What Is Hashimoto’s Disease, And How Can You Test For It?

Do you toss and turn a lot more at night than usual—unable to drift away to the land of Nod as easily as you could before? Is your skin drier and more scaly than normal? Or do you, perhaps, experience unrelenting fatigue—so getting through the day feels like a constant battle against tiredness? If so, you might be witnessing a few of the warning signs of Hashimoto’s disease, or Hashimoto’s thyroiditis—which a thyroid blood test may help assess for.

Our at-home Thyroid Test lets you check your thyroid hormone levels—from the convenience of home—to see if you have an imbalance. From there, your healthcare provider may conduct further tests to determine if a Hashimoto’s thyroiditis diagnosis is appropriate. (Note that diagnosing Hashimoto's disease requires a physician's evaluation of symptoms as well as laboratory test results, so test results alone aren’t enough for a Hashimoto diagnosis.)

What is Hashimoto’s disease?

Hashimoto’s disease is a condition that affects your thyroid gland, which can result in a variety of troubling symptoms. This autoimmune thyroid disorder all starts with your immune system and can impair your thyroid function.

How does this autoimmune disorder affect the body?

The immune system is—most of the time—an impressive line of defense for the body. It protects you from would-be lethal microbes and other dangerous particles. But in people with autoimmune diseases, the immune system can mistakenly attack the body instead of defending it. And certain autoimmune diseases target the thyroid gland. (Wondering what the thyroid does? The thyroid gland is a part of the body that is essential for your well-being because it produces key hormones that help regulate critical body functions like metabolism). One of those autoimmune disorders is Hashimoto disease (mentioned above)—and it is the main cause of hypothyroidism in the United States. Hypothyroidism is a condition in which the thyroid gland is underactive and doesn’t produce enough thyroid hormones.

Having an autoimmune thyroid problem is most prevalent in women—at least 10 women have Hashimoto’s disease for every man that does—and is most common in middle-aged women. The cause of Hashimoto’s disease isn’t fully understood—this autoimmune disease is likely caused in part by genetics, but other factors may play a role, as well.

Risk factors associated with hashimoto’s thyroiditis

In addition to sex, age, and genetics, the following factors may put you at a higher risk for Hashimoto’s disease:

  • Pre-existing autoimmune diseases: Having other autoimmune diseases, such as celiac disease, type 1 diabetes, or rheumatoid arthritis, can put you at a higher risk of developing Hashimoto’s.
  • Pregnancy: Pregnancy can trigger thyroid problems such as postpartum thyroiditis or Hashimoto’s disease due to fluctuations in hormones and the immune system.
  • Too much iodine: Excessive iodine intake, commonly via dietary supplements, has been linked to increased risk of Hashimoto’s disease, though further research is needed to understand the connection between the two.
  • Exposure to radiation: The thyroid gland is known to be particularly vulnerable to radiation, causing those exposed to radiation to carry a much greater risk of thyroid disease.

If you have Hashimoto’s disease, your immune system slowly damages your thyroid tissue—impairing the function of this vital body part. But this is one sneaky-and-insidious disease: the destruction of your thyroid doesn’t happen all at once, so it might take time before you notice any symptoms. However, symptoms will usually surface eventually, so read on to discover what these symptoms are—as well as how Hashimoto disease can be detected.

What are the symptoms of Hashimoto’s thyroiditis?

Some of the very earliest Hashimoto’s symptoms resemble those of hyperthyroidism – where your thyroid ejects too many thyroid hormones into your bloodstream (giving your body high thyroid hormone levels). Why are symptoms of hyperthyroidism (or an overactive thyroid) often the first to occur if you have Hashimoto’s disease?

Here’s the reason why: as parts of the thyroid gland are destroyed, it leaks out an excess amount of thyroid hormones. Thus, your bloodstream can be initially flooded with thyroid hormones – resulting in hyperthyroidism symptoms.

These symptoms include, for example, heightened anxiety or nervousness, an irregular heartbeat, and more sensitivity to heat. You might find, too, that it’s really, really hard for you to fall asleep at night.

But then, these symptoms of hyperthyroidism disappear – which might seem to be a stroke of luck! Remember, though, this thyroid disease is insidious and crafty – and not to be underestimated. Indeed, the reason why these hyperthyroidism symptoms go away is quite disturbing: your thyroid has been so damaged by the disease that it is no longer producing any hormones (or very little amounts). And when the thyroid has reached that state, another onslaught of symptoms appear – mirroring, this time, the symptoms of hypothyroidism.

