How Hashimoto’s Symptoms change over time

How Hashimoto’s Symptoms Change Over Time

Hashimoto’s symptoms can vary drastically from person to person. 

Couple that with the fact that the symptoms of Hashimoto’s disease change through time and can “flare” due to certain triggers making the disease even more difficult to diagnose and manage.

It turns out that your symptoms may be telling you something about your body and can help you determine the source and cause of your Hashimoto’s disease.

Managing and treating the autoimmunity and inflammatory aspect of Hashimoto’s is critical for reducing these symptoms.

Let’s dive in:


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Progression of Symptoms in Hashimoto’s Patients

Hashimoto’s and autoimmune thyroiditis should be differentiated from other causes of hypothyroidism. 


Because autoimmune thyroiditis should be treated differently.

While it’s true that some patients with Hashimoto’s and autoimmune thyroiditis may need thyroid hormone replacement, this statement is not true for ALL patients with this disease. 

Instead of focusing on the thyroid hormones and values, your focus should instead be on the autoimmunity and inflammatory component.

Autoimmunity indicates a deeper problem in the body.

The inability to recognize self from non-self, and an imbalance in the immune system.

This component is usually triggered by various factors (usually a combination of factors that we will discuss later) that results in the dysregulation of this system.

a long list of warning signs of hashimoto's with the background of a coconut.

Physiologically this causes a variety of symptoms ranging from general and diffuse non-specific symptoms to alternating symptoms of both hypothyroidism and hyperthyroidism. 

These issues result in a disease that can be both difficult to diagnose and manage (unless your provider knows to be looking for it). 

In fact, many patients with hypothyroidism likely have some component of autoimmune thyroiditis – they just have never been diagnosed.

  • Bottom line: The symptoms of Hashimoto’s and autoimmune thyroiditis differ from hypothyroidism due to both the inflammatory and autoimmune components of this disease. These two factors change how Hashimoto’s should be managed. 

Fluctuations in TSH and T4 Over Time

Many of the symptoms of Hashimoto’s can be traced back to 2 main areas:

We will talk about both and how they can impact your symptoms:

You can see an example below of how both TSH and FT4 can fluctuate throughout time: 

a graph which shows TSH levels and free t4 levels over time in a patient with hashimoto's.

The blue line represents FT4 which you can see varies as much as 6 times between laboratory results. 

The FT4 level tends to be inversely proportional to the TSH (meaning as FT4 level increases the TSH level decreases). 

The TSH in the pink line varies from episodes of hypothyroidism (high levels of TSH) to nearly suppressed levels (episodes of hyperthyroidism) throughout time.

This variance in thyroid hormone levels can often trick both patients and providers which results in constant changes to thyroid hormone and various symptoms in the patient.

When in reality the focus should be on the autoimmune and inflammatory components and NOT the thyroid hormone themselves.

It’s easy to see how thyroid hormone levels directly impact your symptoms so we will move to the second factor which is changes in your inflammatory markers. 

Inflammatory changes cause a variety of symptoms related to your thyroid and related to other hormone systems in the body. 

Inflammation by itself can cause a reduction in T4 to T3 conversion (1) (leading to worsening symptoms of hypothyroidism). 

Inflammation can also potentiate insulin resistance (2) and make adrenal function worse.

These changes may lead to symptoms such as weight gain (3), fatigue, and neurological symptoms that may complicate or worsen existing hypothyroid/hyperthyroid-like symptoms. 

Your inflammatory status can be measured and tracked by checking non-specific markers in the blood including: 

  • Erythrocyte sedimentation rate (ESR)
  • C reactive protein (CRP)
  • Ferritin
  • Thyroid antibodies and other antibody levels

The elevation of these markers (while not specific) indicates dysfunction in the body and may make the symptoms of Hashimoto’s worse. 

Now let’s discuss how these two component changes and alter the progression of the symptoms of Hashimoto’s over time…

  • Bottom line: The combination of inflammation and autoimmunity cause variations in thyroid function and other hormone function in the body. This is part of the reason that this disease causes symptoms to change over time. 

Generalized and non-specific symptoms -> Symptoms start here

The symptoms of Hashimoto’s usually start out as minor diffuse fatigue. 

Because of these symptoms, it can be difficult to pinpoint where your symptoms are coming from.

You may present with a mild weight gain of 5-10 pounds, or maybe just some mild fatigue.

The issue is that most patients know that something is “off” in their body, but when they go to their physician they usually undergo “standard” lab tests that don’t identify the problem.

Or worse, the provider will identify the presence of antibodies like anti-TPO thyroid antibodies but take the “wait and see” approach to management.

The symptoms generally start out somewhat mild due to the low-grade inflammation and autoimmunity that is present. 

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At this point there isn’t usually significant damage to the thyroid gland, so most damage at this point is reversible if treated correctly.

It also means that undergoing treatment at this point is critical.

Because any treatment you can do to help lower the inflammation and autoimmunity will go a long way to helping reduce long-term thyroid damage and reliance upon thyroid hormone later in life.

How Hashimoto’s symptoms start:

  • General fatigue or sensation of being “run-down”
  • Mild weight gain(usually 5-10 pounds)
  • Flat affect or depressed mood, not feeling like yourself
  • Mild difficulty with concentration or inability to focus
  • Dry skin, cracked lips, dry & brittle hair, non-specific rashes or patches on the skin
  • Mild constipation
  • Mild fluid retention(especially in the face and lower extremities)
  • Voice hoarseness or sensation of a “swollen throat”
  • Reduction in sweating or inability to sweat
  • Mild joint pain or muscle aches
  • Mild to moderate changes to the menstrual cycle including irregular cycle and/or reduced/increased flow

If you are experiencing any of the symptoms listed below make sure to get your antibody levels checked, and not only that but continue to follow them as you undergo treatment.

This will help to determine if you are on the right track.

This is only the start of the symptoms of Hashimoto’s however, and symptoms may fluctuate between hyperthyroidism and hypothyroidism which I will go over below. 

  • Bottom line: The initial symptoms of Hashimoto’s tend to be vague and diffuse making the diagnosis difficult. Treatment at this early stage is critical, however, because you can prevent long-term reliance upon thyroid hormone later in life if you can stop the damage early. 

Progression through hyperthyroidism and hypothyroidism

Many patients, unfortunately, can go years (or decades) without a diagnosis of Hashimoto’s or autoimmune thyroiditis. 

During this time some patients will experience swings or episodes of hyperthyroidism followed by episodes of hypothyroidism.

This can occur as a result of the damage done to the thyroid gland by thyroid antibodies.

As antibodies attach to the thyroid gland your body will react in turn with an inflammatory response that may damage or injure the thyroid gland.

The thyroid as a gland has the job to release hormones under a stimulus. And this stimulus can be triggered by the damage and cause a “flush” of thyroid hormones to be released from the body. 

This flush can temporarily trigger symptoms of hyperthyroidism which can make symptoms worse (especially if the patient is already on thyroid medication).

Symptoms that mimic episodes of hyperthyroidism or a “flush” of thyroid hormones in the bloodstream/body: 

  • Hot flashes or episodes of heat intolerance
  • Mood changes, typically on the anxiety spectrum
  • Jittery sensation or sensation of “too much energy”
  • Fatigue or episodes of energy swings(up and down)
  • Difficulty sleeping or episodes of insomnia
  • Facial flushing or sensation of warm extremities
  • Heart palpitations or sensation of a racing pulse(usually episodic and at night but can occur at any time throughout the day)
  • Weight loss/weight gain accompanied by changes in appetite

These symptoms do not occur in every patient, however. 

Some patients just have a chronic and continuing decline in thyroid hormone throughout time, but some experience these episodes of “ups” and “downs”.

It’s important to realize that the presence of these symptoms may also indicate antibodies that directly stimulate the release of thyroid hormone from the body (it isn’t always caused just by the inflammatory component).

  • Bottom line: The inflammatory component of Hashimoto’s may trigger a “flush” or release of thyroid hormones into the bloodstream which may manifest as hyperthyroid-like symptoms. During these episodes, your free thyroid hormones will be elevated and your TSH will drop. 

Overt Hypothyroidism

Over time, if not treated, most patients will eventually develop symptoms of hypothyroidism. 

As antibodies remain elevated (and untreated) in the blood for long periods of time, thyroid glandular damage (4) will accumulate.

Once this point reaches critical mass you will eventually lose endogenous production of thyroid hormone.

This is usually the point where your symptoms progress and continue to worsen all of a sudden over a 1-2 year period.

Once patients get to this stage they may ultimately require lifelong use of thyroid hormone replacement due to this glandular damage.

The symptoms experienced at this stage generally mimic hypothyroidism but many patients still have lingering “general and diffuse” symptoms from the autoimmune component.

Hypothyroid symptoms due to glandular damage in Hashimoto’s patients:

  • Extreme fatigue and/or exhaustion
  • Moderate weight gain (20-30+ pounds usually gained over a 6-12 month period)
  • Hair loss, hair thinning, and/or hair breakage
  • Changes to mood, usually on the depression spectrum
  • Menstrual irregularities and other conditions like PMS/PMDD
  • Chronic and debilitating muscular and/or joint pain
  • Chronic and daily constipation, development of other GI issues like gas/bloating, acid reflux, low stomach acid, and SIBO/SIFO
  • + any other generalized symptoms above
  • Bottom line: Once the damage has accumulated the thyroid may become permanently damaged leading to reliance upon thyroid hormone replacement. These symptoms generally match symptoms of hypothyroidism from other causes. 

Symptoms of Hashimoto’s Flare-up

At some point in time, you may also experience what I refer to as a Hashimoto’s “flare-up”. 

These flare-ups usually result from some sort of “trigger”.

We’ve already discussed how the immune system and inflammatory cascade in your body are dysregulated when you have Hashimoto’s or autoimmune thyroiditis in the previous section but what we didn’t talk about is how sensitive the immune system really is.

Due to these problems, your immune system is hyperexcitable.

Meaning that small changes may result in a cascade effect causing multiple downstream effects.

This cascade is usually responsible for the symptoms of a “flare-up”.

Symptoms of a Hashimoto’s flare-up include:

  • Abrupt worsening of fatigue
  • Usually weight gain from an unclear source without changing your diet or food intake(rarely some patients do experience some weight loss)
  • A general feeling of weakness or malaise
  • Abrupt worsening of joint pain/muscular pain
  • Racing heart, jittery sensation, or feeling an uncomfortable “rush”
  • Abrupt onset of brain fog, difficulty concentrating, or inability to focus on difficult tasks
  • Changes to GI function
  • Some patients may experience acute symptoms of Hyperthyroidism(see list above)
  • Some patients may experience acute symptoms of Hypothyroidism(see list above)

While flare-ups may differ dramatically from person to person, it’s important not to focus on the symptoms necessarily but instead on what they mean for your body. 

During a “flareup” both your immune system and inflammatory system have been triggered and you may be damaging your thyroid.

It’s important to find the eliminate the cause of whatever triggered this event.

