs most commonly in women who are between 30 and 50 years of age. The ratio of women to men diagnosed with the disease is 20 to 1. People with a family history of thyroid diseases or with other autoimmune diseases, especially type 1 diabetes or adrenal insufficiency are at increased risk.

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About Hashimoto thyroiditis
  • Signs and Symptoms

    Those affected by Hashimoto thyroiditis may not have any symptoms for several years, but eventually most will experience some degree of hypothyroidism that worsens over time. Signs and symptoms may include:

    • Constipation
    • Depression
    • Dry skin
    • Fatigue
    • Forgetfulness
    • Increased sensitivity to cold
    • Menstrual irregularities, heavy and excessive bleeding
    • Muscle and joint pain
    • Muscle weakness
    • Sluggishness
    • Thinning hair
    • Weight gain
    • For pregnant women, increased risk of miscarriage
  • Tests

    Testing is done to evaluate the health of the thyroid, diagnose Hashimoto thyroiditis, and monitor treatment.

    To determine whether the thyroid is functioning properly and for monitoring thyroid function and hormone production, one or more of the following blood tests may be done:

    Additional tests may be used to detect autoantibodies directed against the thyroid and to help diagnose Hashimoto thyroiditis:

    • Anti-thyroid peroxidase antibody (anti-TPO, see Thyroid Antibodies) — this test detects the presence of autoantibodies against a protein found in thyroid cells. A high value usually indicates autoimmune damage to the thyroid due to disorders such as Hashimoto thyroiditis and Graves disease.
    • Antithyroglobulin antibody (TgAb) — if positive, may indicate Hashimoto thyroiditis; while thyroglobulin antibodies are often positive, they are not as sensitive or specific as anti-TPO so they are not routinely ordered.

    People with a very mild form of Hashimoto thyroiditis may not have thyroid antibodies present in their blood.

  • Treatment

    There is no cure for Hashimoto thyroiditis, but the disorder is manageable. No treatment is required when thyroid hormone concentrations (T4 and T3) are normal and the affected person is not experiencing significant symptoms. Thyroid hormone replacement therapy is typically necessary, however, when thyroid hormone production becomes significantly decreased and symptoms begin to emerge or worsen. Those with Hashimoto thyroiditis are closely monitored, and thyroid hormone replacement therapy is initiated and/or adjusted as necessary.

View Sources

NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

American Thyroid Association. 2014. Hypothyroidism. Available online at http://www.thyroid.org/wp-content/uploads/patients/brochures/ata-hypothyroidism-brochure.pdf through http://www.thyroid.org. Accessed April 3, 2015.

Clinical Thyroidology. 2014. Summaries for the Public from Clinical Thyroidology. Vol 7, Issue 9. Available online at http://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-7-issue-9/vol-7-issue-9-p-10-11/ through http://www.thyroid.org. Accessed April 3, 2015.

National Institute of Diabetes and Digestive and Kidney Diseases. 2014. Hashimoto's Disease. Available online at http://www.niddk.nih.gov/health-information/health-topics/endocrine/hashimotos-disease/Pages/fact-sheet.aspx through http://www.niddk.nih.gov/Pages/default.aspx. Accessed April 2, 2015.

U.S. Department of Health and Human Services. 2012. Hashimoto's disease fact sheet. Available online at http://www.womenshealth.gov/publications/our-publications/fact-sheet/hashimoto-disease.html through http://www.womenshealth.gov/index.html. Accessed April 2, 2015.

U.S. National Library of Medicine. October, 2014. Underactive thyroid: Deciding whether to treat subclinical hypothyroidism. Available online at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072784/ through http://www.ncbi.nlm.nih.gov/pubmedhealth/. Accessed April 3, 2015.

Sources Used in Previous Reviews

(2006 January). Hashimoto's Thyroiditis. Womenshealth.gov [On-line information]. Available online at http://www.4woman.gov/faq/hashimoto.htm through http://www.4woman.gov.

Hurd, R. (2006 May 12, Updated). Chronic thyroiditis (Hashimoto’s disease). MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000371.htm.

(© 2004). Hashimoto's Disease and Other Forms of Thyroiditis. Thyroid Foundation of America, AllThyroid.org [On-line information]. Available online at http://www.tsh.org/disorders/thyroiditis/hashimotos_disease.html through http://www.tsh.org.

(© 2004). Chronic Lymphocytic Thyroiditis (Hashimoto's Disease). Thyroid Foundation of America, AllThyroid.org [On-line information]. Available online at http://www.tsh.org/disorders/thyroiditis/chronic_lymphocytic_thyroiditis.html through http://www.tsh.org.

(2003 February 1, Revised). Thyroiditis. Merck Manual Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/print/sec13/ch163cj163d/html through http://www.merck.com.

Eckman, A. (Updated 2010 April 19). Chronic thyroiditis (Hashimoto's disease) MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000371.htm. Accessed November 2010.

(2009 May). Hashimoto's Disease. National Endocrine and Metabolic Diseases Information Service [On-line information]. Available online at http://www.endocrine.niddk.nih.gov/pubs/Hashimoto/ through http://www.endocrine.niddk.nih.gov. Accessed November 2010.

Lee, S. et. al. (Updated 2010 March 12). Hashimoto Thyroiditis. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/120937-overview through http://emedicine.medscape.com. Accessed November 2010.

Mayo Clinic Staff (2009 February 3). Hashimoto's disease. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/print/hashimotos-disease/DS00567/DSECTION=all&METHOD=print through http://www.mayoclinic.com. Accessed November 2010.

Meikle, A (Updated 2009 August). Autoimmune Thyroid Disease – Thyroiditis. ARUP Consult. [On-line information]. Available online at http://www.arupconsult.com/Topics/Thyroiditis.html through http://www.arupconsult.com. Accessed November 2010.

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