30 Common Questions and Answers About Hashimoto’s Thyroiditis

Have you only recently been diagnosed with Hashimoto’s thyroiditis and still have many unanswered questions? Here we have compiled and answered the most frequently asked questions of new victims.

What is Hashimoto’s thyroiditis?

Hashimoto’s thyroiditis is   an autoimmune inflammation of the thyroid gland, named after the Japanese Dr. Hakaru Hashimoto (1881-1934) was named.

This disease is caused by certain autoimmune processes. It is also known as chronic lymphocytic thyroiditis or autoimmune thyroiditis.

Hakaru Hashimoto was a Japanese pathologist and surgeon in Japan and discovered autoimmune thyroiditis. He described it as a disease that primarily affects women going through the menopause.

Today we know that women of all ages can be affected. Men and children are not spared from this disease either.

What is an autoimmune disease?

With an autoimmune disease, it is always the case that the body attacks itself due to a misguided reaction of the immune system. In Hashimoto’s thyroiditis, the thyroid gland is attacked and decomposed over time due to a dysregulation of the immune system.

Is Hashimoto’s thyroiditis an underactive thyroid?

Hashimoto’s is not hypothyroidism. Hypothyroidism is merely a secondary disease or a symptom of Hashimoto’s disease, which is caused by the fact that the thyroid gland becomes smaller and smaller as the disease progresses and at some point can no longer produce the necessary hormones. In the long run, this inevitably leads to hypothyroidism.

What forms of Hashimoto’s thyroiditis are there?

Two forms of Hashimoto’s thyroiditis are known in current conventional medicine. The atrophic form, in which the thyroid gland becomes smaller as the disease progresses.

And the hypertrophic form, in which the thyroid gland enlarges steadily over time (goiter). Both forms of Hashimoto inevitably lead to hypothyroidism.

How long has Hashimoto’s thyroiditis been known?

In 1912, the discoverer of Hashimoto’s thyroiditis, Hakaru Hashimoto, published his  discovery of “lymphatic goiter ,” an enlarged thyroid gland with lymphomatous infiltration associated with hypothyroidism.

It was published in a medical journal in Germany. The disease was later named after him.

How common is Hashimoto’s thyroiditis?

The frequency of Hashimoto’s thyroiditis is currently around 10% of the total population and is therefore the most common autoimmune disease in humans worldwide.

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How is Hashimoto’s thyroiditis diagnosed?

One of the essential measures for making a diagnosis is taking a blood sample to determine the free thyroid hormones fT3 and fT4, TSH and thyroid antibodies.

In addition, a scan of the thyroid gland by the doctor and a sonography of the thyroid gland are essential. You can find more detailed information on diagnosing at: Diagnosing  Hashimoto correctly

How do I recognize an onset of hyperthyroidism?

An overactive thyroid can often be recognized by classic symptoms such as weight loss, restlessness, nervousness, diarrhea, sweating, trembling hands, high heart rate, palpitations and irritability.

You can find detailed explanations of the typical symptoms of an overactive thyroid under:  Symptoms of an overactive thyroid

When will my hormone needs change?

The need for thyroid hormones can change in many situations. The change of seasons or temperatures can require different dosages. But also sports , that age, pregnancy and weight changes due to diets or sports.

If you feel worse in winter than in summer or if you have started exercising and your strength is dwindling, the thyroid hormone levels should always be re-determined and the dosage corrected.

Is Hashimoto’s Thyroiditis Curable?

Hashimoto’s thyroiditis cannot be cured directly. However, many patients can lead a reasonably symptom-free life through treatment with L-thyroxine and other thyroid preparations.

However, not in all patients. They then have to deal with the corresponding secondary issues such as nutrient deficiencies, undiscovered food intolerances,  HPU ,  candida  and  incorrect nutrition  in order to feel better again

What is an endocrinologist?

Endocrinologists are doctors who study the different endocrine systems in the body. They have additional endocrine training and specialize in disorders of the hormone-producing organs.

What should I watch out for when visiting a doctor?

It is important that you have your blood results handed to you and file them carefully. This is the only way to permanently adjust the thyroid gland at a later date and the course of the adjustment can always be looked up and displayed.

All findings and doctor’s letters should also be kept in a separate folder.