Manage flare-ups by managing inflammation and finding the source

Since finding the source of the flare-up is so critical I’ve included several possible factors that can all influence Hashimoto’s symptoms and trigger a “flare-up”. 

List of Hashimoto’s flare-up sources:

a list of endocrine disruptors, an example of where they come from, and their mechanism of action on the thyroid.

You will notice that many of these sources of flare-ups can also be potential triggers of the autoimmune disease itself. 

This makes sense because you can trigger Hashimoto’s with emotional stress and then make the disease worse by introducing another trigger/flare-up source. 

For these reasons I always recommend that patients take a comprehensive approach to managing their Hashimoto’s to eliminate the increased risk of making their disease worse.

If you focus on and treat multiple problems at once then your results will be better and you will have less risk for a flare-up. 

You can find information on how to reduce your antibody levels here, and you can find more information on how to manage other triggers of Hashimoto’s in this post.

Recap & Final Thoughts

Hashimoto’s disease should be differentiated from other causes of hypothyroidism because of the inflammatory and autoimmune component that accompanies it. 

Addressing both of these components is required for optimal treatment.

On the other hand, the symptoms of Hashimoto’s tend to differ drastically from other causes of hypothyroidism from these components as well.

This results in various symptoms ranging from diffuse and generalized symptoms to “flushes” of thyroid hormone causing hyperthyroidism and ultimately hypothyroidism if the disease progresses enough.

Some patients will also experience flares throughout the course of their disease which can be managed by eliminating the source.

Now it’s your turn:

Do you have Hashimoto’s or autoimmune thyroiditis?

Do your symptoms follow the “textbook”?

Have you experienced a flare before? If so what were your symptoms?

Leave your comments below!











a woman's bare neck under emphasizing the thyroid gland under text that states "Hashimoto's flare up symptoms and triggers".

picture of westin childs D.O. standing

About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 80,000+ people have used them over the last 7 years. You can read more about my own personal health journey and why I am so passionate about what I do.

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144 thoughts on “How Hashimoto’s Symptoms Change Over Time”

  1. I was recently diagnosed with Hashimoto’s and am still working to figure out exactly what that means. It is comforting to know that I am not crazy but disheartening and depressing, especially when I am experiencing a flare up and no one around me understands why I feel so horrible. The most recent flare up has resulted in a severe migraine-like headache, upper body aches all over shoulders and neck area, so much so it hurts to breathe. My face and eyes burn like I have a fever, but none is present, I alternate between chills and hot flashes, and did I mention my head hurts…? I feel like my brain is foggy and it is more difficult to see because of the tightness in my head. Depression has increased mainly because my husband still thinks I am crazy and that my attempts at a Paleo diet are just a fad and will garnish no real results. I think this flare up was triggered by a stupid moment of weakness and one dinner with bread and pasta. Lesson learned… but is it? I have such food anxiety right now I am not sure what to eat anymore. I struggle tremendously with making sure I have the right foods to eat in the morning especially.

      • My Hashimotos number was 640. Many stress factors caused this I believe. But I wondered if sun stroke could ever be a culprit? I know after I got too hot now I can’t regulate my temp. And during this stressful time I had a flare up that gives me even a low grade fever. It’s not Covid I’m pretty sure. Trying to protect myself because I don’t know what this will do to my body if I get it. Thank you in advance

        • I know if I get sunburned the inflammation will cause a Hashimoto flare so I always make sure I have plenty of sunscreen and a umbrella or wide brim hat.

    • I experience the same symptoms when I have flare ups. For years I would go through this, feels like a terrible hangover, and my husband and I couldn’t understand it. I suffered from migraines and symptoms would come on every couple weeks after prolonged stress and put me out for a few days at a time. Before I was recently diagnosed with Hashi’s, I just thought I was a typical migraine sufferer and discovered histamine intolerance and inflammation as a possible cause through my own research and experimented with a low histamine diet ( was a godsend) which helped prevent flare ups tremendously (still had flare ups, but only occasionally rather than as frequently), although at the time I never understood why exactly. Makes perfect sense now though! My husband is still trying to understand but is coming around now that I have the hashi’s diagnosis. Good luck to you as you navigate through this tricky condition!

    • Jennifer
      Being told you are “crazy” has got to be the worst part of this disease. My relationships have suffered severe damage as a result of an extended hyperthyroid episode. My endocrinologist recommends I follow a paleo diet. I was surprised by this because he is an otherwise conventional practitioner. I am now taking Low Dose Naltrexone to address the autoimmune component along with my ever fluctuating doses of thyroid hormone replacements.

    • For years I have had same symptoms. Going to a neurologist, rheumatologist, and an endocrinologist. Endocrinologist just diagnosed me with Hashimoto’s but thyroid levels are “within range” so her approach is to wait. Wait for what? For my thyroid to be destroyed. Painful migraines, neck pain, I am petite and lost 25 lbs in 6 weeks and no doctor could figure out why. One said virus! So I feel like crap, extreme temperature fluctuations, lethargy, and frustration. Email if you want to talk.

      • Hello Jane! I was recently diagnosed with Hashimotos also… I’ve had my thyroid tested through out the years because symptoms I was presenting to my doctor pointed to a thyroid issue however they all came back fine. Recently I went in because my mother felt that my thyroid looked swollen to her, after 2 ultra sounds & a biopsy they have discovered I have Hashis. My physician suggested we wait & after my next biopsy in three months we take another look!! After researching Hashis I’m trying to figure out why they are choosing to wait! For years I’ve been showing signs that my thyroid is out of balance & from what I’ve learned it’s in an advanced stage, most likely irreversible damage has already been done. I’m also concerned that if a biopsy is the only way they could figure this out will I have to get a 3rd biopsy if they start me on medication?!? I’m just so frustrated & want to get back to myself again! This past 8 years I’ve gained so much weight & have missed out on life with feelings of fogginess, depression, migranes & just down right feeling tired and weak. I can relate to your frustrations!

        • Hi Kim,
          I read your comments left on a Hashimoto’s article that was posted a few years ago. I was just recently diagnosed and also have thyroid levels that are “in range.” I’m suffering from many different symptoms and would like to know if you ended up having any results since the last time you posted. Thank you so much for any response! Best of luck to you!

      • Hi Jane,
        I read your comments left on a Hashimoto’s article that was posted a few years ago. I was just recently diagnosed and also have thyroid levels that are “in range.” I’m suffering from many different symptoms and would like to know if you ended up having any results since the last time you posted. Thank you so much for any response! Best of luck to you!

      • Ohhhh my goodness this is something!
        I got Covid, my asthma was triggered, I lost 25 pounds from March and constantly nauseous!
        Have the migraines too! However I sometimes feel stifled in the neck. I have been using my asthma pump since March and my Asthma Dr. can’t figure out if I’m taking all these different pumps why do I keep saying there is something still not right with my breathing.
        Endocrinologist says I’m diabetic and increased levels of my prolactin levels.
        Sooooooo reading this about the Moshi sound like what I have!
        So now I will have to tell the Endo Dr to check this out.
        What labs or which type of Dr. determined that you have this condition????
        Please and thank you for sharing your story, I think I’m on to something!!!!!!
        Please explain!
        Have a bless night!
        Sincerely, SG

      • Same here,my daughter has had it since she was little,she’s 14 and heavy ,drs said they can’t do anything till she’s 18..she kept gaining weight and I wasn’t feeding her a lot of food,she just gained a bunch ..And for me wait and see but I have the symptoms and she does too..

      • I understand your frustration. I found out about this myself, drs kept telling me to stay on meds, but my symptoms fluctuated. Some times they were what this video described, but other times I have other symptoms like sweating a lot when my hands and feet are cold, UTi’s, and other urinary issues. I also get migraine and vertigo. So I completely understand going to diff dr at different times and getting diff treatments. One dr recommended journaling my food and symptoms. That helped and I guess it helps other drs know what’s going on. So when they say wait, I guess that is ok, but make sure to journal!

    • Jennifer, no one understands Hashimoto’s unless they are going through it too. My husband is not as understanding as he needs to be either. He has also told me I am crazy. We are not crazy! We have a real autoimmune disease. There are many things that can help to manage the symptoms and disease. Number one thing is the way we eat. I decided 5 and a half years ago I would never intentionally eat gluten again. I never eat anything with wheat or grains in it. Occasionally I will eat rice but even that isn’t good when you have Hashimoto’s. I have learned that some so called healthy vegetables are really not good for me. Night shade vegetables trigger flare -ups as well as eating raw broccoli, cauliflower and spinach. Also many nuts cause flare-ups. I have to do a modified Autoimmune diet mixed with paleo. The only way to really know is to listen to your body and keep a food/ mood journal.
      Keep searching, most doctors don’t know diddly squat about the thyroid. Keep searching!

  2. I have Hashimoto’s thyroiditis. I was diagnosed approximately 20 years ago and I’ve been on levothyroxin for quite some time. Last last year, my doctor upped my dosage from 100 mcg to 125 mcg. But then I was adjusted back down to 100 mcg. My last blood test in October said I was normal, so my internist doesn’t want to do another blood test until October.

    I had rotator cuff surgery Jan 6. I was pumped full of dilaudid and morphine while in recovery. I felt good that day. I was on Percocet for about two weeks, and then on Norco (5/325). I’ve been off the opioids for awhile. I noticed that my judgement seemed to be off from the day of the surgery onward, but not my reflexes. I assumed it was due to the anesthesia and pain meds.

    When I first started driving again, around the 5th week of surgery, I seemed to make a few mistakes, which was unusual for me, and potentially dangerous. But I’ve been off the opioids for weeks and my judgement is fine now.

    My shoulder was massaged by my physical therapist on my first day of PT, which was Feb 20. My shoulder was very sore. I subsequently felt achy all over. I iced the shoulder twice. I felt achy for two days. Ever since then, I have days when I feel achy all over—it’s not every day, but it’s more often than I’d like. I hate that feeling.

    My ortho surgeon told me that feeling achy all over is not directly related to my shoulder. I felt so lousy today, I took a Norco.

    I’m wondering if I’m having a Hashimoto’s flare-up. I’ve been having problems sleeping but that’s a common issue with RC surgery.

    Can the trauma of having surgery trigger a flare-up? In fact, this is my second surgery in a little over eleven months. The first surgery was because I had a torn meniscus. Both surgeries were arthroscopic.

    I made an appointment with my internist for March 6 because of how lousy I’m suddenly feeling. He tends to dismiss things though… for instance, even though I told him that my ortho surgeon had told me I needed surgery because the MRI had showed I had rather large full thickness rotator cuff tear and muscle atrophy, all due to a fall in 2013, the internist didn’t think I needed one because I had full range of motion. Well, I’ve been in pain for 45 years due to musculoskeletal issues, so I’m used to working through the pain—and somehow other muscles stepped up to the plate.

    I’m thinking of asking for a referral to a specialist. Hope he doesn’t fight me on that too.

