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Hashimoto’s Disease and Women

Published on Jun 09, 2016
Authored by Diana Dills, MD

Women go through many hormonal changes throughout their lifetime, from pregnancy to menopause, which can leave them feeling a little run down, chilly, dry and with irregular menstrual periods. But did you know that these are also telltale symptoms of a thyroid disorder called Hashimoto’s disease?

Hashimoto’s disease is an autoimmune disorder that leads to a lower release of thyroid hormones. It is also the most common cause of hypothyroidism (underactive thyroid) in the United States. The disease affects about 14 million people in the U.S., and is 7 times more likely to affect women than men. And yet, anyone can get it, including children.

Named after a Japanese researcher who first described it in 1912, Hashimoto’s disease (also called autoimmune or chronic lymphocytic thyroiditis) occurs when the immune system attacks the thyroid. The thyroid is a butterfly-shaped gland located at the base of the neck. The attack by immune antibodies can lead to chronic inflammation and the inability of the thyroid to produce enough thyroid hormone to keep the body functioning normally. The reason for this, as with most autoimmune disorders, is not well understood. However, people who have family members with the disease may be at a higher risk for developing it themselves.

Don’t Ignore the Signs and Symptoms

In many women, it may be hard to tell the difference between Hashimoto’s disease and other hormonal conditions, such as menopause, because the symptoms can be similar. Possible signs and symptoms of Hashimoto’s disease include:

  • Constipation.
  • Difficulty concentrating or thinking.
  • Dry skin.
  • Enlarged neck or presence of goiter (caused by enlarged thyroid gland).
  • Fatigue.
  • Hair loss.
  • Heavy and/or irregular periods.
  • Difficulty achieving or maintaining pregnancy.
  • Intolerance to cold.
  • Mild weight gain.

If you experience these symptoms, it is important to speak to your doctor right away. Hashimoto’s disease may put you at higher risk for other autoimmune disorders, such as rheumatoid arthritis, type 1 diabetes and Celiac disease. And if you don’t treat it, you may suffer the risk of certain complications such as myxedema (severe hypothyroidism), birth defects in pregnant women, and goiter.

Having symptoms of low thyroid function does not necessarily mean you have Hashimoto’s disease. But reduced thyroid function often leads to Hashimoto’s disease.

Hashimoto’s Disease and Pregnancy

Hypothyroidism can affect ovulation and make it more difficult for a woman to get pregnant. If you are diagnosed with Hashimoto’s disease and you do become pregnant, it is advised that you work with your doctor regularly (about every 6-8 weeks during pregnancy) to make sure your thyroid is functioning properly. Keep in mind that the fetus relies on the mother for an adequate supply of thyroid hormone during the first trimester.

Without enough thyroid hormone, there is a risk of many complications, including: Preeclampsia or high blood pressure during pregnancy, anemia (not enough oxygen due to low number red blood cells), miscarriage, postpartum bleeding, preterm birth, low birth weight babies, birth defects, and other problems. Treatment for Hashimoto’s disease during pregnancy is needed and is safe for both the mother and baby.

Tips for Successful Treatment

There is no cure for hypothyroidism caused by Hashimoto’s disease, but it is treatable. If you are diagnosed with Hashimoto’s, you may need hormone therapy, a synthetic thyroid hormone taken as a pill. Here are a few things to remember when it comes to taking thyroid medication:

  • Stick to the same brand or generic thyroid medicine throughout the course of treatment to avoid possible changes in thyroid levels in your body. There may be some differences in the level of active ingredient depending on who makes the medicine. Whether you take a particular brand or generic, the important thing is to keep taking the same one.
  • Take your thyroid medication on an empty stomach with a glass of water, and wait at least 30 minutes before drinking or eating anything. Many foods or drinks can interfere with absorption, including milk and coffee. First thing in the morning may be a good time to take it.
  • Always take your thyroid medication by itself and not with any other medications. Certain medicines can interfere with the absorption of your thyroid medication, such as calcium supplements, iron supplements, and antacids containing calcium or aluminum. Wait at least 30 minutes before taking any other medication (this includes vitamins, if you take them).
  • Have your thyroid replacement levels checked about once a month until they are stable at a normal level and discuss with your doctor how frequently after that to get tested.  

Dr. Diana Dills is a Senior Director for the Cardiovascular and Metabolic Team at Pfizer.

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