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Can you die from hashimoto disease: Can You Die From Hashimoto’s Disease?


Can You Die From Hashimoto’s Disease?

  • Overview
  • Symptoms of Hashimoto’s disease
  • Diagnosis and treatment options for Hashimoto’s disease
  • What happens if Hashimoto’s disease isn’t treated?
  • The lowdown

Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, is an autoimmune condition that affects the thyroid gland and can cause underactive thyroid or hypothyroidism. In rare cases, it can also lead to hyperthyroidism or overactive thyroid. 

Under Hashimoto’s disease, the immune system makes antibodies that attack the butterfly-shaped thyroid gland found at the bottom of the neck. 

With Hashimoto’s, vast amounts of white blood cells that form part of the immune system build up within the thyroid, affecting thyroid hormone production. Thyroid hormones regulate the metabolic activity, meaning they affect almost every organ in the body.  

The exact number¹ of people with Hashimoto’s disease is not known. However, it is the most common cause of hypothyroidism, affecting about 5 in 100 Americans.

Hashimoto’s is four to ten times more prevalent among women than men, and it might also appear in young women or teens, increasing in prevalence with age. 

Hashimoto’s disease has hereditary risks, which means you are more likely to develop the condition if a family member has genes associated with the disease. 

Additionally, an individual is more likely to have Hashimoto’s disease if they have other autoimmune disorders, such as 

  • Celiac disease: which is a digestive disorder that damages the small intestine

  • Lupus: a long-term, chronic disorder that can affect the whole body

  • Rheumatoid arthritis: a condition that affects the joints

  • Sjogren’s syndrome: usually associated with dry mouth and eyes

  • Type 1 diabetes: a condition marked by high blood sugar levels

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Hashimoto’s disease usually progresses slowly for years with gradual loss of thyroid function until you notice symptoms of the disease. Most people miss the signs and symptoms during the initial stages of the disease. 

As thyroid hormone production declines, the first sign you might experience is goiter, an enlarged thyroid. Goiter is characterized by a swollen area in front of the neck, making it a challenge to swallow. 

Other symptoms of Hashimoto’s disease are similar to other medical conditions, so it is critical to see a physician for a diagnosis. 

Here are some of the signs and symptoms associated with the disease:

  • Metabolic: Less ability to tolerate cold, modest weight gain (due to fluid retention and decreased metabolism), hypothermia

  • Neurologic: Forgetfulness, tingling, or prickling in the hands and feet

  • Psychiatric: Personality changes, depression, dull facial expression, dementia or frank psychosis (myxedema madness)

  • Dermatologic: Facial puffiness, myxedema (swelling of skin or tissues), sparse, coarse, and dry hair, rough, dry, scaly, and thick skin, yellowish skin hue (particularly notable on the palms and soles of feet)

  • Ocular: Swollen or puffy area around the eyes, droopy eyelids

  • Gynecologic: Changes in menstruation

  • Cardiovascular: Slow heart rate, enlarged heart shown on examination and imaging

Unfortunately, there is no known cure for Hashimoto’s thyroiditis, but replacing hormones with medication can help manage the hormone levels and restore normal metabolism.  

Levothyroxine (Synthroid®, Levothyroid®, Levoxyl®), or T4, is the most common medication used to treat this condition.

The recommended prescription dose depends on age, weight, the severity of hypothyroidism, underlying health condition, or other medications that could interact with synthetic thyroid hormones. 

Before treatment, the physician will ensure the proper diagnosis of Hashimoto’s disease based on:

Physical exam and medical history

The physician will check the individual’s medical record and perform physical exams. Apart from exams and history, the doctor will also check your neck for goiter, a common disease symptom.

Blood tests

The doctor could also request blood tests to confirm hypothyroidism and its possible cause. Some of the tests include measuring levels of the thyroid hormones T4 (thyroxine) and T3 (triiodothyronine), thyroid-stimulating hormone (TSH), antithyroglobulin antibodies (AB), and thyroid peroxidase antibodies (TPO), a type of thyroid antibody that is present in most individuals with the disease.

Most diagnoses only need two tests (T4 and TSH/TPO) and a physical exam to confirm Hashimoto’s disease. Still, if a physician suspects you have the condition but cannot spot any antithyroid antibodies in your blood, they might request an ultrasound of your thyroid. 