    • Debbie,
      You and I have had the almost the same experience. I have Hashi’s and just had rotator cuff surgery, which sent me into such a such a flare that I’m now having problems with my left knee in addition to the miserable Hashi’s symptoms. Both the “trauma” of the surgery and the pain medications are major issues for people with Hashi’s. While the endo system is impacted, it is an autoimmune and inflammatory disease for sure. While each of us can have slightly different experiences, the causality remains the same. Because I have multiple joint issues since my Hashi’s onset and diagnosis i.e. torn rotator cuff and knee, I’m definitely going to have more autoimmune testing done because I the two are clearly related. Incompletely changed my diet right after being diagnosed by eliminating all forms of sugar, gluten, soy, dairy, and anything processed. I’ve done all I can to reduce stress, including taking up meditation but I still went into a major flare post surgery. I’ve also found that taking NSAIDS is making my flare worse! I highly recommend the diet changes but tackling this disease requires a multi-pronged attack that includes self education, self advocacy, and looking at the big picture (as well as the immediate symptoms). Best of luck to you and know that you aren’t alone. Thank you for your post! It’s really helpful for those of us with Hashi’s to share our experiences.

    • Debbie,
      I just had my first thyroid ultrasound after 26 yrs of hypothyroidism. I take 75 mcg Levoxyl. My thyroid shriveled up and is almost gone!! Lots of similar symptoms worth checking.

  3. I have had Hashimoto for about 19 years. I have managed fairly well until two years ago when my menstrual cycle stopped.I am 52 and have not had my period since. I have been having a flair up of various symptoms ever since. I have adjusted my meds at least 10 times and am still suffering with brain fog and acid reflux and low stomach acid seems to be a problem which i did not have before.
    I am at my wits end and looking for guidance! any suggestions on how to proceed?
    Thank you,

  4. I have had hypothyroidism for 35 years and was on Armour thyroid and doing well. When it was reformulated, it didn’t work for me anymore. I was also in a motorcycle accident that left me in a coma for over a month. While still in the hospital and rehab, they had me on 1 synthetic thyroid replacement pill a day. After returning home, I started on my Armour (original formula) and had lost the 23 lb. weight gain in the hospital and rehab. When they reformulated the Armour, I went on another natural thyroid medication but, 1/5th of the dose I’d been on for 30 plus years. I had been on 5 grains of Armour thyroid. To this day I have gained 65 lbs. even on thyroid replacement and trying everything to stop the weight gain. I only consume around 500-600 calories a day just to maintain my current weight. Can’t lose even 1 lb. with my medication so low yet, the doctor said the TSH is within range. What can be going on?

  5. Hi, I hope you can clear up some confusion I have on my thyroid.
    my TSH is 1.20
    T4,free is 0.90
    T3,free 2.50
    T3,reverse 11.0
    sex hormone binding globulin 83.0

    I have been told that I have Hypothyroidism some say I am normal but then I was told are you sure you don’t have Low T3

    I eat very clean to the point of measuring I also do cardio 5x a week and weights 2x a week. I feel if I don’t do what i do now that I gain weight very easily and look thick. I also take cytomal compound 15

    Do I have a thyroid problem?

  6. I have had Hashimotos for almost 32 years. It started after the birth of my first child. Over the years I have had flares, with increased classic hypothyroid symptoms, every 5-6 years. The doctor told me that it was another piece of my thyroid dying off. Which made sense as my thyroid tests indicated a need for more medicine after a flare. 2 1/2 years ago I became very sick. In 6 mos my TSH had gone from 3.4 to .1 My endocrinologist did an US which showed my thyroid gland to be very small. She ran a battery of tests trying to find a cause for the dramatic change. All the tests were normal. My levo dose was adjusted and changed to synthroid(name brand) and everything leveled off. Now over the last 6 months, I am slowly becoming hyperthyroid again. TSH has been May~2.3 Oct~1.1 Jan~.7 March~.4 I am having classic hyperthyroid symptoms that are worsening every month. I am not sleeping, I feel like I am buzzing with energy, have panic/anxiety attacks. I have tried almost everything to get my levels to stay consistent where I am symptom free. Could there be something we are missing that might be causing this hormone disruption? I am going back to the endocrinologist Thursday.

    • Hi Laurie,

      It’s always hard for me to answer these questions because the short answer is yes there is probably something that you are missing but the hard part is figuring out what that issue is. It often takes me a complete blood work and at least a 1 hour visit to unmask certain issues so it would be difficult to do over this comment section.

  7. Hi, diagnosed with a prolactinoma and Possible Addisons but not confirmed, is it likely an autoimmune disorder will automatically follow and medication be required even if there are no symptoms. Diet and medication has reduced the prolactin levels from 285,000 to 211 in 4 weeks. Also TSH levels and T4 levels have dropped to 0.3 from 3 and 6.7 from 9.7 respectively. Is that a hypo to hyper scenario? Any information would be greatly appreciated. Thank you.

    • Hey Beverley,

      There isn’t enough information to give you a definitive answer, unfortunately. And yes, if you truly have Addison’s disease then you will be dependent upon cortef or other corticosteroids to preserve your hemodynamics.

  8. I was diagnosed with Hashimoto’s about 6 months ago. After seeing one endocrinologist several times, he prescribed Levothyroxine. I was on it for 3 months and still felt crummy, not to mention I was still gaining weight. His response was to eat 6 times a day and exercise more. (I also have bouts of hypoglycemia)

    I changed doctors a couple weeks ago who changed my meds to Naturethyroid. I’ve noticed a change in just a few weeks…feeling much less exhausted. I have labs scheduled in a couple weeks.

    I’ve changed my diet to eliminate gluten and dairy and found the inflammation a bit less. I still have neuropathy in both feet, though not quite as severe. I’m still a bit foggy, mentally. My eyesight has been affected too.

    Thanks for all of the comments and stories people are sharing, it’s nice not to feel like I’m the only one with this. (or going crazy!)

    • Thanks for sharing, Deb! Sharing stories is definitely important and can help patients understand that they are indeed NOT crazy.

    • I know this is two years later but in case it may help someone else:
      I’m 65 years old and was diagnosed by an endocrinologist with Hashimotos Hypothyroid when I was in my 30’s. I asked what “Hashimotos” meant and was told “the type of thyroid condition you have.” This was prior to home computers/easy method of research so I didn’t know I had an autoimmune illness. Put on Synthroid; over the years and Dr. changes due to insurance switched to levothyroxine. Highest dose was 224 mg. I’ve experienced every symptom listed. Approximately a year ago I discovered a doctor who specializes in thyroid disorders plus uses supplements, food, etc. in combination with medication as needed. This is the first Dr. in over 30 years who tests for antibodies, cortisol, vitamin B12, etc. He put me on Naturethroid then NP Thyroid when the supply of the former became scarce. I began feeling better within weeks and am currently on 4 grains/240 mg of NP Thyroid. Also now studying the connection food has on Hashis (no other medical practitioner ever mentioned diet connection to Hashis)and have drastically changed my diet from almost total processed foods to whole foods, similar to Paleo, Keto diets and preparing to do the Whole30 elimination diet. DRASTIC POSITIVE CHANGES!!!

      It can be difficult to find a Dr. who understands all this.

      • Hi Lyn,

        Thanks for sharing and your story is basically what I’m trying to help everyone understand. I have free resources designed to help people find a doctor similar to the one that helped you here:

        All of my blog posts are updated, by the way, so even if the comments are old, the information in them is not.

  9. I was diagnosed with Hashimoto about 10 years ago, about one year ago I started seeing a Funtional Medicine doctor, but I am getting worse. I am gaining weight again, started having heart papaltations, loosing more energy. I’m just really frustrated that I am getting worse instead of better. I feel like all I do is takes supplements with no help from them. Any suggeestions?

    • Hey Barbara,

      Not all functional medicine doctors have the same understanding as others which can lead to what you are experiencing. Functional medicine is more than just conventional medicine with some supplements on the side.

  10. Hi.I eventually got my doctor to check my TPO antibodies
    It came back 924!! Doc said that’s fine .but I feel awful my TSH was 3.53 in normal range.
    What’s your views on these results

  11. Dear Dr Childs, I have been working very hard for some time to reduce my antibodies and TSH. I managed to 1/2 my tpo and lost 40lbs my tsh however is all over the place and is constantly being adujusted. Last fall I took a supplement reccomended by a functional Dr with Iodine in it-I do take selenium – wasn’t sure what would happen. My tsh jumped 5 pts and my tpo 80. I have since been able to bring the tsh down but the tpo has not. I did read an article you wrote about this lately but I do not remember reading where you go from here and would like some guidance if possible. Also wondering if the b12 shots have ever been linked to cardiovascular issues

    • Hey Cathy,

      No, B12 shots do not cause cardiovascular issues. They are simply filled with vitamin B12 which is essential for proper cellular function, in addition it is a water soluble vitamin which means elimination isn’t a problem.

  12. Dear Dr. Childs,
    I have been treated medically for Hashimoto’s since my 20ties. I am now 53, have been through ups and downs, getting bloodtests every 4 months.
    Lately, I lost a lot of weight, but I think it might be in my genes, my mom is very slim but very healthy, with no Thyroid issues whatsoever. Except 4 years ago, I lost like a third of all my hair… but I had a lot of stressful situations back then, I think it was a connection to stress as well.
    Lately, I have had a TSH of 0,02..(!!) and an slighly elevated T4. But I think I might be a very unique human ;-). I feel like a young woman, I work out, I play acoustic and electric guitar, I have 3 rescue dogs, I am vegan (though I am fully aware that soy products are not very positive on Hashimotos), but I think going vegan 5 years ago made a huge difference in my quality of life.
    I am on the Novothyral 50 microgramms per day.

  13. I was diagnosed with hashimotos last August, but already in 2013 I accidentally was tested for low metabolism (tsh 6), however, couldn’t believe it and my medical doctor let it pass. Last year numbers got worse and TPO proved to be 113. After receiving thyroid hormone fro 6 weeks in October T4, T3 and TPO all went into the normal range. Generally I have felt good, slim, work 6-10 hours a day, exercise. Although when checking on symptoms I realise that I am always cold compared to others, often constipated and late afternoon after teaching for hours my brain sometimes feels muddy. January 19th my test results were all worsened and TPO was 76, tsh 10 and t3 down to 0.9. My doctor rose eltroxin to 450 mkg pr. week from 350 (1 pill 5 days a week and 2 pills 2 days a week) And I started studying, checking out diets etc. February 2nd I dropped gluten, diary and soy, February 9th I went on the paleo autoimmune diet. Also started taking vitamin D and selenium (200 mg pr. day). My new test results are better on all parmeters: vitamin D, LDL cholesterol, B12, T3, T4 and tsh, BUT TPO rose to 86 which is the wrong direction. I wonder if all the improvements are just due to the rise in hormone-intake, and the diet does nothing for me. The reason why I do the diet is in order to reduce the immune system inflammation. Now I am at a loss about the root cause and what to do in my case. I continue the diet, just in case, but rather demotivated. Also I should mention, that I have never suffered from food intolerance of any sort, that I know of. But having read that about 90 percent of hashimoto patients are intolerant to gluten I avoid it. I feel better on the diet because I eat more, I used to go hungry a lot to stay slim, and I don’t put on weight in spite of eating more, probably because of the no sugar policy. I should maybe mention that I am past my menopause (last period June 2014) and I suffer from occasional heatwaves, while usually feeling cold. Any idea why TPO goes up even though I follow the autoimmune paleo diet?

