Hashimoto's: when the thyroid gland develops hypothyroidism
July 22, 2025
10 min
Constant tiredness, unexplained weight gain or hair loss - these symptoms could be due to an underactive thyroid (hypothyroidism), often caused by Hashimoto's thyroiditis. In Switzerland, around one in ten women is affected by this condition in the course of her life.
Understanding Hashimoto's: What happens in the thyroid gland?
Hashimoto's thyroiditis is a chronic autoimmune disease in which the body's own immune system attacks the thyroid gland as if it were a foreign body. This gradually destroys thyroid cells over time. As a result, the thyroid gland produces fewer and fewer hormones, which leads to hypothyroidism.
Hashimoto's often goes unnoticed for years, as the destruction of the thyroid cells by the antibodies progresses slowly and everyone has a large reserve of thyroid cells and stored thyroid hormones. Hypothyroidism therefore only occurs, if at all, after many years and can manifest itself through various symptoms.
The disease is named after the Japanese doctor Hakaru Hashimoto (1881-1934), who first described four cases of chronic inflammation of the thyroid gland in 1912. It was only decades later that the disease was named after him and recognised as an autoimmune disease in its own right, now known as Hashimoto's thyroiditis and the most common cause of hypothyroidism in industrialised countries.
The thyroid gland
Control centre for body and soul
The thyroid gland is a small, butterfly-shaped organ in the neck. It has a major effect: it controls the metabolism, body temperature, energy balance, the cardiovascular system and also influences the psyche.
Symptoms: How to recognise an underactive thyroid
An underactive thyroid leads to a slowdown in metabolism, which can result in various symptoms. However, all of these symptoms can also have many other causes and are not specific to hypothyroidism:
- Constant tiredness and fatigue, even if you get enough sleep
- Weight gain that cannot be explained by diet or exercise
- Sensitivity to cold, even when it is not cold
- Hair loss and dry, brittle skin
- Slowed digestion with constipation
- Difficulty concentrating or memory problems ("brain fog")
- Depressive moods, listlessness or mood swings
- Muscle and joint pain without a clear cause
- Changes in the menstrual cycle, such as heavier or irregular bleeding
- Swelling of the neck due to an enlarged thyroid gland, also known as a "goitre"
If you suffer from one or more symptoms, a measurement of thyroid hormones can provide information as to whether the thyroid gland is the cause of your symptoms.
Although Hashimoto's disease cannot be cured, hypothyroidism is easily treatable. In addition to medical care, you can do a lot to feel better physically and emotionally by making changes to your everyday life. Small steps often achieve more than radical changes.
What helps your body with Hashimoto's in everyday life
Exercise and sport
Regular exercise not only supports the metabolism, but also strengthens the immune system and improves general well-being. Gentle endurance sports such as walking, swimming or cycling are ideal.
Sleep and recovery
Good sleep is particularly important for everyone. Make sure you have a regular sleep routine, a quiet environment and refrain from using electronic devices before going to bed.
Social support and mental health
A stable social environment has a positive effect on your health and well-being.
If you integrate these areas into your everyday life step by step, you can significantly improve your quality of life and reduce symptoms. Every change, however small it may seem, is a valuable contribution to your well-being.
Nutrition as support
A balanced, nutrient-rich diet can help you to feel more energised and balanced. Trace elements such as selenium, iron, zinc, vitamin D and vitamin B12 are particularly important. Make sure you eat fresh, colourful vegetables, healthy fats, for example from nuts, avocado or linseed oil, and protein-rich meals, such as fish, pulses or eggs. In addition, excessive iodine intake (through excessive fish consumption or algae products) should be avoided and attention should instead be paid to iodine intake in line with requirements. Too much iodine can lead to a worsening of hypothyroidism in Hashimoto's thyroiditis by intensifying the autoimmune reaction. Any unanswered questions about this can be clarified by a one-off consultation with an endocrinologist.
Consciously reduce stress
Stress is a strong influencing factor on well-being. Even small breaks in everyday life, conscious breathing or a short walk in the fresh air can help to calm the nervous system. Mindfulness exercises, meditation or quiet yoga, a daily routine with sufficient recovery phases and clear boundaries in everyday life, including in relation to constant availability, can help.
Exercise and sport
Regular exercise not only supports the metabolism, but also strengthens the immune system and improves general well-being. Gentle endurance sports such as walking, swimming or cycling are ideal.
Sleep and recovery
Good sleep is particularly important for everyone. Make sure you have a regular sleep routine, a quiet environment and refrain from using electronic devices before going to bed.
Social support and mental health
A stable social environment has a positive effect on your health and well-being.
If you integrate these areas into your everyday life step by step, you can significantly improve your quality of life and reduce symptoms. Every change, however small it may seem, is a valuable contribution to your well-being.
From symptoms to diagnosis: how Hashimoto's is recognised medically
Blood tests help to check the function of the thyroid gland.
The first and most important hormone measured in a thyroid examination is thyroid-stimulating hormone (TSH). This hormone is produced by the pituitary gland and stimulates the thyroid gland to produce hormones. If the pituitary gland reports a disorder in TSH (with values deviating from the norm), the free thyroid hormones fT4 and fT3 can then be measured to assess the severity. Anti-thyroid autoantibodies (anti-thyroperoxidase antibodies (anti-TPO) and/or anti-thyroglobulin antibodies (anti-TG)) can be measured to confirm the diagnosis if hypothyroidism is detected. In women of childbearing age with suggestive symptoms and/or a family history of thyroid disease, the TSH should be measured as a low-threshold test and treatment should be initiated in the event of hypothyroidism.
In addition to a blood test, the neck is also examined. If this reveals an enlarged or nodular thyroid gland, an ultrasound of the thyroid gland is performed. However, this is not part of the standard thyroid examination, but is only used to visualise a nodular or abnormal thyroid gland and thus detect abnormal and possibly malignant nodules at an early stage. This means that many people do not have an ultrasound scan.
If an abnormal nodule is found in the thyroid ultrasound, a fine needle aspiration is often also performed. This involves taking a few cells from the thyroid gland with a thin needle and examining them microscopically to rule out malignant cells.
Your health at a glance
When you should go to the doctor
If you experience several of the above symptoms or feel "out of balance" for a long time, speak to your GP. If you are diagnosed with hypofunction, you can be referred to the endocrinology consultation if necessary.
Why women in particular are so frequently affected
Autoimmune diseases such as Hashimoto's occur significantly more frequently in women than in men - in this case even 8 to 10 times more frequently. One of the reasons for this is female hormones, in particular oestrogen. This hormone influences the immune system: although it can strengthen the body's defences in certain phases, it can also lead to an excessive immune response in some women.
The first manifestation of hypothyroidism can occur particularly during hormonal upheaval phases such as after giving birth, during puberty or during the menopause. The hormonal balance tends to become unbalanced at these times, which can have an impact on immune regulation.
Genetic predisposition also plays a role: if you have a family history of autoimmune diseases such as Hashimoto's, type 1 diabetes or coeliac disease, your personal risk may be increased.
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