What Types Of Doctor Diagnose And Treat Hashimoto’s Disease? (2023)

  • Overview
  • What is Hashimoto's thyroiditis?
  • Symptoms of Hashimoto's disease
  • Hashimoto's thyroiditis diagnosis
  • What type of doctor treats Hashimoto's disease?
  • The lowdown

A range of specialists may play a role in managing thyroid disease and controlling its symptoms. Some individuals may see only one doctor for their thyroid-related problems, while others may have several doctors who work together to manage their condition.

Here you'll learn about the different Hashimoto's thyroiditis specialists and when you should get a second opinion.

What is Hashimoto's thyroiditis?

Hashimoto's thyroiditis, also referred to as Hashimoto's disease is a common thyroid condition in the U.S.¹ It's an autoimmune condition that affects more women than men, and it's also more common in older individuals.

Autoimmune conditions occur when the immune system in your body begins making antibodies that target parts of the body that they shouldn't.

Generally, your immune system works to protect your body and help fight disease. However, thyroid peroxidase antibodies (TPO), which are antibodies in Hashimoto's disease, target your thyroid gland.

This causes your thyroid to become inflamed and unable to produce thyroid hormones as normal. The results are low levels of thyroid hormone — a condition known as hypothyroidism.

Thyroid hormones are important for your bodily systems to function correctly. So, when you have Hashimoto's thyroiditis and hypothyroidism and leave them untreated, it can result in many complications, including:

  • Goiter: The growth of your thyroid.

  • Heart issues: Hypothyroidism can lead to an enlarged heart, poor heart function, and irregular heartbeats.

  • Mental health problems: Mental health conditions can develop, including depression.

  • Reproductive and sexual dysfunction: This can occur in both men and women and include ejaculation problems, low sex drive, and low testosterone levels.

  • Myxedema: A life-threatening but rare disorder that can develop because of severe, long-term, untreated hypothyroidism.

  • Pregnancy complications: This condition can lead to adverse effects during pregnancy,² including spontaneous pregnancy loss.

Symptoms of Hashimoto's disease

Hashimoto’s disease can slowly progress over many years, and you may not experience symptoms at all.

But, eventually, your thyroid hormone production will decline and lead to any of the symptoms below:

  • Weight gain

  • Fatigue

  • Muscle aches

  • Depression

  • Constipation

  • Reduced exercise tolerance

  • Dry skin

  • Increased cold sensitivity

  • Heavy or irregular menstrual cycles

When to see a medical professional about your symptoms

Hashimoto's disease symptoms aren't always specific to just that condition and can vary from person to person.

Since different conditions can also cause these symptoms, it's essential you see your doctor immediately to receive a timely and proper diagnosis.

Thyroid disease-related emergencies don't occur often, but they can occur. For example, extremely severe and untreated hypothyroidism can lead to hypothyroid ( myxedematous) coma (HC). This is an endocrine emergency that requires urgent care.

When there's a thyroid hormone deficiency, HC is typically triggered by various factors,³ such as:

  • Congestive heart failure (CHF)

    (Video) Hashimoto's Disease: Causes, Symptoms and Treatment

  • Low outdoor temperatures

  • Large liquid amounts

  • Depressants

  • Systemic infections

  • Cerebrovascular episodes

  • Labor

  • Neuroleptics

  • Anesthetics

HC accounts for around 0.1% of hypothyroid patients³ in hospital. It especially affects women who are older than 60.

(Video) Hashimoto’s thyroiditis: What Is It, Who's At Risk and What You NEED to Know

Hashimoto's thyroiditis diagnosis

Doctors may diagnose Hashimoto's disease if you have hypothyroidism symptoms, often with a goiter.

Diagnosis is determined through a physical exam and lab tests, regardless of whether there's low thyroid hormone or not. Typically, when doctors measure the TPO antibody, it's elevated.

On some occasions, doctors can diagnose the disease early, particularly in those with a significant family history of thyroid disease. At this point, there may be no hypothyroidism symptoms.