The ultrasound images show the size of the thyroid and other features of Hashimoto’s disease. It is also great at ruling out other causes of an enlarged thyroid, such as small lumps in the thyroid gland (thyroid nodules).   

After diagnosis, the physician will prescribe treatment depending on whether the thyroid is damaged and causing hypothyroidism. If not currently hypothyroid, the doctor will typically check your thyroid hormone levels and symptoms regularly. 

The most commonly prescribed medication for managing Hashimoto’s disease is levothyroxine which is similar to the thyroid hormone thyroxine.    

The physician will conduct a blood test about six to eight weeks after you start taking levothyroxine and adjust the dose as needed.  

Note that you have to have a blood test every time you change the dosage. Once a perfect balanced dose is reached, the rate of blood tests slows down. 

Before stopping or increasing your dose, consult with your doctor to avoid complications. 

The issue with Hashimoto’s disease is that it has no obvious symptoms in the initial stages. Therefore, regular diagnostic testing is recommended, especially if your physician suspects you might have the condition or there is a family history of Hashimoto’s.

Over time, if Hashimoto’s disease goes untreated, it can cause several additional health problems. 


Subclinical hypothyroidism/thyroid antibodies² are linked to increased risks during pregnancy, particularly high blood pressure, miscarriage, and congenital disabilities. 

Here are more potentially severe conditions resulting from untreated Hashimoto’s disease:

  • Heart disease: The condition could either lead to high blood pressure or congestive heart failure

  • Kidney disease: People with hypothyroidism have a high increase in kidney dysfunction  

  • Peripheral neuropathy: Untreated Hashimoto’s disease could damage your peripheral nerves because of excess pressure

  • Myxedema coma: This life-threatening condition can occur when the levels of thyroid hormones get too low and symptoms get worse

  • Hashimoto encephalopathy: A rare disease that involves impaired brain function

So, can you die from Hashimoto’s disease? It is possible but a rare outcome. However, Hashimoto’s is a risk factor for some severe conditions that are among the leading causes of death in America. 

Women are more likely to suffer from Hashimoto’s disease, mainly due to hormones. It’s important to seek medical attention if you develop any symptoms such as goiter or if there is a strong family history of Hashimoto’s disease.

Death by unnatural causes, mainly suicide, is increased in patients with Hashimoto’s thyroiditis. A nationwide Danish register study

. 2019 Sep;65(3):616-622.

doi: 10.1007/s12020-019-01946-5.

Epub 2019 May 7.

Thomas Heiberg Brix 
, Charlotte Ferløv-Schwensen 
, Marianne Thvilum 
, Laszlo Hegedüs 



  • 1 Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, DK-5000, Odense, Denmark.
  • 2 Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, DK-5000, Odense, Denmark. [email protected].
  • PMID:


  • DOI:


Thomas Heiberg Brix et al.


2019 Sep.

. 2019 Sep;65(3):616-622.

doi: 10.1007/s12020-019-01946-5.

Epub 2019 May 7.


Thomas Heiberg Brix 
, Charlotte Ferløv-Schwensen 
, Marianne Thvilum 
, Laszlo Hegedüs 


  • 1 Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, DK-5000, Odense, Denmark.
  • 2 Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, DK-5000, Odense, Denmark. [email protected].
  • PMID:


  • DOI:




Hashimoto’s thyroiditis (HT) is associated with excess psychiatric in addition to reduced quality of life. However, little is known about risk of unnatural manners of death in HT. We investigated the risk of death by accidents, suicide, violence/homicide, and unknown causes in patients with HT, compared to a matched control population.


Register study covering all adult Danes diagnosed with HT during 1995-2012. In total, 111,565 HT cases were identified and matched for age and sex with four euthyroid controls. The hazard ratios (HR) for mortality were calculated using Cox regression analyses, adjusted for pre-existing morbidity. Median follow-up time was 5.9 years (range 0-17.5).


