Introduction to Hashimoto’s Thyroiditis

Hashimoto’s disease, or Hashimoto’s thyroiditis, is a chronic inflammatory condition of the thyroid gland. This is the most common cause of hypothyroidism, or underactive thyroid function, in the United States and many other countries. Hashimoto’s disease is caused by an immune malfunction where your own immune system attacks your thyroid gland, causing inflammation and fibrosis/scarring of the gland. Hashimoto’s disease affects roughly 4 out of 1000 women and 1 out of 1000 men each year. Overall, 10-12% of the general population will develop Hashimoto’s at some point in their life. Most women are diagnosed between the age of 30-50 years old. But the ultimate question is can Hashimoto’s be cured? This is the question we will address in this blog.

Can Hashimoto’s be cured? Top 3 Things to Know

Can Hashimoto’s be cured by diet and lifestyle changes?

Hashimoto’s disease involves your immune system causing inflammation and scarring in the thyroid gland. This process is often cyclical and causes repeated damage to the thyroid gland itself. This ultimately leads to decreased thyroid hormone production (hypothyroidism) and subsequent symptoms. Many patients with Hashimoto’s disease also have other autoimmune diseases (i.e. Lupus, Sjogren’s, Rheumatoid Arthritis, etc.).

Ingredients in food or certain factors in your lifestyle can actually cause inflammation in your body and can therefore worsen your symptoms of hashimoto’s.  Gluten is a known inflammatory agent and is the most written about in the literature.  There has been evidence to show that a gluten-free diet can relieve some of the symptoms from hashimoto’s, but it is not the ultimate answer to the question of can hashimoto’s be cured.

Stress can also cause inflammation in your body, so any lifestyle changes to decrease your stress level can also improve your symptoms of hashimoto’s.  Examples of this include exercise and meditation.  Again, these lifestyle changes may alleviate some of the symptoms but is not the sole solution to the question of can hashimoto’s be cured.

So, the answer to this ongoing question of can Hashimoto’s be cured with diet and lifestyle changes, is NO…but they can certainly help alleviate some of the symptoms.

Can Hashimoto’s be cured by medication?

Patients with symptomatic Hashimoto’s disease need expert endocrinology care and monitoring. Since there is this scarring, inflammation, and fibrosis caused by the immune system attacking the thyroid tissue, can hashimoto’s be cured by medication? Hashimoto’s thyroiditis frequently requires treatment. Many individuals develop a diseased thyroid gland that is not able to function well enough to meet the physiologic needs of the body with respect to thyroid hormone production (hypothyroidism).

Common symptoms include fatigue, weight gain, memory problems or brain fog, depression, neck/thyroid discomfort, thinning hair or hair loss, heat/cold intolerance, skin and nail changes, joint and muscle pain, constipation, difficulty sleeping, and changes in appetite. Once this occurs and patients have low thyroid function, patients are started on thyroid hormone replacement and are monitored for the rest of their life.

So, can hashimoto’s be cured by thyroid hormone medication? Well, the vast majority of patients do very well on thyroid medication as long as they take the medication as directed.  They live a healthy lifestyle and have their thyroid levels checked regularly (typically 1-2 times per year). However, the thyroid hormone replacement just alleviates the symptoms and does not answer the ultimate question of can hashimoto’s be cured?

Occasionally, a small percentage of patients even need additional treatment for Hashimoto’s disease and the symptoms. In the short-term, some patients need anti-inflammatory medications and/or steroids to alleviate symptoms from the inflammation, particularly the pain and swelling.

So again, can Hashimoto’s be cured by thyroid hormone replacement and/or steroids? The ultimate answer is No, but it can certainly control the thyroid function and symptoms.  If the thyroid function is normal, then many patients will feel well.  Although the thyroid antibodies are still elevated, normal thyroid function may resolve many of the hypothyroid symptoms they were experiencing.

Can Hashimoto’s be cured by surgery?

The short answer is YES! Despite multiple treatments and optimal thyroid hormone replacement, there is a small portion of patients who still do not feel well overall. Although we are unsure exactly why this occurs, the general consensus is that a broader, systemic component of the immune system malfunction is the cause. These patients, along with patients who have trouble regulating the ideal dosage of thyroid medication or who have other thyroid disease (i.e. nodules, thyroid cancer, goiter etc.) are candidates for definitive cure of Hashimoto’s disease with expert thyroid surgery. So, can hashimoto’s be cured by surgery…we believe the answer to this is a resounding YES!

As noted above, some patients with Hashimoto’s disease are symptomatic despite having normal or optimal thyroid hormone labs while taking a consistent dose of thyroid hormone medication. Additionally, a small number of patients are not able to remain on a consistent dose of thyroid medication and continue to have fluctuating symptoms and medication dosages over a long period of time. These clinical situations can be frustrating, exhausting, and overwhelming for patients and their endocrinologists. Fortunately, we believe that thyroid surgery to remove the entire gland is the cure for hashimoto’s.

You cannot have Hashimoto’s disease, or its symptoms, if you do not have a thyroid gland! 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. Thus, total thyroid removal for Hashimoto’s disease should only be done by high-volume, experienced thyroid surgeons at busy centers such as ours. More and more studies are showing that expert thyroid surgery done at the right center with very low complication rates is very effective, and is the ultimate answer to the question of can Hashimoto’s be cured. Some of our patients have even felt noticeably better within 24 hours of surgery!

For more, read our article by Dr. Walsh on Graves Disease vs. Hashimoto's Disease.

Additional Resources

• Become our patient by filling out the form at this link. 
• Learn more about The Clayman Thyroid Center here. 
• Learn more about our sister surgeons at the Scarless Thyroid Surgery Center, Norman Parathyroid Center, and Carling Adrenal Center
• Learn more about the Hospital for Endocrine Surgery.