What type of doctor treats Hashimoto's disease?

You may be asking yourself, "what are the top doctors for Hashimoto's disease near me?" Or, "which specialist for Hashimoto's disease should I choose?"

Figuring out what type of doctor to see for your Hashimoto's thyroiditis can be a little confusing, as there is more than one type of doctor who can treat and manage this condition.

Doctors specializing in Hashimoto's disease come down to two types: a primary care doctor and an endocrinologist (Hashimoto's disease specialist, sometimes referred to as a thyroidologist).

(Video) A Doctor's Guide to Hashimoto's: Learn How to Heal Your Thyroid!

Primary doctor

Primary doctors are your first point of contact for an undiagnosed health problem and the continued management of various health disorders.


Endocrinologists are doctors who have special training in diagnosing and treating endocrine system disorders, including Hashimoto’s disease.

The endocrine system makes up your organs and glands that make hormones. These disorders include infertility, diabetes, along with adrenal, pituitary, and other thyroid gland issues like hyperthyroidism.

Along with performing a medical examination and taking your complete medical history, diagnostic procedures for this condition may include blood testing to detect levels of thyroid antibodies and thyroid hormones. Usually, a primary care doctor can manage this condition.

Your doctor may prescribe you a synthetic thyroid hormone replacement drug to help replace what your body isn't producing. However, there are times when you'll need to see a thyroid specialist and/or receive a second opinion.

When to get a second opinion

Some situations will require you to see an endocrinologist to oversee your care. This is a doctor specializing in the endocrine system. They are especially knowledgeable about thyroid gland function and the other hormone-secreting glands in the body. This makes them the best doctor for treating and managing Hashimoto's thyroiditis.

You may end up seeing an endocrinologist after you receive your initial diagnosis to evaluate your disorder, go over the results of tests, and go over your treatment plan. After one or two appointments with the endocrinologist, you may not need to see them regularly. This is typically where your primary care doctor can take over.

If you see your primary care doctor first, even with "textbook" hypothyroidism (with or without Hashimoto's disease), they may still refer you to an endocrinologist for various reasons, including:

  • They're not experienced in treating this condition.

  • You have a complex case due to multiple health issues.

  • They want the opinion of a specialist about your treatment and diagnosis.

The endocrinologist may wish to manage your disease on their own, depending on your diagnosis and plan of treatment. Or, they may decide to work closely with your primary care doctor to manage your condition.

Sometimes, it's a good idea to see an endocrinologist when:

1. You're experiencing hypothyroidism symptoms that aren't getting better with treatment

(Video) The Functional Medicine Approach To Hypothyroidism And Hashimoto’s Disease

If your symptoms persist despite taking thyroid hormone replacement medication, you may wish to set up an appointment with an endocrinologist to get a second opinion.

Some people with hypothyroidism have a harder time finding the right thyroid hormone medication concentration that works best for them. A specialist can usually help in these situations.

2. You have a lump or thyroid nodule

Your thyroid gland is situated right below your voice box in the front of your neck. If you have a nodule, lump, or another type of growth on your thyroid, it's best to have an endocrinologist look at it.

Most lumps are typically benign (noncancerous) and harmless, but in some cases, more severe changes can occur.

Some thyroid nodules turn out to be cancerous. And, while it's rare, some can cause hypothyroidism.

3. You have a goiter or enlarged thyroid gland

If you have a goiter, the endocrinologist can help determine why it developed and what type of treatment can help. They can also determine if you have hypothyroidism or not.

4. You have a pituitary gland condition that causes hypothyroidism

Your pituitary gland is located at the base of your brain, along with your hypothalamus. It controls your body's thyroid hormone production.

It's extremely unusual, but in some people, this gland can fail to give off the thyrotropin-releasing hormone (TRH) that helps stimulate thyroid hormone production.

Because this condition is complicated, seeing an endocrinologist will assist you in your next steps.

5. You're trying to conceive or are pregnant

It's important to know how Hashimoto's disease can affect your pregnancy or how pregnancy can affect your condition because hormone levels change considerably during pregnancy.

