29 common questions and answers about Hashimoto’s thyroiditis

  1. What is Hashimoto’s thyroiditis?
  2. What is an autoimmune disease?
  3. Is Hashimoto’s disease the same as hypothyroidism?
  4. Which forms of Hashimoto are there?
  5. Since when the Hashimoto Thyroiditis is known?
  6. How often does this disease occur?
  7. How is this disease detected?
  8. How can I recognize an onset of hypothyroidism?
  9. How do I recognize an onset of thyroid hyperfunction?
  10. When does my hormone requirement change?
  11. Is the Hashimoto’s disease curable?
  12. What is an endocrinologist?
  13. What do I have to pay attention to when visiting a doctor?
  14. May I take immunostimulant medication?
  15. Is this disease contagious?
  16. May I get vaccinated?
  17. May I smoke cigarettes?
  18. May I go to the sauna?
  19. May I donate blood?
  20. May I do sports?
  21. Do I get an ID card for severely handicapped with Hashimoto?
  22. Can I apply for early retirement with Hashimoto?
  23. What is a goiter?
  24. How is the size of a healthy thyroid?
  25. Which thyroid medications are available?
  26. What should I watch out for when planning a pregnancy?
  27. Which blood values ​​do I have to check during pregnancy?
  28. How does Hashimoto’s thyroiditis affect the child?
  29. Can Hashimoto’s thyroiditis be inherited?

What is Hashimoto’s thyroiditis?

Hashimoto’s thyroiditis is an autoimmune inflammation of the thyroid gland that was named after the Japanese Dr. Hakaru Hashimoto (1881-1934). This disease is caused by certain autoimmune processes. It is also known as chronic lymphocytic thyroiditis or autoimmune thyroiditis.

Hakaru Hashimoto was a Japanese pathologist and surgeon in Japan and discovered the autoimmune thyroiditis. He described it as a disease that affects mostly menopausal women. Today we know that women of all ages can be affected. Even men and children are not spared from this disease.

What is an autoimmune disease?

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

Is Hashimoto’s disease the same as hypothyroidism?

Hashimoto is not an underactive thyroid. The hypothyroidism is only a sequelae or a symptom of Hashimoto’s disease, which is caused by the fact that the thyroid becomes smaller and smaller in the course of the disease and at some point can no longer produce the necessary hormones. This inevitably leads to permanent hypothyroidism in the long run.

Which forms of Hashimoto are there?

In the current conventional medicine, two forms of Hashimoto’s thyroiditis are known. The atrophic form, in which the thyroid becomes smaller as the disease progresses. And the hypertrophic forms in which the thyroid gland increases steadily over time (goiter). Both forms of Hashimoto inevitably lead to hypothyroidism.

Since when the Hashimoto Thyroiditis is known?

The discoverer of Hashimoto’s thyroiditis, Hakaru Hashimoto, published in 1912 his discovery of “Struma lymphomatosa”, an enlarged thyroid gland with lymphomatous infiltration associated with hypofunction of the thyroid gland. The publication took place in a medical journal in Germany. Later, the disease was named after him.

How often does this disease occur?

The incidence of Hashimoto’s thyroiditis is currently around 10% of the total population, making it the world’s most common human autoimmune disease.

How is this disease detected?

One of the essential measures of the diagnosis is the blood draw with determination of the free thyroid hormones fT3 and fT4, the TSH and the thyroid antibodies. In addition, a scan of the thyroid gland by the doctor, as well as a sonography of the thyroid gland are inevitable. For more detailed information on how to diagnose, see: diagnose Hashimoto correctly

How can I recognize an onset of hypothyroidism?

An underactive thyroid is characterized by its typical symptoms. These include: severe fatigue, weakness, constipation, weight gain, brittle hair and nails, hair loss, pale skin, depressed mood, lethargy and sleep disorders. Detailed information on the typical symptoms of hypothyroidism can be found at: Symptoms of hypothyroidism

How do I recognize an onset of thyroid hyperfunction?

Hyperthyroidism is often recognized by classic symptoms such as weight loss, restlessness, nervousness, diarrhea, sweating, shaking hands, high heart rate, palpitations and irritability. For detailed information on the typical symptoms of hyperthyroidism, see: Symptoms of Hyperthyroidism

When does my hormone requirement change?

The need for thyroid hormones can change in many situations. The change of seasons or temperatures may require different dosages. But also sports, age, pregnancy and weight changes due to diets or sports. If you feel more worse in the winter than in the summer or have begun to exercise and your strength dwindles, you should always redetermine the thyroid hormones and correct the dosage.

Is the Hashimoto curable?

Hashimoto’s thyroiditis is not really curable. However, treatment with L-thyroxine and other thyroid preparations in many patients can achieve a reasonably symptom-free life. But not in all patients. They then have to deal with ancillary construction sites such as nutrient deficiencies, undetected food intolerances, HPU, candida, and malnutrition to feel better again.

What is an Endocrinologist?

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

What do I have to pay attention to when visiting a doctor?

It is important that you have your blood draw results handed out and filing them carefully. Only then a later setting with thyroid is permanently possible and a course of the setting can always be looked up and displayed. Also, all collected findings and medical reports should be kept in a separate folder. It is also useful to make a note of your questions in advance and take them with you to the doctor’s visit. Otherwise, due to the nervousness during a visit to a doctor, it always happens that you forget to ask important questions.

May I take immunostimulant medication?

Medicines that stimulate the immune system should be avoided in Hashimoto’s thyroiditis. These include echinacea, red coneflower and thymus preparations. Since the immune system already works excessively in Hashimoto patients anyway, there is the possibility of increased production of thyroid antibodies. This would cause the disease to progress faster.

