Hashimoto’s Disease: Causes, Signs, Symptoms, Treatments

What exactly is Hashimoto’s disease? Perhaps you’ve been feeling tired all the time, and none of your usual ways to perk up are working anymore. Maybe you’ve been gaining weight despite having no appetite. Or, perhaps you’re having a hard time focusing and starting to feel depressed for seemingly no reason.

Hashimoto’s Disease, or Hashimoto’s thyroiditis, is a relatively common health condition that’s often diagnosed years after symptoms first appear.


Signs and Symptoms of Hashimoto’s Disease

Hashimoto’s Disease features a broad range of often nonspecific symptoms. This is why it can be difficult to get the correct diagnosis. A clear sign of Hashimoto’s Disease is an enlargement of the thyroid gland, much like the goiters seen in severe iodine deficiency.

Symptoms may include:

  • Fatigue, including poor exercise tolerance
  • Constipation
  • Weight gain
  • Little to no appetite
  • Slow speech or movements
  • Dry skin and dry hair
  • Slow heart rate
  • Cold body temperature

Pathology testing will often show that your thyroid hormones (T3 and T4) are low, but thyroid-stimulating hormone (TSH) is elevated, in your body’s attempt to correct the problem. Remember that having T4 and T3 levels at the low end of the normal range can still indicate an issue if you have symptoms.

You will also test positive for higher levels of anti-thyroid antibodies, a sign that the immune system is attacking your thyroid gland. It’s normal to have anti-thyroid antibodies below 34IU/mL, but a healthy immune system will remove any wayward cells before they can cause significant damage. Some people have no symptoms at all, only elevated antibodies.


What Causes Hashimoto’s Disease?

The difference between Hashimoto’s Disease and hypothyroidism caused by iodine deficiency is that it’s an autoimmune condition. If you have another autoimmune disease, where your immune system is already attacking another part of your body, you are at a higher risk of developing Hashimoto’s thyroiditis.

Age and Sex

Hashimoto’s Disease is up to ten times more likely to develop in women than men, because of a more powerful immune response. Although its frequency rises with age, diagnosis is most common between the ages of 30 and 50. This may suggest a link with perimenopause or menopause.

Genetic Risk Factors

If you have family members with Hashimoto’s Disease or other autoimmune conditions, you are more likely to develop the illness yourself. However, there are many possible gene variations that only contribute to your risk, and their interactions with your environment can be more important than your genetic profile. They include genes related to thyroid hormones and immune function.


Modern cancer treatments are increasingly shifting their focus to supporting the immune system’s natural ability to fight tumors. While they are less toxic than chemotherapy and radiation, some immunotherapies may, unfortunately, increase your risk of Hashimoto’s disease by turning off the “brakes” that prevent T cell activation. Only 5-10% of people given immune checkpoint inhibitors, such as Keytruda, develop autoimmune thyroid conditions.

Nutrient Deficiencies and Excesses

Nutrient deficiencies or excesses, including iodine, iron, and vitamin D, can contribute to the development of Hashimoto’s Disease, or worsen the condition. Keep in mind that everyone has different nutritional needs, and this is influenced by genetics. You may have higher requirements for certain vitamins and minerals, or be more prone to excessive intake. A Premium CircleDNA test can show you whether you have higher or regular requirements for a range of essential nutrients.


Iodine deficiency is the most common cause of hypothyroidism worldwide, but excessive intake can contribute to autoimmune thyroid disorders. This is because high levels of iodine can over-stimulate the immune system, impair immune regulation, and increase oxidative stress. My own CircleDNA test showed that I have higher iodine requirements, so this is less of an issue. If you need a regular amount of iodine but have a higher risk of Hashimoto’s Disease, consider your intake of iodized salt.


Your thyroid gland has a high demand for selenium, an essential trace mineral found in Brazil nuts. Population studies have found that people with similar genetic and environmental risk factors have half the risk of developing an autoimmune thyroid disorder if their blood levels of selenium are higher.

Vitamin D

Vitamin D, produced during sun exposure, is critical for healthy immune function. It suppresses autoimmune inflammation while supporting appropriate responses against infection, but Hashimoto’s disease may involve disrupted vitamin D absorption and metabolism.

Environmental Toxins

With thousands of artificial chemicals being invented and introduced to the world since the beginnings of the 20th century, there’s been a growing awareness of how much they affect our health. Environmental toxins that may contribute to your risk of Hashimoto’s disease include:

  • PCBs, found in some lubricants and coolers. These may increase TSH and anti-thyroid antibodies.
  • PBDEs, a type of flame retardant, which may raise your risk of Hashimoto’s disease.
  • BPA; once everywhere in plastics, it could interfere with thyroid hormone receptors.
  • Triclosan, found in some antimicrobial soaps.
  • Organochlorine pesticides, which can disrupt hormone metabolism.
  • Perchlorate and thiocyanate, found in rocket fuel and fertilizer.
  • Radiation from nuclear waste and medical interventions.

Home use, occupational exposure, and your local environment determine whether these are relevant to you. This includes whether you live around (conventional) agricultural land, chemical factories, or nuclear power plants.

