Understanding Hashimoto’s Disease and Hypothyroidism: A Dietitian’s Perspective
- Megan Tomlin
- Feb 6
- 3 min read
Did you know that up to 60% of Hashimoto’s disease cases go undiagnosed? Or that women are five to eight times more likely to have a thyroid condition than men? Given these statistics, it’s surprising how little awareness there is about these common health issues.
As a Registered Dietitian with hypothyroidism, I have extensively researched these conditions to help educate others on what they are and how they can be managed through both functional and traditional medical approaches.
What Is Hashimoto’s Disease, and How Does It Differ from Hypothyroidism?
The thyroid gland, located in the neck, plays a crucial role in regulating metabolism, digestion, heart function, and muscle activity. Hashimoto’s disease is an autoimmune condition that can lead to hypothyroidism—a condition in which the thyroid gland does not produce enough hormones.
One of the reasons Hashimoto’s often goes undiagnosed is that it does not always result in hypothyroidism, which is typically detected through standard thyroid blood tests.
In cases of hypothyroidism, blood tests typically reveal low levels of T3 and T4 hormones and elevated thyroid-stimulating hormone (TSH) levels. However, individuals with Hashimoto’s disease may have normal or borderline T3, T4, and TSH levels while still experiencing symptoms. In such cases, healthcare providers may test for thyroid peroxidase (TPO) antibodies, which indicate Hashimoto’s disease.
Recognizing Symptoms of Thyroid Disorders
The symptoms of Hashimoto’s disease and hypothyroidism often overlap and include:
Weight gain
Fatigue
Low heart rate
Irregular menstrual cycles
Dry skin
Sensitivity to cold
Anxiety and depression
Swelling
Constipation
Because these symptoms can also be associated with other health conditions, it’s essential to work with a healthcare provider to determine an accurate diagnosis.
On the other hand, hyperthyroidism—a condition where the thyroid is overactive—manifests with symptoms such as:
Weight loss
Rapid heart rate
Feeling excessively warm
Restlessness
Blood tests for hyperthyroidism typically show elevated T3 and T4 levels with low TSH levels. Hyperthyroidism is less common, affecting approximately 1.3% of the population.
Navigating Treatment Options
When I was diagnosed with hypothyroidism, I felt a sense of relief—I finally had an explanation for why I had been feeling “off” for so long. The most common treatment for hypothyroidism is hormone replacement therapy, typically with levothyroxine (to increase T4 levels) and liothyronine (to increase T3 levels). Alternative treatments include natural desiccated thyroid medications such as NP Thyroid and Armour Thyroid. These medications mimic the hormones that the thyroid gland is unable to produce.
Can Diet and Supplements Help?
As a nutrition professional, I delved into research on diet and supplementation for thyroid health. While scientific evidence is limited on whether diet alone can treat Hashimoto’s or hypothyroidism, nutrition can play a key role in managing inflammation and symptoms.
Since autoimmune conditions trigger an immune response that attacks the thyroid, reducing inflammation through diet may help alleviate some symptoms. Anti-inflammatory diets—such as the Mediterranean diet and the DASH diet—emphasize:
A variety of fruits and vegetables
Fish and healthy fats
Spices and fresh herbs
Whole grains
Additionally, certain nutrients may support thyroid function. Individuals with hypothyroidism may benefit from supplements such as:
Selenium (found in Brazil nuts)
Zinc
Vitamin D
Magnesium
Iron
However, supplementation should be tailored to individual needs, so it’s best to consult a doctor or dietitian before starting any new regimen.
Advocating for Your Health
With more than half of Hashimoto’s disease cases going undiagnosed, it is essential to be proactive about your health. If you experience symptoms, discuss them with your healthcare provider and request appropriate tests. Many of these tests are covered by insurance or available at a low out-of-pocket cost.
At the end of the day, we are the stewards of our own bodies. Nourishing and supporting them is one of the most powerful steps we can take toward better health.
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