Compared to controls, HT patients had an increased frequency of death by suicide (0.10% vs 0.07%, p < 0.001) and unknown manners (0.05% vs 0.02%, p < 0.001). There were no significant differences between controls and HT patients in risk of death by accidents (0.36% vs 0.37%, p = 0.384) or violence (0.004% vs 0.005%, p = 0.749). After adjustment for pre-existing somatic and psychiatric morbidity HT patients still had an increased risk of suicide and death by unknown causes, whereas risk of death caused by accidents was reduced.


Mortality due to suicide and unknown causes, but not accidents and violence, was increased in HT. This indicates that HT may have a significant role in the pathophysiological mechanisms of suicidal behavior. This suggests that physicians caring for HT patients should be vigilant when facing expressions of suicidal ideation or signs and symptoms of self-harm as a first step towards prevention.


Hashimoto’s thyroiditis; Hypothyroidism; Mortality; Population-based; Suicide; Unnatural death.

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MeSH terms

Autoimmune thyroiditis of the thyroid gland

Many are sure that the cause of fatigue and chronic fatigue syndrome is in “malfunctions” with the thyroid gland. Namely – in chronic inflammation of the tissues of the thyroid gland (autoimmune thyroiditis). But is it?

Doctor’s consultation

You can get the consultation of the necessary specialist online in the Doctis application


You can undergo a comprehensive examination of all major body systems

  • Signs of autoimmune thyroiditis?
  • Autoimmune thyroiditis – as a cause of chronic fatigue
  • Diagnosis of autoimmune thyroiditis
  • Causes of autoimmune thyroiditis
  • Treatment of autoimmune thyroiditis

Autoimmune thyroiditis accounts for 20-30% of all thyroid diseases. Occurs in women
10-20 times more often than in men. What you need to know about this disease – signs
autoimmune thyroiditis and possible consequences?

Symptoms of autoimmune thyroiditis

What are the signs of autoimmune thyroiditis? Is it true that at the first stage the disease proceeds
no symptoms?

In fact, autoimmune thyroiditis is not one, but several diseases that are united by
inflammation in the thyroid gland. The classic variant is chronic autoimmune thyroiditis, or thyroiditis.
Hashimoto. It can lead to a persistent decrease in thyroid function – hypothyroidism.
I emphasize – maybe. But not always.

Autoimmune thyroiditis itself does not have any clinical
signs. Manifestations can only be in violation of the function of the thyroid gland. And then not immediately. Usually,
chronic thyroiditis leads to hypothyroidism years later, often even decades later.

Diagnosis of chronic fatigue syndrome

It is believed that autoimmune thyroiditis is the cause of rapid fatigue, weakness, syndrome
chronic fatigue.

Is it so?

Since autoimmune thyroiditis does not manifest itself in any way with intact thyroid function, let’s immediately
talk about its possible consequence – hypothyroidism. Hypothyroidism can indeed be accompanied
asthenia-like symptoms. Symptoms such as menstrual irregularities, constipation,
anemia, increased
cholesterol levels. However, similar manifestations occur in many diseases. That’s the problem
diagnosis of hypothyroidism, since even at advanced stages it does not have
specific signs.

Fatigue, weakness and drowsiness in some cases may be
associated with decreased thyroid function. But they can be a trail of other chronic diseases. And what
As for chronic fatigue syndrome, this is a beautiful, but not quite definite concept.

What tests to take to confirm (or rule out) autoimmune thyroiditis?

Search for autoimmune thyroiditis, in most cases, does not make much sense. A person can live a lifetime with
signs of autoimmune thyroiditis and die from another disease. But hypothyroidism is really
should not be ignored, since thyroid hormones (thyroxine and triiodothyronine) regulate
supply of oxygen to cells. With a deficiency of thyroid hormones, all cells without exception function.
in power saving mode. They seem to run out of batteries. They cannot adequately exercise their

Accurate and simple test for diagnosing hypothyroidism – TSH (thyroid stimulating hormone) level determination
in blood. With a decrease in thyroid function, it rises.

Why does autoimmune thyroiditis develop? I read that there are many provoking factors. For example,
pregnancy, lack of iodine in food.

A question for the Nobel Prize – no less! We do not know exactly the root causes of autoimmune diseases.
Even when it comes to the most common autoimmune disease – autoimmune thyroiditis. For some reason
cause, in predisposed persons, the normal functioning of the immune system is disrupted, and it attacks its own
cells. In this case, thyroid cells. Any autoimmune disease in general
significantly more common in women than in men. Sometimes – 10-20 times.