Hashimoto’s Disease Treatment

Hashimoto’s Disease treatment plans work best when you combine pharmaceutical hormone replacement therapy and natural remedies.

Hormone Replacement Therapy

Hormone replacement therapy always features levothyroxine, a synthetic form of T4. Your body can convert this to T3, so many people may only need this. However, some don’t respond to T3 alone, and need a combination of T4 and T3. Others prefer desiccated thyroid extract as it is a natural source of the hormones.

Dietary Supplements

Research on selenium demonstrates better results if you are also taking levothyroxine. Across 16 trials, selenium supplementation reduced levels of anti-thyroid antibodies at all timepoints, while it only benefitted untreated volunteers in the short term. These benefits were partly thanks to selenium’s antioxidant properties, protecting the thyroid tissue from damage. It may also boost activity of regulatory T-cells.

A high proportion of people with Hashimoto’s disease have celiac disease or autoimmune gastritis, which contribute to iron deficiency. Hypothyroidism also directly impairs iron absorption, making deficiencies common. On the other hand, iron deficiency lowers thyroid function. Some women with persistent symptoms despite levothyroxine treatment see their remaining issues resolve once they start iron supplementation.

As for vitamin D, its benefits may be stronger if you take it alongside inositol, once known as vitamin B8. A recent clinical trial comparing them both alone and together found that only the women taking the combination supplement had lowered levels of TSH and higher rates of thyroid hormone production.

The Hashimoto’s Diet

Sometimes a good treatment is the Hashimoto’s diet. This diet for Hashimoto’s disease treatment is a modified Autoimmune Protocol. It’s similar to the Paleo diet but forbids nightshades, eggs, nuts, and seeds. Food sources of zinc, selenium, and magnesium are top considerations, alongside anti-inflammatory ingredients such as turmeric.

Perhaps the most important aspect of this diet is going gluten-free. Celiac disease, an autoimmune reaction to gluten, is 10 times more common among people with Hashimoto’s disease. Even if you don’t have any symptoms, such as diarrhea, bloating, and poor digestion, you may still benefit from a gluten-free diet. A study where women who only had anti-tissue transglutaminase antibodies (but no symptoms of celiac disease) went gluten-free for six months found significant benefit. Their levels of thyroid hormones also rose a little, while their anti-thyroid antibodies dropped significantly.

Avoid Soy

Soy products can contain antithyroid substances, which can impair the thyroid function you do have or make thyroxine less effective. In fact, a case study of a woman needing unusually high doses of levothyroxine revealed that she was taking a soy protein supplement immediately after each dose. It’s best to either separate levothyroxine from soy products by several hours or consider alternatives if you have persistent symptoms.

Stress Management

Stress is an unavoidable part of life, but how you manage it can protect you from the effects of chronically elevated stress hormones. A trial of an eight-week stress management program, introducing practices such as diaphragmatic breathing and guided imagery, found reduced levels of anti-thyroid antibodies. TSH levels also slightly fell.

But how did reducing stress work? First, acute stress can boost inflammation by disrupting normal cortisol rhythms. In the long-term, chronic stress can dysregulate the normal balance between different types of immune cells, which may worsen their attack on the thyroid gland.

Hashimoto’s Disease Treatment: Can Your DNA Test Help?

Although Hashimoto’s Disease has strong genetic risk factors, you mitigate your risk by getting a Premium CircleDNA test. Over 500 reports about yourself, based on your DNA, not only shed light on your genetic disease risks, but also on your unique nutritional requirements and detoxification rate. Better yet, we provide you with access to personalized advice, so you can take preventative action as soon as possible.


  1. Hypothyroidism (Nikita Patil et al.), https://www.ncbi.nlm.nih.gov/books/NBK519536/
  2. Hashimoto’s Thyroiditis (Renata Lorini et al.), https://pubmed.ncbi.nlm.nih.gov/16444160/
  3. Hashimoto Thyroiditis (Dana Mincer & Ishwarlal Jalal), https://www.ncbi.nlm.nih.gov/books/NBK459262/
  4. Environmental Exposures and Autoimmune Thyroid Disease (Gregory Brent), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935336/
  5. An update on the pathogenesis of Hashimoto’s thyroiditis (AP Weetman), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049926/
  6. Multiple Nutritional Factors and the Risk of Hashimoto’s Thyroiditis (Shiqian Hu & Margaret Rayman), https://pubmed.ncbi.nlm.nih.gov/28290237/
  7. The impact of vitamin D on thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity in myo-inositol-treated and myo-inositol-naïve women with autoimmune thyroiditis: A pilot study (Robert Krysiak et al.) https://pubmed.ncbi.nlm.nih.gov/35775148/
  8. The importance of nutritional factors and dietary management of Hashimoto’s thyroiditis (Paulina Ihnatowicz et al.) https://pubmed.ncbi.nlm.nih.gov/32588591/
  9. Use of soy protein supplement and resultant need for increased dose of levothyroxine (DS Bell & F Ovalle), https://pubmed.ncbi.nlm.nih.gov/11421567/Stress Management in Women with Hashimoto’s thyroiditis: A Randomized Controlled Trial (Zoe Markomanolaki et al.), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688766/

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