Is this disease contagious?

Hashimoto’s thyroiditis is not contagious. Neither body contact nor blood infusions. Only a bone marrow transplant could be a risk of infection.

May I get vaccinated with Hashimoto´s?

That depends on the severity of the disease. Basically, protection against flu or other diseases using vaccines would be useful, especially if the immune system is disturbed anyway. By disrupting the immune system, Hashimoto patients are at greater risk of contracting an infectious disease. In this regard, in a mild form of Hashimoto’s thyroiditis, it may be useful to get vaccinated.

If Hashimoto’s thyroiditis is severe, it is not recommended to vaccinate, since vaccination is always a challenge for the impaired immune system and its ultimate impact would be unclear. Therefore, a vaccine should always be carefully weighed up with the doctor to be treated.

May I smoke cigarettes?

The smoking of cigarettes usually has a very negative effect on the disease course of a Hashimoto’s thyroiditis, because the smoking of cigarettes affects the immune system and suppresses it. Also, the treatment measures in smokers usually worse.

May I go to the sauna?

It depends entirely on the general condition of the patient. If the patient is not correct hormonally adjusted yet and in hypofunction, it may be that the circulation in the sauna weakens. Therefore, you should always be accompanied by someone at the first sauna visit.

On the other hand, if the patient has no symptoms in the sauna and is also hormonally well adjusted, there is nothing wrong with a sauna visit, it supports the body’s own detoxification and strengthens the immune system. The main thing is, that the patient feels comfortable in the sauna. Sauna sessions above the 15 minute limit are not recommended.

May I donate blood?

Hashimoto patients are not allowed to donate their blood for other people’s transfusion because the antibodies in the blood could be transferred to other people. For scientific purposes, a blood donation is of course allowed.

May I do sports?

Regular, modest exercise has a positive effect on the body and does not interfere with Hashimoto’s disease. On the other hand, excessive exercise is stressful for the body and is not conducive to disease progression in Hashimoto’s thyroiditis. This also applies to completely symptom-free phases. Since many Hashimoto patients also suffer from adrenal fatigue, extreme sports also worsen the constant release of cortisol and cause further discomfort. It is important to explore your personal limit of exercise and to not exceed it, if possible.

Do I get an ID card for severely handicapped with Hashimoto?

You can apply for a disability application at the competent pension office. However, you must expect difficulties from the authorities there because the recognition of a particular health impairment in the context of an autoimmune disease is assessed individually and the stubbornness of the authorities is known in such cases. In any case, a written statement from the attending physician or a specialist for Hashimoto is always helpful when applying for a severely handicapped ID card.

Can I apply for early retirement with Hashimoto?

If there is “only” a Hashimoto thyroiditis, a pension application in Germany is usually rejected. Even if this disease leads to a permanent impairment of the ability to work. However, in cases where Hashimoto is associated with other autoimmune diseases, a pension scheme can be quite positive.

What is a goiter?

A goiter is a pathological enlargement of the thyroid gland. However, this term is not limited to autoimmune diseases. A goiter is not a diagnosis, but merely a description of a too large thyroid. Often, a goiter develops with long-lasting iodine deficiency. But also autoimmune diseases can develop a goiter. A goiter from a certain size pressure on the surrounding tissue, causing a lump in the throat.

How is the size of a healthy thyroid?

The size of the thyroid gland is always given as volume in milliliters. In an ultrasound scan (sonography), the doctor can measure the thyroid gland and calculate the volume. The thyroid volume depends on several factors. Gender, age and height play a decisive role here. Children between 4-14 years usually have a thyroid volume of 3-10 ml. Adult women about 13-18 ml. Men are usually between 15 and 25 ml.

Which thyroid medicines are available?

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

T4 preparations

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


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

T3 + T4 Combination preparations

  • Novothyral® / Novo thyral75® ratio 5: 1, in the doses 100μg T4 + 20μg T3 / 75μg T4 + 15μg T3 available
  • Prothyrid® in the ratio 10: 1, in the dosage 100μg T4 + 10μg T3 available

Besides the synthetic hormones, there are also natural thyroid hormones, which are extracted from the thyroid glands of pigs or cattle. These are usually much more compatible and effective. I will soon be adding various manufacturers here.

What should I watch out for when planning a pregnancy?

Pregnancy is more likely if the thyroid gland is set correctly. The ripening of an ovum is disturbed by too high or too low thyroid levels. Therefore, the thyroid levels should all be within the normal range, so that nothing stands in the way of a pregnancy.

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

The most important parameters are the free thyroid levels fT3, fT4 and the TSH. These should be monitored every 4 weeks during pregnancy to adjust the dose if necessary, as the hormone requirement often can increase significantly during pregnancy. Even after pregnancy, these values ​​should be kept in mind as the need for hormones decreases and the dose of thyroid hormones must be adjusted. Also, the TSH receptor antibody levels should be determined regularly. If these antibodies increase, the child should be closely monitored by ultrasound and heart sound recordings.

How does Hashimoto’s thyroiditis affect the child?

A persistent hypothyroidism of the mother can lead to a reduced intelligence of the child. Persistent maternal thyroid hyperfunction may result in miscarriages, malformations and failure to thrive.

Can Hashimoto’s thyroiditis be inherited?

The passing on Hashimoto’s thyroiditis to the child is possible but not necessarily the rule. Women who suffer from multiple autoimmune diseases, however, are much more likely to inherit.

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