Pregnancy can indeed be a provoking factor. And more precisely –
period. The fact is that during pregnancy, the activity of the immune system is suppressed (this is necessary,
to carry an immunologically foreign fetus), and after childbirth is activated. Sometimes – excessively, causing autoimmune

Dietary iodine deficiency does not lead to autoimmune thyroiditis. And in general, you shouldn’t
associate thyroid disease only with iodine deficiency. Dozens of diseases have been described
thyroid gland – completely different in causes, course and prognosis – and only
some of them are directly or indirectly related to iodine deficiency.

Treatment of autoimmune thyroiditis

Is it true that hypothyroidism is the only indication for treatment
autoimmune thyroiditis, and in other cases, treatment is not required?

When it comes to chronic
autoimmune thyroiditis – absolutely right. Specifically affect the autoimmune process
modern medicine, alas, does not yet know how. Moreover, autoimmune thyroiditis, as already noted, is far from always
has an adverse effect on the body. Its only significant consequence is a decrease in function
thyroid gland.

And hypothyroidism is fairly easy to control. Replacement therapy for hypothyroidism involves taking daily
levothyroxine tablets. The dose is selected and
supervised by an endocrinologist
when determining the level of TSH. Any restrictions compensated patients with hypothyroidism,
usually do not experience.

The author of the article: Valentin Viktorovich Fadeev

Doctor’s consultation

You can get the consultation of the necessary specialist online


You can undergo a comprehensive examination of all major body systems

Autoimmune thyroiditis – causes, symptoms and diagnosis, indications for visiting a doctor

A typical representative of a large group of autoimmune diseases is autoimmune thyroiditis. This is an inflammation of the thyroid gland that occurs from the destruction of its cells by the immune system. It proceeds for a long time, often becomes chronic, therefore it is also found under the wording Hashimoto’s thyroiditis (Hashimoto) in honor of the scientist who, at 19In 12, he studied and described the disease, and as “chronic thyroiditis” (although there is another form of chronic inflammation – Riedel’s thyroiditis). This is the most common type of inflammation in the thyroid gland, among the four main forms of pathologies. Let’s take a closer look at what causes inflammation, how to diagnose, treat, and avoid it.

What is Hashimoto’s thyroiditis

This is inflammation that results from damage or destruction of thyroid follicles by cells of the immune system (T-lymphocytes). At the same time, infiltrates appear in the gland, and the activity of the gland and the amount of thyroid hormones in the body decrease. Hypothyroidism develops slowly.

The disease is diagnosed in 3% of all thyroid pathologies. Most of the patients are women. In them, this diagnosis occurs 10-20 times more often than in men. There is also a dependence on age – Hashimoto’s thyroiditis rarely occurs in people under thirty years of age. Most patients are middle-aged women (30-50 years).

Symptoms of autoimmune thyroiditis of the thyroid gland

The clinical picture largely depends on the form of the disease. In autoimmune thyroiditis, there are:

  • Atrophic course – the gland retains its former dimensions, but as the cells die, the glandular tissue is replaced by fibrous tissue.
  • Hypertrophic – a dense goiter is formed.

This is a slowly progressive inflammation, which is rarely characterized by exacerbations and signs of damage to the body as a whole (fever, increased ESR).

A typical picture at the beginning of the inflammatory process is implicit. Usually there are no symptoms.

Approximately 10% of women and 5% of men are carriers of antibodies to TPO or TG, while thyroid dysfunction may develop in 3-6%. Later, the production of TSH increases, the diagnosis is made according to the results of the tests. A sign of the next stage is hypothyroidism – the growth of the gland and a significant decrease in the hormones T3 and T4. As a result of the inflammatory process in the thyroid gland, it is destroyed and it stops producing hormones.