      • Dear Dr. Childs! Thank you so must for answering my question. I have studied the article and will probably look through it again and take some of the measures suggested there. Hopefully that will help. So far I am only taking Vitamin D3 90 iu’s pr. day and I don’t test deficient for that. Selenium I am taking 200 mcg. All other supplements I am not taking yet, so that will be my first step, especially probiotics and probably zink.
        Your mention of LDN sounded also very interesting, so I will ask my physician if she can prescribe that. Thank you so much for all your great articles.
        I have one more question: Have you ever experienced clients who “feel” their liver, ie. has a sensation that it is swollen although not hurting? My physician says numbers on that issue are fine and I have had an ultrasound scanning that showed normal too… still I am suspecting that it is not working too well, since T4 to T3 conversion is so poor that my T3 level is lower now (1,0) than in August 2016 (1,2) before I started taking T4 hormone.
        Hope to hear from you again 🙂
        Sincerely, Navina

  14. Dear Dr. Childs, I have been diagnosed with Hashimotos for 25 years, after my Mom was killed tragically. Since then I have gained about 75 lbs, after initially losing about 25, (and gaining it back with the additional 75) when I stopped eating for about 1 year. When I was diagnosed my TSH was outside the normal curve, so whenever I get tested the less knowledgeable want to lower my dosage. Since it was so long ago the initial diagnosis is no longer available (on paper in the clinic’s basement, I assume). I was on 150 mcg levothyroxin for quite a while, but had the above scenario and it was lowered to 137. I gained 12lbs almost immediately. In the last year I switched to Amour at 60, then 70. I had my t3 and t4 tested and t3 was low,so they increased to 70.

    I have a very difficult time losing weight and often use sugar to combat the chronic fatigue. I am mostly gluten free as I noticed it caused inflammation. I am on the weight loss program called OMADA where I weight in daily, and my weight is ‘all over the place’. I have fairly severe stomach problems, and am not regular with bm’s. I often have to eat something to calm my stomach since I got off omeprazole after 4 years.

    I really would like to lose some weight and be more active as I have in the past.

  15. I have been diagnosed with hypothyroid but believe I likely have hashimotos. I have every symptom and have been in a flare for about a year due to several major stressors. Because of that, my joint pain and swelling have been off the charts. I am taking 30 mg of Armour Thyroid every other day. Should I suggest that my doctor test me for hashimotos?

    • Hey Diane,

      It would be a good idea to have a complete thyroid panel to have a better understanding of what is going on in your body.

  16. Thanks for your website with great information. My hair is thinning, very brittle and falling lots due to hashimotos. My DHEA is 2.1 (normal range 0.95 to 11.65) My Best’diol is 273 (normal range 100 – 977). I like to try DHEA but I do not know the side effects and what to look for. Please comment on the symptoms of intolerance to DHEA supplement. Is evening primrose oil can be used to balance my hormone and how is it in comparison to DHEA?

  17. Hi,

    I was diagnosed with hypothyroidism a year and a half ago. I’m 31 years old and my Dr told me it was ‘auto-immune.’ I take 75mcg levothyroxine every morning but the last couple of weeks I’ve been waking up at 4.30-5am every morning (despite being really tired!) low mood and more worryingly, I’ve had two strange fluttering sensations in my heart this week. I know I’m not quite right… been making silly mistakes at work. I’m not really sure what I should be doing to help… brain fog has well and truly set in, so clear advice would be really appreciated.

  18. Hi!
    I’m REALLY hoping you can shed some light on some symptoms that I’ve been having the last few months. I started having what seems like a “flare up” of some sorts where I will have a few days of feeling more exhausted than normal and just a general unwell/malaise feeling. It will typically last a few days and it seems to occur every 2 weeks or so. My blood work all came back normal except my TSH was 6.148 and T4 was normal range at .81. Do you think it’s possible that what I am feeling could be thyroid related? I have even been tested for mono wondering if that is the cause and that was negative. I would greatly appreciate any input that you have, as I am desperate for some answers! Thanks so much!!

    • Hi Samantha,

      With a TSH of 6 it would be silly to assume your thyroid is not playing some role in your current set of symptoms – but there may also be other factors contributing.

  19. Hi!
    I was diagnosed with Hashimotos as well as Sjogrens 2 years ago after the birth of my son. Have taken synthroid and then was changed to WP thyroid without any improvement. I deal with many symptoms ( chronic muscle and joint pain, fatigue, fluid retention, digestive, hormonal, weight gain, hair loss, and many others you have mentioned. I was in top shape just a few years ago and now exercise is exhausting and have gained body fat and lost muscle. I have become very frustrated. I have had some success with diet and supplements but always seems to have relapses. I cant figure out how to manage this and without docs that know how and what to look for. Are u accepting patients do you have distance consulting?

  20. I was diagnosed 8 years ago with Hashimoto’s., thyroid cancer 4 years ago followed by a total thyroidectomy. I tried eating a gluten free, dairy free, soy free diet for 6 months and it didn’t help my symptoms or flare ups. I have a positive ANA and thyroid antibody levels are still high. All other Auto immune diseases have been ruled out. The inflammation now affects the tendons in my arms, etc.. All the Doctors I’ve seen, agree on what I have but no one seems to know how to help me feel better.

  21. Hi, I was diagnosed with Hashimoto’s this year in February. My Dr. is currently treating the Hypothyroidism with 75mg medication, and my levels are good. However, my problem comes when I call and tell him that I am experiencing other symptoms and having a flare up. I become tired, weak, my back hurts, and my legs feel heavy and numb. I even have numbness in my hands. He says that it has nothing to do with my Thyroid because my TSH levels were not that high. It seems like he does not recognize the Hashimoto’s at all. He even checked my blood levels for Diabetes and said that I was on the borderline of being prediabetic with my A1C being 5.6. I’m not sure what to do, and it seems as if they believe that I am making these feeling up because he told me to see my PCP. What can I do to feel better?

  22. I’ve been diagnosed with hashimotos since 2014 and I saw great improvement once I started taking levothyroid pills. However, due to over-exercise I got amenorrhea and worked for a year to get my period back. Now that it is, I’m struggling with acute depression, anxiety, irritability, bloating, gases, facial flushes and discomfort in my literal phase and it’s making me go crazy. I eat a balanced diet and exercise 1-2 times a week with walks almost everyday. I don’t know what’s wrong with me and I don’t know how to overcome the symptoms, they really make life so daunting.

    • Hi Soraya,

      It would probably be a good idea to assess both your sex hormones and your thyroid status especially in light of these new symptoms!

  23. I’ve been diagnosed with hashimotos since 2014 and I saw great improvement once I started taking levothyroid pills. However, due to over-exercise I got amenorrhea and worked for a year to get my period back. Now that it is, I’m struggling with acute depression, anxiety, irritability, bloating, gases, facial flushes, fluid retention and discomfort in my lutea phase and it’s making me go crazy. I eat a balanced diet and exercise 1-2 times a week with walks almost everyday. I don’t know what’s wrong with me and I don’t know how to overcome the symptoms, they really make life so daunting.

    • Hi Soraya,

      I would start with a complete hormone evaluation to help identify what issues are contributing to your symptoms.

  24. Dr.Child, I am a doctor and Nuclear Medicine Physician from Bangladesh, trying to communicate u…..but failing….I need your help for my wife…
    She was diagnosed as hypothyroid 1 year back. She had no other feature of hypothyroidism except exessive hair fall.
    Her TSH was 25.
    On 75mcg Thyroxine for last one yr her TSH is now 2.2…FT3 and FT4 is now in also under normal range.
    But last week I first time did her TPO Ab and her TPO Ab was reported so high that I am now much afraided… is >1300
    On ultrasound, thyroid is showing diffuse non homogenous echotexture with borderline enlargement ( AP of boyh lobe-1.3 cm)
    Her symptoms of hair fall has not significantly improved……
    Please, doctor, how can I save her thyroid and what medication can I give to reduce TPO antibody????

  25. Hello Dr. Roy,

    I have been diagnosed with Hashimoto’s for over 8 years now. My TSH is within normal limits, but honestly, I cannot lose weight and I just never feel that good. Always fatigued and just a general sense of malaise. I do HIIT workouts daily (crossfit) and I also run and walk daily. I eat enough calories and keep a high protein diet. I keep going back to my doctor letting her know that I just don’t feel well and I can’t seem to lose any weight with all the working out I am doing. My doctor then tells me to eat less and workout more. I tried that I felt even worse. My doctor says there is nothing else she can do to help me. I just need to keep increasing my workouts. I’m not sure what to do anymore. Any thoughts? I take levothyroxine, 75mcg daily. I asked her to check my cortisol levels and she said they were within normal range. I’ve gained 25 pounds without changing anything. I’m at a loss and want to feel good again. Thank you so much, Maile

  26. Hi Dr. Childs,

    Apologies for the typo on my previous message. I typed in Dr. Roy instead of Dr. Childs. Very sorry for the oversight.


  27. I received a Hashimoto’s diagnosis in 2011 though believe that after child birth in 2001 and subsequent divorce I experienced the onset of Hashimoto’s. My mother also is diagnosed with it however experiences nearly no symptoms and is easily managed with a low dose of thyroxine. My journey has been very much unlike my mother’s. After two years of see-saw between hyper and hypo with thyroxine I found a gp with natural health insights also. We eliminated a huge amount of copper, upped the zinc, found out I had reverse T3 factors and was not converting t4 well, I started ERFA that contains both and have regained some stability and use B12, d3 and iron for further stability. I still have approx half yearly flai ups. Sometimes just the hypo type, sometimes hyper then hypo. I’ve done the AIP for 6 months with marked improvements but fund the restrictions and effects in my social life pretty depressing. I am GF and DF which appears to make a difference regarding symptom reduction. I would still consider myself having the majority of symptoms however at lower degrees than in the early stages of my diagnosis. Since March I have trailed LDN which seems to significantly improve inflammatory issues and food sensitivities. Weirdly (or maybe not as I have purchased a business that has caused a fair amount of stress for the last 2 months) I have a flush flair up at the moment and plan to go paleo for a while as well as up my zinc and d3. Any observations that are outside of my radius would very much be appreciated.
    Thank you

  28. Hello Dr Child’s

    My name is Penny From Australia loved all the info I have just read and heard.

    I never knew about flare ups although I used the term myself whenever I felt fatigued or crappy etc and used to say oh my Hashimotos is flaring up again and showing its ugly face. and now I know it’s a real thing.
    I take Herbalife nutrition which helps make me feel great 99% of the time. I think taking a balance of good nutrition and having a good villi to absorb the nutrition def helps you feel a lot better.

