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Medical Author:

Ruchi Mathur, MD, FRCP(C)

Ruchi Mathur, MD, FRCP(C)

Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The signs and symptoms of Hashimoto's disease are the same as those of hypothyroidism. The disease is slow to progress, and it may take years for true hypothyroidism to develop.

The signs and symptoms of hypothyroidism vary widely, depending on the severity of hormone deficiency. Some of the complaints experienced by those with hypothyroidism include:

• fatigue,
  
  
• mental fogginess and forgetfulness,
  
  
• feeling excessively cold,
  
  
• constipation,
  
  
• dry skin,
  
  
• fluid retention,
  
  
• non-specific aches and stiffness in muscles and joints,
  
  
• excessive or prolonged menstrual bleeding (menorrhagia), and
  
  
• depression

These signs and symptoms can increase in severity as the condition worsens.

Complications of Hashimoto's disease

The complications of Hashimoto's disease are the same as those of an underactive thyroid gland. The complications may be local and related to the structural changes in the gland or systemic (body-wide) and related to the decrease in hormone production.

Local complications

Goiter: As described above, the pituitary will try to stimulate production of thyroid hormone in an underactive thyroid gland affected by Hashimoto's disease. This may cause the gland to become enlarged. Unlike a thyroid nodule, in which only a part of the gland is enlarged, in this case the entire gland enlarges- a condition called goiter. Goiterous glands are usually no more than a cosmetic nuisance. However, in extreme cases, growth of the gland may cause impingement on the esophagus or the trachea, impairing swallowing and breathing, respectively.

Systemic complications

Cardiac: Prolonged hypothyroidism that may result from untreated Hashimoto's disease also may be associated with an increased risk of heart disease. The heart disease may be directly related to hypothyroid effects on the heart, causing changes in contraction and rhythm that may lead to subsequent heart failure. There may also be indirect influences, such as hypercholesterolemia (an increase in "bad" cholesterol is often seen with hypothyroidism).

Psychiatric: Depression may occur early in Hashimoto's disease and if underlying depression exists, the addition of Hashimoto's may worsen the condition. Patients may complain of mental fogginess or slowing of reaction times, and a decrease in sexual desire is often observed.

In its severest form, hypothyroidism may result in a rare life-threatening condition called myxedema or myxedema coma. There is mental slowing, profound lethargy, and ultimately coma. This is a life-threatening emergency.

It is important to remember that during states of hypothyroidism, the metabolism of drugs slows down. Thus, a very small dose of a sedative may have profound results. Unintentional overdosing becomes a very real possibility.

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