The Thyroid

The thyroid gland is the “master controller” of metabolism.

About Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis is an autoimmune disease in which the body’s immune system turns against itself and attacks the thyroid.1 This leads to the gradual, long-term destruction of the thyroid gland, and therefore insufficient levels of thyroid hormones.1 As the disease progresses, the thyroid may produce too few thyroid hormones, resulting in hypothyroidism.1

Who is at risk?

Hashimoto’s thyroiditis can affect any individual at any age, but mostly occurs in middle-aged women and people with a family history of thyroid disorders.1 Why the immune system attacks the thyroid gland is not yet known, but possible risk factors include viral or bacterial infection and having another autoimmune disease such as type 1 diabetes.2

Symptoms of Hashimoto’s disease

This disease can go unnoticed for a long time. In the course of the disease the thyroid gland can become exhausted, and you might develop hypothyroidism with symptoms such as:1,3

  • Fatigue and drowsiness and/or weakness
  • Cold intolerance
  • Difficulty concentrating or thinking
  • Depression
  • Weight gain
  • Enlarged neck or presence of goiter, which may be an early symptom, and, later in the disease, a small or shrunken thyroid gland
  • Abnormal menstrual periods with heavy/irregular menses
  • Constipation
  • Joint or muscle pain
  • Hair loss
  • Dry skin

How Hashimoto’s thyroiditis is diagnosed

People with Hashimoto’s thyroiditis often present symptoms of hypothyroidism, sometimes accompanied by the finding of a goiter.3 Symptoms alone are not a reliable proof of this disease. Blood tests are needed to make a valid diagnosis. If you have high levels of TSH in the blood and low levels of free T4 (thyroxine circulating freely in the blood) you probably have hypothyroidism.4 Antibodies against thyroid peroxidase, an enzyme involved in the production of thyroid hormones, are usually elevated in cases of Hashimoto’s thyroiditis.3

Treatment for the disease

If you are diagnosed with Hashimoto’s thyroiditis your doctor will prescribe thyroxine replacement hormone to treat this condition.1 Most patients with Hashimoto’s thyroiditis will require lifelong treatment with the appropriate medication.3 Finding the appropriate dose, particularly at the beginning may require testing with TSH every 6-8 weeks after any dose adjustment, until the correct dose is determined. After that, monitoring of TSH once a year is generally sufficient.3

Useful websites

Patient information on thyroid health published by the American Thyroid Association.

Patient information from Thyroid Federation International.

Therapiegebiete/Endokrinologische Erkrankungen/Schilddrüse/Broschüren „Ihr Hashimoto Ratgeber“ und „Ihr Basedow Ratgeber”

  1. Medline Plus. Chronic thyroiditis (Hashimoto’s disease). Available at Last accessed February 2022.
  2. Mayo Clinic. Hashimoto’s disease. Symptoms and causes. Available at Last accessed February 2022.
  3. American Thyroid Association. Hashimoto’s thyroiditis (lymphocytic thyroiditis). Available at Last accessed February 2022.
  4. British Thyroid Foundation. Thyroid function tests. Available at Last accessed February 2022.


Date of preparation: February 2022