    My question is I don’t want to bandaid this with here are some thyroxine pills take them for the rest of your life and we will just keep an eye on things.
    I keep asking my doctor surely there is someone who knows more about this than just my GP. But you need a referral from your doctor to get to see any specialists. Would you please tell me who specialises in this area so I could ask my doctor to send in a referral to them. And if he still doesn’t is that a red flag to change doctors.
    He just tells me that I have it and it’s easier to keep the thyroid working than treat the Autoimmune side.

    Thankyou for all your Information.

  29. I noticed I get flare ups a week before and during my period. Still trying to figure out why. This was a great read. Thank you!

  30. I’ve been diagnosed with Hashimoto autoimmune disease. On thyroid meds. Not getting better. My arms and legs hurt so bad most of the time. Constant sore throats and sinus infections and inflamed inside. My joints crackle. Sick of feeling sick. My Dr is a numnut,. What can I do? To get her to help treat my symptoms? My insides feel like they are on fire too

  31. I just stumbled upon this article and thank you! I was diagnosed last year after I got really fatigued after a cruise. I’ve been treated for hypothyroidism for years before this diagnosis and it was surprising but I wasn’t overly concerned. This past March, I started experiencing super dry eyes, a racing heart and joint/muscle pain especially in my legs and hips. The heart concerned me, I put it down to extreme stress from work and then almost losing my husband to a sudden illness. Turns out I had swung to super hyper thyroidism. I’m 51 and have never been hyper. I have all of the symptoms you list. Over the past few months, I have gained 15 pounds although I have not changed my eating and I’m highly active. I am a little depressed and I am hyper sensitive and emotional. None of these things are “me,” and I hate it. Mentally I understand what’s happened but emotionally I am struggling really bad. I can’t believe that I am looking forward to swinging back to the hypo side. At least I know how to live there.
    I have been a practicing vegetarian and eating relatively healthy for years. Last week, my endocrinologist suggested I go gluten/dairy free for 3 weeks to see if I notice any changes. He said sugar too, but I hardly eat sugar so I’m not worried about that. He said at the end, we’ll decide to extend it for 3 weeks or to start putting things back in. We’ll see. I’m willing to try almost anything at this point to get my normal self back. I feel desperate.
    Are there any indications this diet could help? Has anyone had luck with this? How long might a flare up last? I mean, are we talking years?! My husband is better but my work situation won’t change as I’m the sole supporter. He is disabled but thankfully, has also been very supportive of my struggling the past few months. Good guy there!
    Thanks for reading.

  32. Hello Dr. Childs (and any viewers who might have some ideas for me!)
    I have hashimotos, in addition to low progesterone/estrogen (in an estrogen dominant ratio), elevated DHEA, and a delayed cortisol curve.
    My antibodies are currently around 750, though my thyroid hormones are techically “ok.” (I take WP thyroid plus additional T3). My T3 is top of the range, T4 is low, and TSH is .04. My doctor told me the low T4 was alright, because its converting, and not as much storage is needed if the mechanisms are working properly (I don’t know if this is really the case…). My RT3 is middle of the acceptable range from the laboratory.
    I am writing here because I continue to experience weight gain (I am about 7kg above my steady previous weight). I have played around with different exercise regimes (weight lifting, just walking and yoga/pilates, hiit, etc.), as well as different macro ratios and intermittent fasting, and nothing seems to really have an impact. On a daily basis, I tend to only make it to 1300 calories. I am 160 cm and 59 kg.
    My doctor thinks my weight gain is coming from something other than my thyroid. My adrenal profile doesn’t seem to be ordinary adrenal fatigue; I can barely find any information about high DHEA and low-normal/delayed cortisol curves, and what I DO find points to PTSD.
    I have a history of childhood trauma, leading to chronic stress in my body. Could this really be the main culprit for my weight and hormone issues? and if it were, what would be the best route in terms of exercise, diet, and treatment?


  33. Hi there I’m 40 I was diagnosed with hypothyroidism 7 yrs ago since then I’ve been up and down with symptoms I can only describe as a flare up. Feeling mentally physically and psychologically burned out. Problems with mental health deafness confusion aches and pains in bones and muscles and fatigue, I’ve just this last month been diagnosed with hashimotos and presume these symptoms are a hashimotos flare up, I plan to go gluten free my endo took antibodies and they are high positive for hashimotos my meds of Levo have been adjusted. During this latest flare up I’ve had uti,sinus infection and anaemia at the same time. My tsh was high in Aug and t4 normal now t4 high and tsh normal with high antibodies, how do I know if it’s a hashimotos flare up or a hypo flare up.

  34. I have been diagnosed two months ago with Hashimotos. I find that several times during the day and night I am experiencing heat intolerance while just while sitting and relaxing. My body begins to feel real hot and I break out literally into a sweat! Drives me crazy lol any suggestions on how to calm this symptom down? Thank you.

  35. Wow! I glad I found this because it explains so much. I’ve had what I now believe are two flare-ups in the last two weeks. The bad news is that there isn’t a quick solution to the source of my stress at this point. I see my doctor in the mornkng and will look at secteasing my meds. I hope that helps a little. These episodes are so hard to function through. My husband and kids think I’m crazy. Maybe by working on meds and diet I can get a handle on this!

  36. I recently got a full thyroid blood work up including the antibodies due to feeling like complete crap and thinking all of my symptoms would be explained as Hypothyroidism. Blood work came back with elevated thyroid antibodies but normal TSH so my doctor isn’t offering any treatment. I requested to see an Endocrinologist but she believes that my symptoms are not related to the elevated antibodies. I’m so confused because I’ve read a lot about Hashimotos and I’m pretty certain that you can have all of these symptoms, elevated antibodies, and normal TSH and could still be treated with medication. I’m left feeling hopeless and that I’m just supposed to feel like this all of the time? I don’t know what to do.

    • Hi Susan,

      You definitely don’t have to feel hopeless as there are many ways that you can improve your symptoms. The best thing you can do is try to find a physician who specializes in Hashimoto’s or thyroid disease near you. You might also find further help reading articles such as these:

  37. Dear Dr Westin
    Thank you for this article. I will share it with my adult children to help them understand what this disease I have is.
    Due to poor insurance I went for years without a diagnosis and then a decade of poor management after diagnosis. For 20 years my symptoms were assumed to be mental and were treated with ever increasing doses of antidepressants. I believe that the antidepressants masked some of the symptoms.
    I had an extreme hyperthyroid episode 3 years ago that was likely brought on by my slowly weaning myself off of the antidepressants and coupled with a severe emotional trauma. This episode continued for over a year and nearly killed me. I finally got a good job with good insurance and a good endocrinologist who immediately identified elevated T3 and reduced my thyroid hormone replacement. He also identified very high levels of antibodies.
    My Hashimotos has become very difficult to control since that hyperthyroid episode.
    In my endless research to find a way heal myself I came across Low Dose Naltrexone. I now take 3.0 mg per day. My antibodies are slowly coming down. I also follow a paleo diet for the most part.
    I’m not sure if I’ll ever be “normal” again. So much damage has been done due to inept medical care.

    • Hi Allison,

      Glad to hear that you are improving! You may not get back to 100% of your normal self but you can definitely get VERY close to it with the right medication and treatment.

  38. Dr. Westin, great to find your webpage! I’m 69 yrs., male, strong & pretty stable. 3 yrs. ago got my diagnosis. The first yr. I went to 3 dr’s. all put me on Levo. Very hard time, one flare after another. Even the endo did not know what to do. I read for 1 1/2 yrs. everything I could find. Finally went on the AIP diet – no carbs, sugar or gluten. In 4 day’s my immune system reset – normal, no more reaction’s. Now I have gone full circle, after the last year of eating everything I want (not healthy food) This week I had a mild flare up. I know that I need to rebalance my lifestyle again, this time for good. More hyper than hypo! Learning!
    Thank you for your column.

  39. I’ve been gluten free for 8 years, but only diagnosed with Hashimoto’s a couple of months ago. I have to be honest that I decided to not take the prescription medication and try to do this by improving my diet and lifestyle. I also take iodine, selenium, zinc, iron, vitamin D and as of yesterday magnesium. Eventually my symptoms improved and two weeks ago I was almost ready to say I’m feeling like myself again. I even lost 3 lbs (I know it’s not much, but I stopped gaining and started losing, so it’s good).
    All of the sudden my hair starts falling out again, almost overnight, and now I have flam in the back of my throat all the time. I have no idea what happened. I did have some stress at work, but it was nothing crazy and I’ve made no changes to my diet. I’m GF (I have celiac), grain free, low carb, low sugar and I have rock solid will power, and I don’t cheat. I have no idea what’s happening and I’m sorry to say that I cannot even tell my doctor that I am not taking the meds, she doesn’t really talk to me she just copy-pastes stuff into email (or her nurse does) so I don’t know where to turn with this. Is it a mistake to try to treat Hashimotos with diet changes and supplements? The only thing my doctor will prescribe is Levothyroxine and based on what I see I don’t like it. Any advice would be greatly appreciated.

    • Hi Lenka,

      The single best thing you can do is to get your labs tested so you have some idea where you stand. Without comparing your after labs to your before you really have no idea (outside of symptomatic improvement) if you are actually getting better.

  40. I met with a rheumatologist who told me that Hashimoto’s does not cause any symptoms at all. All it does is cause hypothyroidism which is fully corrected by taking thyroid hormone. Also that the level of antibodies is totally insignificant. All they tell you is you have Hashimoto’s or you don’t. I don’t agree with this assessment since I suffer from flares (fatigue, weakness, depression, inability to concentrate, etc.) One thing I don’t understand is why I still have Hashimoto’s after 25 years. I thought my thyroid would be dead by now. Can you shed any light on this?

  41. I feel fine for a while, full of energy, able to do everything I want… Then, one day, I slow down by the afternoon, body hurts and freezing and literally can’t remember anything, in bed by 9pm. I wake up after 10 hours of sleep and can barely get out of bed. This lasts from 4 days to a week.
    Eventually, my energy comes back, I get everything done, sweat and cant sleep well at night, and my anxiety sky rockets.

    Based on my fluctuations of Thyroid tests and an ultrasound showing wear and tear on the Thyroid gland that is consistent with Hashimotos, along with my family history of Grandma and Aunts and uncles having it….I was diagnosed with early onset.
    I am going to start keeping a Hashi flare up diary to see when and how often. I am a paleo diet person.

    My question is: How often does a typical flare up and round of the high energy and low energy usually happen? Sometimes I think I am making it up until I go to the store and can’t even get myself to reach for an item on the shelf. I think, “oh, never mind, I can’t even walk to the end of the isle. Guess I don’t need it…..

    What is happening???

  42. I was diagnosed with Hashimotos about 5 years ago. I have so many highs and lows. I will do great for awhile and then all of a sudden I will have a flare. Some last a few weeks, some a few months. It’s hard to pinpoint what caused the flare sometimes. However, I know now for sure when I am in one. I instantly have the signs of being hypo thyroid. I gain weight and experience fluid retention. I get so tired it’s hard to make it through my days. I am on thyroid medication and LDN. I was feeling great for about 4 months and then it’s like I get hit by a truck. I went really down hill in a short period of about 2 weeks. I’ve attempted to clean up my diet. I’m planning on doing more rest and recover and perhaps taking an extra day off from the gym. Any other suggestions on managing these symptoms and getting back on track.