In an acute form of inflammation or as the disease develops, symptoms of destructive thyroiditis appear – palpitations, trembling in the hands, sweating.
This process usually takes 3 to 6 months. Subsequently, it turns into hypofunction of the thyroid gland, which is characterized by:

  • The induration on the neck is rather hard in structure, but painless on palpation and pressure (only 10% of patients complain of pain on palpation). Over time, iron, on the contrary, significantly decreases in volume.
  • As the gland grows, the neighboring structures of the neck are compressed, there is a feeling of a foreign body in the throat, lack of air, hoarseness of the voice.
  • Pain in the joints, rarely in the muscles.
  • General weakness.
  • Weight gain.
  • Constipation or indigestion.
  • Loss of hair, including on the eyebrows.
  • Dryness, unhealthy pallor of the skin, brittle nails.
  • Mental disorders of depressive type.
  • Frequent feeling of cold, chilliness.
  • Deterioration of memory and attention.
  • Edema of the face.
  • Bradycardia.
  • Decreased sex drive.

Many of the symptoms are associated not so much with inflammation, but with already developing hypothyroidism.

The characteristic symptoms of autoimmune thyroiditis in women are: irregular menstruation, prolonged absence of pregnancy with regular sexual activity, spontaneous miscarriages.

Causes of autoimmune thyroiditis

The disease occurs due to a malfunction in the immune system, which leads to the fact that gland cells are mistakenly perceived as foreign organisms. Why such a failure occurs is not exactly established. But there are a number of factors that can be considered risk factors and causes of autoimmune thyroiditis of the thyroid gland:

  • Hereditary predisposition at the gene level – dependence is confirmed by the fact that often the disease is familial and occurs in representatives of several generations. In such patients, often thyroiditis is complemented by such diseases as: vitiligo, rheumatism and others.
  • Infections of the nasopharynx, tonsils and oral cavity: laryngitis, pharyngitis and others, as well as untreated caries. The most dangerous are chronic diseases or acute forms of infection with complications in neighboring organs.
  • Severe or chronic stressful situations.
  • Polluted ecology (for example, excess chlorine in water, air).
  • An excess of iodine in the body for a long time.
  • Radiation exposure or a course of radiation therapy in the treatment of oncology.
  • Thyroid tumors of a benign nature (eg endemic goiter).
  • UV exposure, frequent and long exposure to the sun without protection during the hours when it is most active.
  • Uncontrolled or on the recommendation of a doctor (if necessary) intake of immunomodulators (for example, Interferon).
  • Long-term treatment with certain medications.
  • Blood diseases.


The main complications of thyroiditis include hypothyroidism and thyrotoxicosis.

Thyroid dysfunction may adversely affect:

  • Nervous, digestive, respiratory and cardiovascular systems.
  • Kidneys.
  • Skin and its appendages – nails and hair.
  • Musculoskeletal system.
  • Organs of the reproductive system.
  • Disorders of growth and mental development.
  • Metabolism.


If you suspect thyroiditis or other pathologies of the thyroid gland, you should contact an endocrinologist. It is this doctor who prescribes examinations, finds out the possible causes of thyroid dysfunction and decides how to treat the patient. At the appointment, the doctor will examine the patient and assess the condition of his skin, enlargement and soreness of the thyroid gland, learn about complaints, family history, concomitant diseases. Depending on the clinical picture, certain examinations may be prescribed.

Help with diagnosis:

  • Blood test – general, for TSH, T3, T4 hormones and antibodies to them.
  • Ultrasound is an affordable, quick and informative examination to assess the condition of the gland, its size, uniformity of structure, the presence of nodes, seals, fibrous areas and other pathologies.
  • Scintigraphy will help distinguish thyroiditis with thyrotoxicosis from other diseases with similar signs. It is based on the property of the affected gland not to accumulate a contrast agent in large quantities.

After clarification of the diagnosis by the endocrinologist, the method of therapy is selected.


In the early stages, when there are no disorders in the thyroid gland, no specific treatment is required. The doctor will recommend leading a healthy lifestyle, normalizing nutrition, giving up bad habits and monitoring your well-being. Regular annual consultations and examinations are necessary in order not to miss the further development of the disease.

If the function of the gland is already impaired, then in most cases hormone replacement therapy is prescribed.

Against the background of maintenance therapy, it is recommended to undergo periodic examinations to monitor the dynamics of changes and, if necessary, change the dosage of the drug.

It is not recommended to self-medicate, use folk remedies, take vitamins on your own or increase the dose of iodine in the diet.