It is also useful if you write down your questions in advance and take them with you to the doctor’s visit. Due to the nervousness when visiting a doctor, it happens again and again that important questions are forgotten.

Can I take immunostimulating drugs with Hashimoto’s thyroiditis?

Medications that stimulate the immune system should generally be avoided in Hashimoto’s thyroiditis. These include echinacea, purple coneflowers, and thymus supplements.

Since the immune system in Hashimoto’s patients is already working excessively, there is a possibility of increased production of thyroid antibodies. This would cause the disease to progress faster.

Is Hashimoto’s Thyroiditis contagious?

Hashimoto’s thyroiditis is not contagious. Neither through physical contact nor through blood infusions. The only risk of infection is through a bone marrow transplant.

Can I get vaccinated with Hashimoto’s thyroiditis?

That depends on the severity of the disease. Basically, protection against flu or other diseases with the help of vaccinations would make sense, especially when the immune system is already disturbed.

By disrupting the immune system, Hashimoto’s patients are more at risk of contracting an infectious disease. In this regard, it can make sense to get vaccinated if you have a mild form of Hashimoto’s thyroiditis.

If Hashimoto’s thyroiditis is in a severe form, vaccination is not advisable, since vaccination is always a challenge for the impaired immune system and its ultimate impact would be unclear. Therefore, vaccination should always be carefully weighed up with the doctor treating you.

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Can I smoke cigarettes with Hashimoto’s thyroiditis?

Smoking cigarettes usually has a very negative effect on the course of Hashimoto’s thyroiditis, since smoking cigarettes affects and suppresses the immune system. Also, the therapeutic measures in smokers usually have a worse effect.

Can I go to the sauna with Hashimoto’s thyroiditis?

It all depends on the general condition of the patient. If the patient is not yet properly hormonally adjusted and is underactive, it may be that the circulation in the sauna weakens. That’s why you should always have someone with you when you visit the sauna for the first time.

If, on the other hand, the patient has no complaints in the sauna and is also hormonally well adjusted, there is nothing to be said against a visit to the sauna, as this promotes the body’s own detoxification and strengthens the immune system.

But the main thing is that the patient feels comfortable in the sauna. However, sauna sessions longer than 15 minutes are not recommended

Can I donate blood with Hashimoto’s thyroiditis?

Hashimoto patients are not allowed to donate their blood for transfusion to other people because the antibodies in the blood could be transferred to other people. This has not been proven, but for safety reasons one prefers to refrain from doing so. Blood donations are of course permitted for scientific purposes.

Can I exercise with Hashimoto’s thyroiditis?

Regular, moderate physical exercise has a beneficial effect on the body and does not conflict with Hashimoto’s disease. Excessive exercise , on the other hand, means stress for the body and is not conducive to the course of the disease in Hashimoto’s thyroiditis. This also applies to the phase of complete freedom from symptoms.

Since many Hashimoto’s patients also suffer from adrenal fatigue, extreme exercise also worsens the constant levels of cortisol and creates other ailments. It is important to explore your personal stress limit during sport and, if possible, not to exceed it.

Can I get a severely disabled pass with Hashimoto’s thyroiditis?

You can apply for a disability certificate at the responsible pension office. However, you must expect difficulties from the authorities here, since the recognition of a particular health impairment in the context of an autoimmune disease is assessed individually and the stubbornness of the authorities in such cases is well known.

In any case, a written statement from the doctor treating you or a specialist in Hashimoto’s thyroiditis is always helpful when applying for a disabled person’s pass.

Read detailed information on severe disability and Hashimoto’s thyroiditis here

Can I apply for early retirement with Hashimoto’s thyroiditis?

If there is “only” Hashimoto’s thyroiditis, an application for a pension is usually rejected in Germany. Even if this disease leads to a permanent impairment of the ability to work.

However, in cases where Hashimoto’s thyroiditis is associated with other autoimmune diseases, a pension procedure can be positive.

What is goiter?

Goiter is an abnormal enlargement of the thyroid gland. However, this term is not limited to autoimmune diseases. Goiter is not a diagnosis, just a description of an oversized thyroid. Goiter often develops with a long-lasting iodine deficiency.