  43. I’m incredibly confused at the moment. I have been on levothyroxine for a good 10 years now and my previous doctor confirmed it’s Hashimotos. I was managing fine on the same dosis (50µg) for many years, with regular blood tests and some minor adjustments.
    I moved in October and my new GP found almost non-existant TSH (0.01 mu/L [0.27 – 4.2]) and elevated T4 (29.4 pmol/L [12.0 – 22.0]). He didn’t test for anything else but halved my dosage. I’ve had my latest test (again, TSH and T4) last week and I was convinced it would come back showing the dosage is too low, because I’ve been feeling absoluely horrible – very low energy, constantly exhausted, weight gain, depression, concentration issues, constant flu-like symptoms etc. Instead, my TSH is now so low it’s undetectable, and my T4 is even more elevated (35.2 pmol/L [12.0 – 22.0]). I had him do a full blood count, check the ferritin level and glycated haemoglobin as well, to rule out other causes, but everything came back normal.
    I specifically asked whether it could be a conversion problem, but they said that would not explain the TSH. Is that true? They don’t want to test anything else until I’ve been off levothyroxine for 6 weeks.
    I feel like there must be something going on, my thyroid can’t spontaneously have regenerated, can it? I didn’t change my diet or my habits at all, but I have moved closer to the seaside. However, that still would not explain why I have been feeling so horrible. I have been accidentally overdosed before and it felt nothing like this. It does feel a lot like I felt before I was put on levothyroxine and now I’m absolutely terrified of the next couple of months without medication.

  44. My Doctor called today to tell me I have Hashimoto disease. I am trying to absorb and learn all that I can in a brain that is currently quite fuzzy… My Dr already seems to be solely focused on the hypothyroidism factor instead of the disease its self. I have every symptom of hypothyroidism except the weight gain. I am a skin and bones. Where is the best place to begin in seeking proper care and treatment? How do I go about figuring out what may have caused or triggered this and discover what my triggers are? What test should I be having them run as far as hormonally? what should my concerns be? Could a tdap trigger a flareup? Are there any questions that I’m not asking that I should be? Any help is appreciated!

  45. Hi doc — I’m having a bad flare now, and taking 125mcg levo. Should I stop the levo during the flare? I feel like I have too much thyroid hormone, but I don’t want to make things worse by stopping my meds. TSH was 1.25 on last lab. Thanks!

  46. Hi! I was diagnosed with Hypothyroidism two years ago and three weeks ago I was diagnosed with Hashimoto’s. My doctor has instructed me to go on a gluten free diet. I’m curious if this has truly helped people with Hashimoto? I think I am going through a flare up. I felt so great last week and this weekend, I ate some some desserts I know had gluten I’m them and now I have zero energy, my stomach feels awful, and my mind feels like it’s on another planet. Could my birth control also be messing with my thyroid levels? I’ve been wondering that since I was diagnosed with Hypothyroidism. Also, any tips on how to overcome this flare up, or at least get my energy back, would be greatly appreciated.

  47. I was diagnosed with Hashimoto’s about 10 years ago. I have had my meds (levothyroxine) adjusted dozens of times in that 10 years. I went on a strict paleo regimen about 3 years ago and was doing well until just recently. I am suddenly losing hair, unable to sleep, suffering from brittle hair and cracked lips. I’m also having obsessive thoughts, which if I look back over my lifetime, seems to be part of the cycle of the disease. At this time I have crummy insurance and am unable to see an Endocrinologist, and am being treated by a nurse practitioner who is unfamiliar with Hashi’s. I’m not really looking for help here, I know I need to have my thyroid hormone levels checked, but am just expressing the frustration of having Hashi’s. It’s a never ending battle.

  48. Hi Dr Child’s, I read an article of yours a few months ago about musculoskeletal pain and Hashimotos (diagnosed a year ago) and I must say it was a relief because all the docs had told me that Hashimotos doesn’t cause pain. They told methat I was ‘obviously ‘ getting it from nerve damage from type 1 diabetes (35 years but super controlled HBA1C 6.6) and tried to give me drugs for nerves (I chucked them in the bin )
    I was sick of hearing ‘your TFT levels are fine ‘ and ‘there’s nothing wrong with you’ (insert all hypothyroid symptoms here) so to a degree I took matters into my own hands. My aim was to change from desicated thyroid to t4 only in an attempt to get greater stability across the day (longer half life) as I noticed my symptoms seemed to get better / worse at different times of the day.
    To do this I increased my t4 dose and took T3 whenever I felt low during the day. In two days I felt fantastic… even the knee and quad pain I had been getting over the last 7 years left … I rode my bike for the first time in a year … Zero pain during the ride or after. That spectacular period lasted for about 4 days then I found out I had slightly overdosed and just clipped the upper limit of acceptable rt3. I changed to a t3 solution to get the rt3 down and went and fessed up to my doctor.
    One good outcome of it all was that I had proven that the pain was associated to thyroid and not ra or nerve damage . The doc changed me to a sustained release desicated solution but im still trying to find the right dose (my doc told me to keep experimenting (slowly).

    My question is this; I feel that during some days I get Symptoms at different times of the day … could this potentially be something that is adrenal related ? Of something else … I seem to get the worst in the afternoon and during the middle of the night.
    I did get a saliva test showing overall lowish cortisol (still in range) but below range in the afternoon. Could this be causing instability in thyroid levels across the day? If that is the case then that could explain why I ‘overdosed’ a bit on t3 when treating to just symptom. Thanks Martin

  49. I was diagnosed with Hashimoto when I was 15. I got on Synthroid and was fine until recently. I’m currently 33 and have been experiencing what I guess are flare-ups for the past year and a half. I used to smoke a lot of pot since I was about 18. I’m not a stoner or a pothead and was a very high functioning adult (no pun intended). I’ve been to see several endos and they all refer me back to my GP for some of my issues. I’ve been going through bouts of depression and massive mood swings. It is impacting me to the point where it is damaging relationships.

    I don’t really want to get back to smoking pot as I think that just covered up my disease symptoms but part of me thinks it helped me manage my stress. I’m at a loss for what to do and my doctors are all saying anti-depressants are the answer when I don’t think they are. I’m lost and need help and don’t know where to go or what to do.

  50. First of all, I just want to say thank you for the effort you have made to share your knowledge with patients. I work in the realm of healthcare and I am guilty of fluffy off my generalized symptoms as colds, stress, etc. I’ve known for a while now that my TSH levels were elevated but we took a ‘wait and see’ approach. Over time I just more an more symptoms that just did not seem to amount to anything… bouts of palpitations (I get PVCs), low mood (pre-existing depression), low energy (anemia), muscle aches (getting older lol), headaches (stress), menorrhagia and wonky cycles, weight gain, sleep problems, etc. I will say that diet and exercise modification helped but none of it ever really got ‘better’. Multiple specialist consultations with GYN, NEURO, and CARDIO didn’t really result in much. Recently we’ve found that my TPOab is elevated and it finally feels like we’re moving in the right direction. Other than the symptoms the next worst thing has to be the feeling of helplessness. I felt like nobody was taking me seriously so it’s nice to finally have some validation! Thank you again for all the wonderful info you’ve shared here, it’s been so very helpful!

  51. Hello Dr. Child’s, I was diagnosed with autoimmune hypothyroidism when I was 20. I was informed that it was also called Hashimoto’s. I have been on Synthroid for 12 years, I’m now 32 and struggling again. I experience these episodes that are difficult to explain, I’ll do my best to describe. For the past year, I’ve experienced more and more frequently a sudden “crash” which is followed by a severe faint, weak, and dizzy feeling. When this happens, I cannot think, even process words, my joints on my hands and feet throb and my get serious muscle pain. I also become anxious and frustrated and I need to lie down. This episode lasts about 4 hours and I can best describe it as “I don’t feel like myself”. Drinking water, taking that nap, vitamins, don’t help at all. After the 3.5 hours, I feel the heaviness and fog lift and I’m able to go back to working or school. What is most dangerous is when in driving. I’m growing more and more frustrated because I don’t know how to present this to my doctor since my blood tests are normal. Also, I don’t know what triggers this and don’t know how to prevent it. Reading your articles helps to put a name to it, I can mostly identify with the overt hypothyroidism when the episodes come on.

  52. Hi, I was recently diagnosed with Hashimoto’s. It all started after the birth of my second daughter. Both of my pregnancies were rough so I’m not sure if that set it off or what. I have antibodies which are why they deemed it Hashi’s. My more recent flare-up has been lightheadedness and dizziness, weakness in my legs (calves) and bad brain fog. My bloodwork after this last flare looked pretty good except that my t3 was a 67. My antibodies didn’t show on the last test which is weird because the last one was positive. The time before that it was negative and the time before that was positive. I’m so confused. I don’t test know what my triggers are except that I know I’ve been under a lot of stress. I’m a teacher and this year has been rough. Now I find myself in an anxiety cycle too wondering how I’m going to feel each day. It stinks. I went from a gym rat to just trying to make it through a day.

  53. Hi there—great info!
    I’m 48 and have known about having Hashimoto’s since diagnosis when I was 33. I am on 50 mg Synthroid, which hasn’t changed in YEARS. I’m currently in an extremely stressful job and work situation. I have gained weight, I’m napping, and many of the other symptoms you mentioned. My annual last October showed thyroid levels normal; however, the stress of this job has gotten increasingly worse over the course of the school year—I’m talking BAD. I also have high cholesterol, which caused me to think FOR SURE my thyroid meds needed to be upped. Should I get checked again? Do I need to ask for more specific tests? Thank you for listening!!!

