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Symptoms

By Mayo Clinic staff

Hashimoto's disease does not have unique signs and symptoms. The disease typically progresses slowly over a number of years and causes chronic thyroid damage, leading to a drop in thyroid hormone levels in your blood. The signs and symptoms are mainly those of an underactive thyroid gland (hypothyroidism).

The signs and symptoms of hypothyroidism vary widely, depending on the severity of hormone deficiency. At first, you may barely notice any symptoms, such as fatigue and sluggishness, or you may simply attribute them to getting older. But as the disease progresses, you may develop more-obvious signs and symptoms. Signs and symptoms of hypothyroidism include:

  • Fatigue and sluggishness
  • Increased sensitivity to cold
  • Constipation
  • Pale, dry skin
  • A puffy face
  • Hoarse voice
  • An elevated blood cholesterol level
  • Unexplained weight gain — occurring infrequently and rarely exceeding 10 to 20 pounds, most of which is fluid
  • Muscle aches, tenderness and stiffness, especially in your shoulders and hips
  • Pain and stiffness in your joints and swelling in your knees or the small joints in your hands and feet
  • Muscle weakness, especially in your lower extremities
  • Excessive or prolonged menstrual bleeding (menorrhagia)
  • Depression

Without treatment, signs and symptoms gradually become more severe and your thyroid gland may become enlarged (goiter). In addition, you may become more forgetful, your thought processes may slow or you may feel depressed.

When to see a doctor
See your doctor if you develop these signs and symptoms:

  • Tiredness for no apparent reason
  • Dry skin
  • Pale, puffy face
  • Constipation
  • Hoarse voice

You'll also need to see your doctor for periodic testing of your thyroid function if:

  • You've had thyroid surgery
  • You've had treatment with radioactive iodine or anti-thyroid medications
  • You've had radiation therapy to your head, neck or upper chest

If you have high blood cholesterol, talk to your doctor about whether hypothyroidism may be a cause. And if you're receiving hormone therapy for hypothyroidism caused by Hashimoto's disease, schedule follow-up visits as often as your doctor recommends. Initially, it's important to make sure you're receiving the correct dose of medicine. And over time, the dose you need to adequately replace your thyroid function may change.

References
  1. Davies, TF. Pathogenesis of Hashimoto's thyroiditis (chronic autoimmune thyroiditis). http://www.uptodate.com/home/index.html. Accessed Nov. 15, 2010.
  2. Frequently asked questions: Hashimoto's disease. US Department of Health & Human Services. http://www.4woman.gov/faq/hashimoto-thyroiditis.cfm. Accessed Nov. 15, 2010.
  3. Hashimoto's thyroiditis: Information for patients. American Association of Clinical Endocrinologists. www.aace.com/pub/thyroidbrochures/pdfs/Hashimoto.pdf. Accessed Nov. 15, 2010.
  4. Hashimoto's thyroiditis. American Association for Clinical Chemistry. http://www.labtestsonline.org/understanding/conditions/hashimoto-4.html. Accessed Nov. 15, 2010.
  5. Hashimoto's thyroiditis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec12/ch152/ch152d.html. Accessed Nov. 16, 2010.
  6. Ross DS. Treatment of hypothyroidism. http://www.uptodate.com/home/index.html. Accessed Nov. 16, 2010.
  7. Hashimoto's disease. The Hormone Foundation. http://www.hormone.org/Resources/Thyroid/loader.cfm?csModule=security/getfile&pageid=1113. Accessed Nov. 17, 2010.
DS00567 Feb. 3, 2011

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