What happens in the body
The immune system produces antibodies against components of the thyroid. Over the years, thyroid cells are destroyed as a result, the organ scars and gradually produces fewer hormones.
Because this happens slowly, the body compensates for a long time. Many women only learn of their Hashimoto's through an incidental finding – or only once hypothyroidism makes itself felt.
At a glance
- What it is: an autoimmune disease of the thyroid – women are five to ten times more likely to be affected
- How it is detected: TPO antibodies and the typical ultrasound picture
- Course: often goes unnoticed for years and usually leads to hypothyroidism
- What we treat: the functional disorder, not the antibody level
- Trying to conceive: please tell us early – the target range is narrower then
- Appointment: book online or call us on +43 1 5333 654
Two forms of the disease
- the classic form with goitre, in which the thyroid initially enlarges
- the atrophic form, in which it shrinks – this is the more common form in Austria
At the outset there can even be a brief period of hyperthyroidism: as cells break down, stored hormone is released all at once. This phase is called hashitoxicosis, lasts a few weeks and passes on its own.
How we diagnose Hashimoto's
Three building blocks together make up the diagnosis:
- TPO antibodies in the blood, supplemented by Tg antibodies
- Ultrasound: the tissue appears darker and more uneven than in a healthy thyroid
- Function tests: TSH and fT4 show whether the thyroid is still producing enough
Incidentally, the antibody level says nothing about severity. A very high value does not mean you are worse off – and a falling value is not a treatment success. We treat the function, not the number.
Selenium, iodine and diet – an honest look
Selenium: Studies show that taking selenium can lower antibody levels. Whether it actually makes you feel better or improves the course of the disease has not been proven. We therefore do not recommend selenium across the board, but discuss it on a case-by-case basis.
Iodine: Normal amounts from your diet are safe and necessary. We advise against high-dose iodine supplements and seaweed products if you have Hashimoto's – they can adversely affect the course of the disease.
Diets: There is no special Hashimoto's diet. Anyone who also has coeliac disease must eat gluten-free; for everyone else the benefit has not been proven.
Living with Hashimoto's
As long as the thyroid is still producing enough, there is no treatment – we check once a year. If hypothyroidism develops, we replace the missing hormone with levothyroxine.
With well-adjusted levels, the vast majority of women with Hashimoto's lead a completely normal life: sport, travel, pregnancy, all without restriction. If you are planning a pregnancy, please tell us early – the target range is narrower then, see Thyroid and fertility.
Frequently asked questions
Can Hashimoto's be cured?
According to current knowledge, the autoimmune reaction itself cannot be reversed. However, the resulting hypothyroidism can be fully compensated – and that leaves you symptom-free. In practice, that is the decisive difference for most women.
I have antibodies but normal levels. Do I need to do anything?
There is nothing we need to treat. What makes sense is an annual check of TSH and fT4 so that we notice developing hypothyroidism early. If you are trying to conceive or are pregnant, we monitor more closely.
Can stress trigger Hashimoto's?
Stress alone does not cause an autoimmune disease. Stressful periods in life, infections or a pregnancy can, however, be the trigger that brings an existing predisposition to light for the first time.
Can I do sport with Hashimoto's?
Without restriction, once your levels are in the target range. With untreated hypothyroidism, exercise often feels laborious and unrewarding – that usually changes markedly once your medication is properly adjusted.