If you're looking to become pregnant or already are, you should see an endocrinologist to closely monitor your thyroid hormone treatment.

Leaving hypothyroidism untreated also increases your miscarriage risk, which is another reason you should see an endocrinologist if you're pregnant.

The lowdown

Finding the right doctor to manage your Hashimoto's thyroiditis can be overwhelming since this relationship is intensely personal. And, finding the right match isn't always easy.

When in doubt, start with your primary care doctor, and, if needed, they'll refer you to the right specialist for your case.

(Video) HASHIMOTO'S Thyroiditis: (5 Things YOU Need to Know) 2023


What is the best doctor to see for Hashimoto's? ›

Endocrinologists are doctors who have special training in diagnosing and treating endocrine system disorders, including Hashimoto's disease.

Should I see an endocrinologist if I have Hashimoto's? ›

Temple Simpson, MPAS, PA-C, an endocrinology PA at Magnolia Endocrinology, recommends seeing an endocrinology provider when you're first diagnosed with a thyroid disorder to review and understand your condition, your test results, and your treatment plan.

Can an endocrinologist help with Hashimoto's? ›

Our endocrinology specialists are experienced in diagnosing and treating all kinds of thyroid-related conditions, including Hashimoto's.

What test confirms Hashimoto's disease? ›

Anti-thyroid antibodies (ATA) tests, such as the microsomal antibody test (also known as thyroid peroxidase antibody test) and the anti-thyroglobulin antibody test, are commonly used to detect the presence of Hashimoto's thyroiditis.

What autoimmune diseases go with Hashimoto's? ›

Having another autoimmune disease — such as rheumatoid arthritis, type 1 diabetes or lupus — increases your risk of developing Hashimoto's disease. Genetics and family history. You're at higher risk for Hashimoto's disease if others in your family have thyroid disorders or other autoimmune diseases.

What are severe symptoms of Hashimoto's? ›

What are the symptoms of Hashimoto's disease?
  • fatigue.
  • weight gain.
  • trouble tolerating cold.
  • joint and muscle pain.
  • constipation.
  • dry skin or dry, thinning hair.
  • heavy or irregular menstrual periods or fertility problems.
  • slowed heart rate.

What is the best Hashimoto's treatment? ›

T4 Thyroid Medication

The most common Hashimoto's treatment is synthetic T4 hormone medication, usually prescribed as the drug Synthroid® or Levoxyl®. Synthroid® is actually the most commonly prescribed drug in America, with 21.6 million prescriptions a month.

What not to do if you have Hashimoto's? ›

Eliminating or avoiding the following foods can help reduce Hashimoto's symptoms and improve your overall health.
Worst Foods for Hashimoto's
  1. Added sugars and sweets. ...
  2. Fast food and fried foods. ...
  3. Refined grains. ...
  4. Highly processed foods and meats. ...
  5. Gluten-containing grains and foods.
Feb 28, 2021

What should my TSH be if I have hashimotos? ›

The authors did find that a TSH value of 4.2 to the be the upper limit of normal in their analysis. However, the authors used a “prevalence of Hashimoto's thyroiditis” factor to determine the upper limit of TSH and found a range of 2.6-2.9 to be more appropriate.

Should you remove your thyroid if you have Hashimoto's? ›

Due to the scarring and inflammation from Hashimoto's thyroiditis, surgery can be very challenging. The entire thyroid gland must be removed to cure Hashimoto's disease.

What are the best supplements for Hashimoto's? ›

Supplements containing vitamins D and B along with selenium, zinc, iron, curcumin, and magnesium are among the best supplements for Hashimoto's disease. Supplements may be beneficial for some patients with this condition but should be taken with your doctor's supervision as part of a treatment plan.

What levels indicate Hashimoto's? ›

The most common laboratory findings demonstrate elevated thyroid-stimulating hormone (TSH) and low thyroxine (T4) levels, coupled with increased antithyroid peroxidase (anti-TPO) antibodies.