  54. I have Hashimoto’s and hypothyroidism. I believe I may be having a Hashimotos flare right now brought on by stress. I used to take Synthroid only – for about 30 years. Needless to say a developed a lot of other issues. When I changed to an NDT (Wpthyroid) all those other issues went away – most especially the weight, pain, high cholesterol, brain for and cell deep tiredness. That was 4 years ago. Then in December WPthyroid stopped production. In January I switched to Naturethroid. I did OK on for several months but gradually noticed an increase in sweating. I read that others were also having this same issue. My sweating got so bad that I sweated all day until my NDT was out of my system later in the day. I still had some WPthyroid left in reserve so switched back to that and the sweating gradually stopped. So I called my doctor and asked to be changed to NPthyroid and did so on 5/9/18. The sweating has not come back but I’m very tired. This thing is due to a lot of family stress that began about the same time I started the NP. It was family issues and my husband had an operation on 5/22. We are finally settling back in at home and I’m still tired but getting better. My dose was 2 grains NDT UPON rising and 2 grains just before bed. I also take 30 mcg compounded t3 around 10:30 am and again around 3:30 pm. Today I raised the morning dose to 3 grains and I’m not so tired but I can feel more energy. I also raised the afternoon dose of t3 by 10 mcg. I’m hoping this adjustment will work to get me through this tiredness. I had been out of breath when I even get up to walk or go up the stairs. That seems to be getting better in the last day or so. Please advise is I am making the right med adjustment. I believe if all goes well and I start feeling better that I will be able to reduce it again. I should also mention that I also have an MTHFR gene mutation (a1289c/a1289c) for which I am taking methylated B vitamins and Leaky Gut for which I am taking L-glutamine. Thanks for your help,

  55. I was diagnosed with hypothyroidism back in 2006 and given levothyroxine. I believe I tried 25 mcg for a short period but have been stable on 50 mcg ever since. TSH has always been a reliable indicator in my case of whether or not things are as they should be. My TSH improved after I removed gluten from my diet, either by lowering reverse T3 levels or by reducing GI inflammation caused by reactions (or both), but it did not reduce my need for replacement hormone. I found out later that I was allergic to wheat, but I’ve not tried to see if I have any sort of reaction to barley or rye. Other than the food reactions, my TSH has remained fairly stable. Balancing my diet has also not had an effect on my level of thyroid replacement. I most likely have some kind of permanent damage to my thyroid but am not sure how it happened. I’ve never been diagnosed with Hashimoto’s. I had my antibodies tested back in 2012, and they were negative. I’m having my antibodies tested again now to see where things stand, and I hope to have another round done later if needed. I have an endocrinologist appointment in November. I hope he can provide answers and can perhaps do an ultrasound to find out exactly what’s going on. If it’s not Hashimoto’s, I wonder if a severe ear infection I had in the summer of 2005 might have caused thyroiditis that eventually led to permanent hypothyroidism. The ear that developed the infection I believe was already vulnerable due to acoustic trauma about 10 years earlier, when a child I was babysitting pointed a cap gun at my ear and pulled the trigger. I also cannot recall any serious hypothyroidism (or hyperthyroidism) symptoms leading up to the diagnosis. If any symptoms were present, they were mild.

  56. Hi all, I know this is a dated article but I’m desperate. I’ve been dealing with some sort of an autoimmune response for the better part of a year. Doctors and rheumatologists don’t know what to think. I’ve tested positive for my ana. After being told by my first rheumatologist that he couldn’t help me I felt on my own and decided to do my own research, and have come to the conclusion that I’m dealing with something thyroid related, and possibly of the autoimmune kind. Thyroid dysfunction runs in my family. But I am rather confused as to what I’m dealing with, either hypo or hyper. When my symptoms started I felt very much hypo and now as of the last month or so I feel I am having symptoms of hyper. It’s very confusing, this fluctuation of symptoms. I see my second rheumatologist at the end of this month but I’m very anxious and disheartened, afraid I will be turned away by this one as well. My symptoms scream autoimmune. I have had flare ups of some kind already, my life is in shambles and no doctor can help me. Strangely my TSH has been tested twice in the last year and it’s both been within the normal range. I don’t know what to do. I don’t want to be backed into a corner by doctors anymore but I’m afraid I won’t find a doctor whose willing to run a full thyroid panel.

  57. I’ve had Hashimoto for 2.5 years now and my GP put me on 30mg NP Thyroid. My original symptoms were dry crepe skin, thinning hair, foggy brain, achy muscles and joints, plus 10-15 lbs weight gain. Most of my symptoms were corrected rather quickly, especially my foggy brain which made me very happy, but my hair was still falling out and my skin was still extremely dry and thin. All my test results after starting the NP came back within normal range. So I began doing some research and found articles on the promising benefits of turmeric and Hashimoto. I began making my own Golden Milk and drinking it twice a day ( I also take Selenium, Zinc, Desiccated Liver, D3, and B12) and I was thrilled to find my hair stopped falling out after about two weeks on GM!!! I have been pretty much symptom free now since I began treatment and I continue to drink GM at bedtime everyday. Now I’m wondering if Hashimoto can be reversed completely? I’ve been reading about the benefits of celery juice and the connection between EBV virus and autoimmune disease, and so I’ve been drinking celery juice every morning for two weeks at a time with on one-off, for about six months, but now I’m having hot flashes quite often and I’m gaining weight!! I’ll be getting lab work done in Sept. In the meantime, should I cut my NP Thyroid in half? Could I be reversing my Hashimoto? Thank you.

    • Hi Miranda,

      It would be best to get your labs tested and to see those results before you make any decisions about your medication.

  58. Dear Dr. Childs. Thank you for the information. I was recently diagnosed with Hashimoto’s and am trying to figure out what my triggers are and if what I’m feeling is related to Hashimoto’s or something else. I will be seeing an Endocrinologist soon (long wait for new patients), since the physician who diagnosed me originally didn’t think it was much of an issue. My question for you and other posters here is, how long does it take for symptoms to appear once you’ve been exposed to a trigger? For example, if I eat soy products for dinner one night will the symptoms appear the next day or in a couple of days? How quickly does the body react to something that it sees as a trigger? Or does it vary by trigger? Thank you.

    • Hi Jennifer,

      It just depends on your body, it could be very quickly (days) or up to weeks depending on the exposure, your sensitivity and so on.

  59. I have been looking for some way to understand what has been wrong with me for about a year and a half. I’m almost positive it may be Hashimotos. It started with severe fatigue and hormonal problems. I was bleeding abnormally. I take birth control pills. I skip the period partly due to the fact my OCD is bad when I have monthly stuff. They thought just taking a break from the pills would help. It did but only for two weeks. It would constantly happen over and over. It wasn’t like a full blown period but it was annoying and I felt weak and in pain. Not cramps but the pain in my back and joints. I felt awful for like a year. I even went to the emergency room when I felt awful. My back hurt, my joints were in pain, I didn’t feel well at all. I was tired and dizzy but I could only nod off not sleep. I was severely constipated. My stomach was swollen. They did a test. The said I was just constipated and my blood sugar was low. Eat some fruit they said. I ate fruit like crazy and took a stool softener. It didn’t help enough. I had labs that I looked at online. My white and red blood cells were high. TSH was about a tenth of a point below being too high. So cause it was in there range I was ok. I went to my doctor did more blood test. It went down. What a surprise I felt better so everything was better. I’m sure I had a flare-up. But they said I had a vitamin D deficiency. Take some vitamin D3 and then go meet with the psych doctor again. It was so frustrating that I haven’t gone back since. I have done some research and am trying gluten free. But the problem is money. I find myself eating stuff I shouldn’t because it was cheap or work had a pizza party. I usually don’t feel well after eating stuff with gluten. My stomach is still swollen sometimes. Probably because of a flare-up. I also have had several stressors due to my husband leaving two years ago. I don’t know what to do. I’m afraid to go to the doctor. As long as I’m gluten-free and I take a thyroid supplement I found called T8 or Thyro8 for thyroid support I’m fine. But financially I’m having a hard time. I find myself giving in and just eating gluten. When I’m around friends and family I just eat what they have because I don’t want them to go thru trouble for me. Most people think I’m crazy. They don’t get why gluten free if I don’t have celiac disease. Many think I’m a hypochondriac. But I know something is wrong. But no one will believe me. So I try to eat a certain way at home but the problem is when I’m out elsewhere for dinner. I’m not sure what to do but your so helpful thanks.

  60. I am a 25 year old petite female and have just this year been experiencing all the symptoms for hypo/hyperthyroidism, leading me to do a lot of research on Hashimoto’s. I have normal TSH/T4 levels although my TSH has been closer to hypo. I have the TPO antibodies which my doctor has only checked once. My symptoms came on suddenly and have not changed for a month: anxiety, panic, lethargy, fatigue, brain fog, trembling, loss of appetite, weakness, restless sleep, emotional, etc. I’ve also been sick with a cold/flu/post nasal for months on and off with no resolve. I have also stopped driving because of the anxiety, morning sleepiness, so much crying!

    Initially, my doctor treated me for anxiety…and sent me to behavioral therapy/psychiatry. Basically calling me crazy! It helps but I don’t think is the root cause because I have never had an anxiety/panic attack before this year.

    My Endo has me on 12.5mcg of Levothyroxine to see if it will help my symptoms, it has only been a week so nothing noticeable yet.

    I am also trying a gluten free diet because I have heard that has helped other with symptoms. I have never been tested for celiac disease, or any other food allergy.

    I am very interested in trying CBD oil, however there is no doctor or anyone I’ve found that would talk about this other than on the internet. Does anyone have an opinion on this?

  61. Thank you for this article!
    I’m 44 and I was diagnosed hypo 20 years ago and put on thyroid meds. Only 4 years ago did I find an endocrinologist who got my levels within the “normal” range.
    I was diagnosed with Hashimoto 4 months ago.
    My situation is complicated by a nasty fight with BRCA1 breast cancer in recent years. I was on study meds, intense chemotherapy radiation, tamoxifen for 4.75 years now and had 17 surgeries. It gets hard to tell what symptoms are from what.
    I have been tired got a year now.
    I am 60 lbs heavier than I used to be but am one of the healthiest eaters I know.
    Due to my Hashimoto’s, I recently eliminated every bit of gluten and lectins. I eat an anti-inflammatory diet containing no soy, gluten, nightshades, sugar, grains and specific and limited dairy (following the plant paradox diet). My food is organic and my animal products grass fed.
    I have not sweated in 10 years which leads to overheating (heat strokes) in the summer.
    My legs recently started hurting a lot. My knees started last year.
    My question: how do I know what is caused by Hashimoto and how do I know I am on the right track and that my strict dietary efforts are worth it? I read so many books on these topics, take loads of supplements and exercise daily. What am I missing and why is there never any progress despite 10 years of efforts? I want nothing more than to be thin again.

    • Hi Jennifer,

      It will just take a lot of diligence and a caring doctor to figure out what is what. The truth is that most physicians won’t have the time to devote to such a task but it is certainly possible. And it is also definitely possible to improve your weight, but it sounds like you have more issues than just your thyroid contributing. You’ll need to identify and treat those issues as well.

  62. Good Morning,

    My Dr.. insists that I don’t need my antibodies checked due to the fact we know I have Hashimotos – but I feel that’s how I know if I’m having a flare ( like currently ) or if all these symptoms are something else I should be looking into. Wondering if anyone experienced air hunger, slight blood pressure swings – blood sugar swings during your flares?

    Thank you!

  63. I was diagnosed with Hashimotos about 4 years ago, after struggling with symptoms for about 15 yrs. As a simple sono and then antibodies test made it impossible to deny, something that no dr before cared to even check. I was 12 when I started feeling there was something wrong with me and I convinced my mother I needed to see a doctor. Because of my age, and I feel like because I was female, doctors never took me seriously all the times I visited one, and I was made to suffer in silence, made to feel like it was all in my head. I was a very depressed, child, teen, young adult with absolutely no energy and constant pain and discomfort.