But goiter can also develop as a result of autoimmune diseases. A goiter of a certain size puts pressure on the surrounding tissue, leading to a lump in the throat.

How big is a healthy thyroid?

The size of the thyroid is always given as a volume in milliliters. During an ultrasound examination (sonography), the doctor can measure the thyroid gland and calculate the volume. The volume of the thyroid depends on various factors.

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Gender, age and body size play a decisive role here. Children between the ages of 4-14 usually have a thyroid volume of 3-10 ml. Adult women, on the other hand, have about 13-18 ml. Men are usually around 15-25 ml.

What thyroid medications are available for Hashimoto’s thyroiditis?

In the field of synthetic thyroid hormones, the following preparations are available in Germany:

T4 preparations

  • Euthyrox® 25µg / 50µg / 75µg / 88µg / 100µg / 112µg / 125µg / 137µg / 150µg / 175µg / 200µg / 300µg
  • L-Thyroxin® Henning® 25µg / 50µg / 75µg / 100µg / 150µg / 175µg / 200µg / 300µg
  • Berlthyrox® 50µg / 100µg / 150µg
  • Eferox® 25µg / 50µg / 75µg / 100µg / 125µg / 150µg / 175µg
  • L-Thyroxin® Henning® depot contains 1mg levothyroxine sodium
  • L-Thyrox® Hexal® 25µg / 50µg / 75µg / 88µg / 100µg / 112µg / 125µg / 137,5µg / 150µg / 175µg / 200µg
  • L-Thyroxin beta® 25µg / 50µg / 75µg / 100µg / 125µg / 150µg / 175µg
  • L-Thyroxin HF® 50µg / 75µg / 100µg / 125µg
  • L-Thyroxin Aristo® 25µg / 50µg / 75µg / 100µg / 125µg / 150µg
  • L-Thyroxin ratiopharm® 50µg / 100µg
  • L-Thyroxin Hexal® 88µg / 112µg
  • L-Thyroxin AL® 50µg /10 µg

T3 preparations

  • Thybon® 20µg / 100µg
  • Trijodthyronin® BC 50µg

T3 + T4 combination preparations

  • Novothyral100® / Novothyral75® ratio 5:1, available in the dosages 100µg T4 + 20µg T3 / 75µg T4 + 15µg T3
  • Prothyrid® in a 10:1 ratio, available in a dosage of 100µg T4 + 10µg T3

In addition to the synthetic hormones, there are also natural thyroid hormones that are extracted from the thyroid glands of pigs or cattle. These are usually much more tolerable and effective. I will soon add various manufacturers here.

What do I have to consider when planning a pregnancy with Hashimoto’s thyroiditis?

Pregnancy is more likely when the thyroid is properly regulated. The maturing of an egg cell is disturbed by too high or too low thyroid values.

Therefore, all thyroid values ​​should be in the normal range so that nothing stands in the way of pregnancy .

Which blood values ​​do I have to have checked during pregnancy?

The most important parameters are the free thyroid values ​​fT3, fT4 and the TSH. These should be checked every 4 weeks during pregnancy in order to be able to make any necessary dose adjustments, as hormone requirements can often increase significantly during pregnancy.

These values ​​should also be kept in mind after pregnancy, as the need for hormones decreases and the dose of thyroid hormones has to be adjusted.

The TSH receptor antibody levels should also be determined regularly. If these antibodies rise, the child should be closely monitored with ultrasound and cardiac recordings

How does Hashimoto’s thyroiditis affect a newborn child?

Persistent hypothyroidism in the mother can lead to reduced intelligence in the newborn child. Persistent maternal hyperthyroidism can result in miscarriage, birth defects, and failure to thrive.

Can Hashimoto’s thyroiditis be inherited?

Although it is possible for the child to pass on Hashimoto’s thyroiditis, it is not necessarily the rule. However, women who suffer from multiple autoimmune diseases are much more likely to be inherited.

Can Hashimoto’s thyroiditis also affect the brain?

In extremely rare cases, Hashimoto’s thyroiditis can occur in combination with an inflammatory brain disease. In this so-called Hashimoto’s encephalopathy, there are increased psychiatric and neurological symptoms. These include, above all, depression, hallucinations, confusion and delusions.

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