What is the main cause of Hashimoto's disease? ›

It is caused by a reaction of the immune system against the thyroid gland. The disease begins slowly. It may take months or even years for the condition to be detected and for thyroid hormone levels to become lower than normal. Hashimoto disease is most common in people with a family history of thyroid disease.

What can make Hashimoto's worse? ›

The following factors could increase your risk of a Hashimoto's thyroiditis flare-up:
  • Stress. Stress may not directly cause a Hashimoto's thyroiditis flare-up, but it's thought to worsen the condition. ...
  • Medication. ...
  • Nutritional factors. ...
  • Genetics. ...
  • Radiation.

Does Hashimoto's show up in blood work? ›

Hashimoto's is typically diagnosed through a combination of your signs and symptoms, as well as blood tests. First, your healthcare provider will review your health history, symptoms, and perform a physical exam to check for goiters.

What viruses cause Hashimoto's? ›

Direct evidence of the presence of viruses in Hashimoto's thyroiditis has been found with Epstein-Barr virus (EBV), Herpes Simplex (HSV), HTLV-1, enterovirus, mumps, rubella, parvovirus, Coxsackie B, Human Herpes and Hepatitis C.

What organs does Hashimoto's affect? ›

Hashimoto's thyroiditis can cause your thyroid to not make enough thyroid hormone. It is an autoimmune disease. It occurs when your body makes antibodies that attack the cells in your thyroid. Symptoms may include an enlarged thyroid gland (goiter), tiredness, weight gain, and muscle weakness.

Can hashimotos turn into lupus? ›

For example, women with Graves disease or Hashimoto thyroiditis are at greater than 10‐fold risk of developing lupus (risk ratio [RR] 11.69 [95% CI 6.23‐20.0; P < 0.001] and RR 14.64 [95% CI 3.02‐47.5; P < 0.001], respectively).

What is end stage Hashimoto's? ›

Overt hypothyroidism or full-blown disease

The end-stage of Hashimoto's is when your thyroid has become so damaged that you no longer have enough thyroid hormones and have to go on medication.

What is the difference between Hashimoto's disease and Hashimoto's thyroiditis? ›

Also referred to as Hashimoto thyroiditis or Hashimoto's hypothyroidism, Hashimoto's is an autoimmune disease. It begins with inflammation of your thyroid gland and an autoimmune attack on your thyroid hormones. The inflammation can occur suddenly and without warning, and often with no related symptoms.

Is Hashimoto's a big deal? ›

If Hashimoto's is left untreated, complications can be life-threatening. Because the hormones produced by the thyroid are so vital to the body's functions, untreated Hashimoto's can lead to serious and even life-threatening complications.

What is the first line treatment for Hashimoto? ›

The treatment of choice for Hashimoto thyroiditis (or hypothyroidism from any cause) is thyroid hormone replacement. The drug of choice is orally administered levothyroxine sodium, usually for life.

Can you manage Hashimoto's without medication? ›

The best therapy for Hashimoto's thyroiditis is to normalize thyroid hormone levels with medication. A balanced diet and other healthy lifestyle choices may help when you have Hashimoto's, but a specific diet alone is unlikely to reverse the changes caused by the disease.

How many stages of Hashimoto's are there? ›

The 5 Stages of Hashimoto's Thyroiditis.

What fruit helps Hashimoto's? ›

fruits, including berries, apples, and bananas. healthful fats, including avocado and walnuts. lean proteins, including tofu, eggs, nuts, beans, and fish.

Does walking help Hashimoto's? ›

With Hashimoto's thyroiditis, you may have times where you lack energy, making it challenging to get up and start moving. But, since exercise can help manage your symptoms, regularly exercising plays an essential role in your Hashimoto's disease and hypothyroidism management plan.

What vegetables should you avoid with Hashimoto's? ›

Foods to Avoid

On the autoimmune protocol diet, you remove all grains, legumes, nightshades (such as eggplant and peppers), dairy, eggs, coffee, alcohol, sugar, oil and food additives from your diet.