    Anyway, my younger sister has been having symptoms that to me seem mostly hyperthyroid.
    She’s gained 30 lbs in less than a year, she has anxiety, heart palpitations, can’t sleep, has developed a red rash on her face that never really goes away. I keep telling her to continue to check her thyroid but the results always come out within range and doctors dismiss her. She wants to rule out thyroid issues because as they don’t find anything, she trusts it must just be stress and anxiety-like they tell her.
    I just want to help her, I don’t want her to suffer as I did, but I don’t know-how.
    Would you recommend any tests that may be telling or any way that doctors will take her symptoms and suffering seriously?

  64. I have been experiencing one of the worst flare ups I’ve ever had. I gained 7 lbs in a week; my hands, face and feet are so swollen, especially my feet, which makes walking extremely painful; GI issues; rough red dry patches on my skin; fatigue; brain fog; feeling out of breath… And the list goes on. My doctor simply raised my medicine and now I’m at 150mc of Synthroid and 5mc of Cytomel. I’ve reached my max dose in a little over two years. Is it normal for this disease to progress so quickly? I feel like my doctor just throws medicine at me every time I see her. It leaves me wondering what my next steps are now that I can’t increase my medicine anymore.

      • When I was 7 I started gaining weight at an insane pace and by the time I was in 3rd grade, I had started my period and was already overweight reaching the point of obese for my age. This never made sense to me or my family because I was, and always have been very active ( I am always on my feet doing things around the house or in the yard. Playing with my, then, siblings and now my girls) and I never ate more than any of my 6 other siblings. The doctors didn’t have any other advice for my mom than to put me on a series of ever more stringent diets that did nothing as I continued to gain weight at a pace of 15-20 pounds a year. it wasn’t until I was in high school and I realized that the bump on my throat was not normal that anything changed. They removed the bump, benign, and I lost 30 pounds in 2-3 months doing NOTHING!!! not even an occasional run or burpee… Nothing. I wasn’t even in sports! I was on robotics for gosh darn sakes! Anyway, the weight stayed off for five years until suddenly it all came back within a matter of months. It seemed like there was nothing I could do to stop it. My lifestyle didn’t change I was still as active but I could not get rid of it or stop it from happening. Then I became unexpectedly pregnant with twins and so I stopped trying to lose the weight. Over the next 6 years, I have gained an additional 30 pounds that will not budge. After they were born I dealt with depression, which I have NEVER experienced, coupled with brain fog, memory problems, intense fatigue, and just recently my hair is falling out, my joints hurt as if they are swelling up, stomach problems that range from each spectrum day to day, and a constant pressure in my brain that radiates to my eyes. I am very conscious of how and what I eat and I am always moving, you have to with twins, but the only thing the doctors tell me are your tests are normal, maybe you should take this class on portion control and how chips are not an appropriate snack. I am so frustrated and angry especially after bawling my eyes out at one doctor and saying “it has to be my thyroid I don’t think it could be anything else.” And her response “what do you want me to do about it? Your tests are normal… Here is a pamphlet on healthy choices.” I feel like I’m going crazy, every couple of months it’s a new symptom or a worsening symptom from before. One month I can’t sleep and my heart is racing strangely to the next I sleep for 9-10 hrs and it’s never enough. day to day I go from having the energy to do anything to laying on the couch all day, or being able to remember the entire script of beauty and the beast ( my girls love the movie) to not remembering my brother-in-law’s name, someone I have known for ten years!…… I just want to know if I’m crazy or if I am on to something. Is it really that I’m just fat and too lazy to do anything about it? Or do I have a serious problem?

  65. Now if only I can convince my GP that Hashimoto flare-ups are a real thing. Apparently “hypothyroid symptoms are only ever gradual. They don’t ‘flare-up'”. I love having my symptoms completely invalidated like that.

    • Hi Serene,

      Yes, I would consider it serious. Most doctors ignore antibodies because they don’t believe they can be treated. They would rather wait until your thyroid gets destroyed and then put you on Synthroid/levo, this is just how they approach Hashimoto’s.

  66. I’ve had all of these symptoms getting progressively worse for 13 years. Three years ago I got pneumonia and I’ve really struggled afterwards, I have no life due to fatigue, low energy, hip and shoulder pain, migraine and bloating etc.

    I’ve had fluctuations in TSH for years and was told borderline Hypothyroidism and was monitored.

    I have a diagnosis of ME and Fibromyalgia. I have Microvascular Angina.

    Finally, in March. I was found to be hypothyroid and started on Levothyroxine 50mcg. My TSH came down to 1.1 so GP happy to leave me for a year.

    We just got my bloods done privately and TSH up to 2.4. Thyroglobulin antibodies positive/high. T4 not converting to T3 very well. Low vitamin D. The doctor who reported said I may have autoimmune disease, possibly Hashimoto.

    Reading this article and some posts I can identify with everything. Sudden brain fog, fatigue, lack of energy, mood changes, painful debilitating hips and shoulders, flushing, intolerance of cold, bloating, weight problems…etc

    I feel a bit overwhelmed at the moment, taking it in and wondering whether to see my GP (who can be stubborn) or see if I can go private??

  67. To begin.. I’m not trying to sound Unsympathetic to the side effects of Hashimoto Disease. But I work with a female that says She has Hashimoto’s. Trust me I understand the feelings of some of the symptoms due to my Anti Estrogen medication. But I do have a question regarding the other thing she says is going on… I am not finding anything connecting her other issues with Hashimoto’s. She says she is having Muscle Biopsies on her leg… 2 0f the 3 tests I have ruled out ( I know I’m not a Doctor) But ruled out because she is not male. She says she has Thyroid cancer but has not been diagnosed.. I know approx. 90% of the nodules on a thyroid of a person with Hashimoto’s is usually Benign. I ended up having a muscle spasm due to over exertion of my pectoral muscle after a fill of my tissue expander. A few days later a co-worker asked me about my spasm and asked if I knew of any problems prior to this and explained that this girl was complaining of having Spasms. She is also said that she was in the hospital for one afternoon with Kidney stones and a kidney infection, but a few hours later..she told someone else she was sick at home and not going anywhere. Now she is saying that all of her organs are failing and they have given her one year to live. I am not finding any branch, avenue or bridge to connect these ailments to Hashimoto’s. I am beginning to believe this is a ploy to get sympathy Is there a possibility that these issues/ailments are connected to Hashimoto’s or could there be another underlying condition that is present?

  68. Hello,

    I was diagnosed many many years ago, now my son had been diagnosed with hypothyroidism now. Neither of us have a doctor here that actually understands what’s going on with us, I lost my job (a job I had done for years because the brain fog was so bad I couldn’t even remember how to do my job) my son is overweight had sleeping problems, falls asleep driving, and he can’t breathe. It’s been terrible, some days I wake up fine sometimes I can’t even walk or use my hands.

  69. Hi Dr. Westin Childs,

    While I don’t have Hashimoto’s Disease, I do have multiple sclerosis. So, I read and try to absorb any and all information I can find on autoimmune diseases.

    What was particularly interesting was the view that autoimmunity is a deep-rooted problem in the body. This is true, with the same probable causes, for MS.

    I am not entirely sure, what role hormones play in multiple sclerosis, but they are certainly likely to be a factor. This is something new for me to investigate.

    Thank you for the very detailed write-up.

  70. Dr Child’s:
    Thank you for this article that saved my sanity! I’ve been back to my Dr several times asking “why do I have these high/lows”! I’ve battled Hashimotos for 11 years now, have been on AIP diet for last 5 years. My husband was in near fatal vplane crash 5 years ago, which took a toll on my health & I can’t seem to get on top. My TSH is suppressed for last 2 years, with correlating T3/T4 moving like a seesaw! So, I flip between hyper/hypo.
    It’s frustrating & very lonely since you don’t tell anyone because no one “gets it” anyway, and especially Drs!
    Just this past month my brain issues have been so bad, I CANNOT talk on the phone past 20 minutes anymore because I get so antsy & feel like patience, ability to focus, memory is SO bad right now!
    I just had him switch me to Armour (from compounded levo/cytomel that I’ve taken for years) to see if that will help.
    Thank you for this article,, I need to back up & check for triggers. Drs like you are so few, who REALLY care..God bless you!

    • Hi Susan,

      So glad you enjoyed it! Thanks for sharing and I hope you are able to find a doctor who is more willing to listen.

  71. I’ve had Hashimoto’s since 2000. My experience with foods that contain a lot or even moderate amounts of iodine is that I’ll feel hyper, which means I’ll feel too warm and the most disturbing effect is trouble sleeping that night. But by the next day, the effect wears off.

  72. I’m 43, diagnosed with Hashimoto when I was 16. Been on Levo/synth. since diagnosis, with little issues.
    However, within the last few weeks I’ve developed a horrible rash directly on my thyroid gland area. It comes and goes, gets really red and inflamed, is triggered by heat, and not only itches like hell, but burns like a chemical burn would feel. There are also two distinct red lines across my throat that consistently come and go as well. This has never happened to me before, what the heck is going on?!

  73. I was diagnosed over 2 years ago with Hashimoto’s. I have been through several flare ups since. My NP keeps telling me that my numbers are fine. Then why do I feel like I did before I started thyroid medicine? I’m being to think I am “crazy” and it’s all in my head. That’s how many of my family members treat me. I wish they could feel for 1 hour like I do, just so they would maybe understand. The fatigue, IBS, brain fog and migraines are horrible. I just want my life back.

  74. Can a person have Hashimotos but have normal labs and no antibodies? My thyroid ultrasound showed thyroiditis and recommended a fine needle aspirant my labs are fine even according to my functional medicine doctor.

  75. I have been dealing with hypothyroidism for years with the last 3 years being the worst. At the start my doctor kept telling me I was in the normal ranges, then I was borderline so let’s just wait and see. Finally my doctor acknowledged the hypothyroidism and started me on 50mcg of synthroid. Three years later that has increased to 125mcg. My symptoms are all over the place between hypo and hyper. I can be freezing cold to the touch but burning up inside and sweating through my clothes. Then in an instant I’m so cold nothing will warm me up, my temperature frequently drops to 35 C (95 F) which is basically hypothermic. Extreme fatigue to the point of afternoon naps and falling asleep at work, gained 40 pounds in 3 months but lack of appetite, lack of concentration, muscle weakness, achy joints, terrible constipation, headaches, depression. The list is exhausting. I am now on 5 different prescriptions: 125mcg synthroid, 60mg duloxetine for depression, 20mg dextroamphetamine to keep me awake during the day, 1000mg metformin to try and balance my hormones and 10mg oxybutynin to control the excessive sweating. I also have an inhaler to use as needed and get a B12 shot every month. I’m 42.
    I went to a naturopath a few times and my number was in the 600s. I took her talk of hashimotos to my doctor and he brushed it off and didn’t want to even consider it. Unfortunately the naturopath hasn’t been available lately due to 2 maternity leaves and her own health issues.
    Stress is my major trigger. During Covid I worked from home for over a year, it was great and my stress levels were down. Since going back to the office 8 months ago, my antidepressant had to be changed because it was no longer effective and 2 of my other meds had to be increased. Everyday I come home and I am absolutely exhausted, I want to go to bed before supper. My doctor tells me I just need to exercise, and that will solve most if not all of my problems.


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