Untreated hypothyroidism is a condition in which your thyroid can’t produce enough hormones – disrupting your body’s metabolic balance. This difference in hormone production is the key distinction between hyperthyroidism vs. hypothyroidism.

When caused by this autoimmune thyroid disease, symptoms of an underactive thyroid can initially include a feeling of perpetual tiredness (and those early-morning cups of coffee can’t so easily kick this fatigue to the curb), constipation, weight gain, and drier, more scaly skin than usual. If you continue having a thyroid hormone deficiency, symptoms can worsen.

As your body begins facing the full brunt of an underactive thyroid gland, you can develop symptoms like cold sensitivity, hearing loss, a hoarse voice, loss of energy, and hair loss. Also, your nails might become much more brittle – chipping easily under circumstances they normally wouldn’t have. When you don’t have enough thyroid hormone, you could experience joint pain and muscle weakness – as well as depression. You can even have slowed speech and a loss of good muscle coordination. High blood pressure can also occur as a result of the hypothyroidism induced by Hashimoto’s disease.

When to Seek Treatment

This all sounds rather alarming – without a doubt – so it’s best to stop Hashimoto thyroiditis in its tracks as soon as possible, before it continues its ruthless rampage against your thyroid. But Hashimoto’s disease must first be detected before it can be tackled and treated. Fortunately, this form of thyroid dysfunction leaves clues in your blood – clues that take the form of distinct molecular markers (which may be identified with a home Thyroid Test).

Detecting Hashimoto’s thyroiditis

Thyroid hormones and TSH

If you’re in good health – no Hashimoto’s disease getting in the way of your well-being, for example – then your thyroid will secrete hormones in response to signals from another hormone: thyroid-stimulating hormone, or TSH. TSH circulates in your blood; high thyroid-stimulating hormone levels tell your thyroid that the body needs more thyroid hormones – and the thyroid then proceeds to fill your blood with its hormones. These hormones, in turn, communicate with different parts of your body – which allows your body to carry out a vast number of coordinated, balanced metabolic processes.

But if and when Hashimoto’s autoimmune thyroiditis comes along – and “eats” away at your thyroid and destroys thyroid cells – your body will ultimately have a dire lack of thyroid hormones, potentially resulting in chronic thyroiditis. So, in response, TSH levels shoot up – the body’s desperate attempt to tell the thyroid that you aren’t getting enough of its important hormones. Thus, if you have Hashimoto’s disease, you’ll have low thyroid hormone levels and elevated levels of TSH.

However, this is typical of hypothyroidism in general – which can also result from iodine deficiency, among other factors – so detecting Hashimoto’s disease requires looking for another marker, as well. That marker is the thyroid peroxidase antibody, or TPOab.

If you’re checking thyroid levels and increased levels of this thyroid antibody are detected—along with high TSH and low thyroxine (T4) levels—it may be an indication of Hashimoto's thyroiditis. If a physician determines that a Hashimoto diagnosis is appropriate, they may recommend thyroid medication and/or thyroid hormone replacement therapy to treat the condition.

Thyroid peroxidase antibodies (TPOab)

Thyroid peroxidase antibodies (TPOab) are key signs of Hashimoto’s disease. Why? Because if you have this thyroid disease, the immune system uses these thyroid antibodies – TPOab – to attack the thyroid gland. So if these thyroid antibodies are detected in your blood – with the Everlywell home Thyroid Test, for example – along with low thyroid hormone levels and high TSH levels, there’s a strong likelihood that you may have this autoimmune condition.

(Of course, if you have symptoms of Hashimoto’s disease and/or have abnormal thyroid test results, consult your healthcare provider for a thorough evaluation to determine if a Hashimoto’s thyroiditis diagnosis is right for you.)

Are thyroid problems genetic?

What are the potential early signs of thyroid problems?

Causes of thyroid problems


1. Mincer DL, Jialal I. Hashimoto Thyroiditis. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: URL

2. Chung HR. Iodine and thyroid function. Ann Pediatr Endocrinol Metab. 2014 Mar;19(1):8-12. doi: 10.6065/apem.2014.19.1.8. Epub 2014 Mar 31. PMID: 24926457; PMCID: PMC4049553.

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