How to tell the difference between Hashimoto's and hypothyroidism? ›

The main difference between Hashimoto's and hypothyroidism is the cause of each condition. Hashimoto's disease happens when your immune system attacks your thyroid gland. Hypothyroidism occurs when your thyroid is underactive and not producing enough thyroid hormone. And this can happen for many different reasons.

Can you have normal TSH levels and still have hashimotos? ›

It's possible to have Hashimoto's disease but not yet have a severe enough case that your thyroid function has been impacted. In these cases, you can have Hashimoto's disease with normal TSH.

What is a dangerously high TSH level? ›

A TSH over 10 mIU/L has been linked to an increased risk of coronary heart disease and heart failure, which is why you'll probably want to seek treatment if your TSH is close to (but still under) that upper limit.

What should I ask my endocrinologist for Hashimoto's? ›

12 Questions You Should Ask Your Endocrinologist
  • What caused or is causing my thyroid issue? ...
  • What are my next steps and treatment options? ...
  • How often and for how long do I need to take this medication for? ...
  • What kinds of food or other medication will affect my thyroid medication?

What aggravates Hashimoto's? ›

Worst Foods for Hashimoto's
  • Added sugars and sweets. Soda, energy drinks, cakes, cookies, ice cream, candy, sugary cereals, table sugar, etc.
  • Fast food and fried foods. ...
  • Refined grains. ...
  • Highly processed foods and meats. ...
  • Gluten-containing grains and foods. ...
  • High-glycemic fruits. ...
  • Nightshades. ...
  • Dairy & eggs.
Feb 28, 2021

What should you not do with Hashimoto's? ›

The Autoimmune Protocol (AIP) diet is designed for people with autoimmune diseases. It removes potentially harmful foods like grains, dairy, nightshades, added sugar, coffee, legumes, eggs, alcohol, nuts, seeds, refined sugars, oils, and food additives ( 2 ).

What is Stage 4 Hashimoto's thyroiditis? ›

Stage 4: Overt Hypothyroidism

At this stage, the person has started to have thyroid gland failure. Their thyroid gland will be destroyed to the point where they will no longer be able to make their own thyroid hormone. The person will have an elevated TSH, with low levels of free T3 and free T4.

What are the mental symptoms of Hashimoto's? ›

The psychiatric symptoms include various mental aberrations, depression, irritability, and confusion. Indeed, patients may be mislabeled as having psychotic depression, paranoid schizophrenia, or the manic phase of a manic depressive disorder.

What are some tips for living with Hashimoto's? ›

There is no diet or exercise program that will prevent or cure Hashimoto's disease, but eating well and staying active may help you manage your symptoms. Eating a balanced diet rich in fruits and vegetables, with meat in moderation, and avoiding fried or processed foods may improve your symptoms.

Can you have a normal TSH and still have Hashimoto's? ›

It's possible to have Hashimoto's disease but not yet have a severe enough case that your thyroid function has been impacted. In these cases, you can have Hashimoto's disease with normal TSH.

Do you treat Hashimoto's different than hypothyroidism? ›

Treatment for Hashimoto's thyroiditis and hypothyroidism can be the same in some cases. This depends on whether the damage to the thyroid gland from Hashimoto's is severe enough to cause hypothyroidism. If so, treatment will typically include thyroid hormone replacement medication, like levothyroxine (Synthroid).

What is a good TSH level with Hashimoto's? ›

The authors did find that a TSH value of 4.2 to the be the upper limit of normal in their analysis. However, the authors used a “prevalence of Hashimoto's thyroiditis” factor to determine the upper limit of TSH and found a range of 2.6-2.9 to be more appropriate.

Is Hashimoto's hard to diagnose? ›

The signs and symptoms of Hashimoto's disease can be vague, making them difficult to identify and diagnose. For instance, stress and fatigue are common symptoms of Hashimoto's disease, but they are also common to other diseases. The fatigue can even be mistaken for iron deficiency.


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