How to Test for Hashimoto's

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A healthy thyroid gland is essential to your overall health. A crucial part of the endocrine system (a system in your body that controls the release of hormones), this small, butterfly-shaped gland has a pretty important job: it churns out some pretty crucial hormones that help control things like your weight, energy levels, and even your heart rate. When your thyroid is unhealthy, it can wreak havoc on your entire body.

Enter Hashimoto’s Thyroiditis, or Hashimoto’s Disease, an autoimmune disorder that causes inflammation and damage to the thyroid gland, which, over time, can lead to hypothyroidism, AKA an underactive thyroid. 

Unfortunately, a diagnosis can be challenging, but there are ways to detect the condition. By learning the signs and symptoms and knowing how to test for Hashimoto’s, you're taking a big step towards taking control of your hormonal health.

Understanding Hashimoto's Thyroiditis

Also known as chronic lymphocytic thyroiditis, Hashimoto’s is an autoimmune condition. Essentially, it's like your immune system has gone rogue and started attacking the healthy tissue in your thyroid gland, causing serious inflammation.

Over time, this inflammation can lead to the development of goiters, visible lumps under the skin of your neck where the thyroid gland is located. More than that, eventually, your thyroid stops producing enough hormones, and that is when the real trouble starts. 

Hashimoto’s is more common in women and mostly diagnosed between the ages of 30 to 50. People with a family history of Hashimto’s or other thyroid conditions are at a higher risk. Detecting Hashimoto’s early is critical because untreated Hashimoto's can progress to hypothyroidism, causing various health problems. Unfortunately, it's often not caught until later stages when symptoms like goiters or hypothyroidism appear.

Luckily, there are tests available if you suspect you have Hashimoto’s or have a family history of thyroid issues. 

Here are some signs and symptoms to look out for.

Signs You Might Need a Hashimoto's Test

At first, many people with Hashimoto’s don't know they have it because they don’t feel anything, which is what we call “asymptomatic.” However, as time goes on and the disease progresses, signs and symptoms start popping up. Unfortunately, many symptoms are not specific to Hashimoto’s or mirror regular life changes, so you can easily overlook them.

Some of those symptoms include:

  • Fatigue
  • Weight gain
  • Joint and muscle pain
  • Constipation
  • Intolerance to cold weather
  • Dry skin or dry, brittle hair
  • Period and fertility issues, such as irregular or heavy periods or trouble conceiving
  • Slowed heart rate

For many, the severity of these symptoms will not impact their quality of life until months or even years after they initially develop Hashimoto’s. That is why it is so important to monitor your health and, when something feels “off,” take action and seek medical care.

Testing for Hashimoto's: What to Expect

Getting diagnosed with HT may involve a few tests. Your healthcare provider will most likely ask for a medical history of hormonal or thyroid-related issues and do a physical examination to see if you are developing a goiter or any other physical signs of HT. Next comes the lab work. There are several lab tests for Hashimoto’s Disease. Sometimes, your healthcare provider might also do an ultrasound to closely examine your thyroid gland. 

Thyroid Stimulating Hormone (TSH) Test

The TSH test is a blood test that measures the amount of the hormone present in your body. This hormone is important; it sends messages from your brain to your thyroid gland. In turn, your thyroid produces essential hormones your body relies on to keep things moving smoothly. 

Two hormones, thyroxine (T4) and triiodothyronine (T3), are essential to maintain your body’s metabolic functions and may be assessed in separate tests.

Free Thyroxine (T4) Test

Thyroxine, or T4, is one of two hormones produced by the thyroid. Both measure how well the thyroid is working. A low T4 count can mean that the thyroid is not doing well. There are two forms of T4 present in your blood: 

  • Bound T4 is a form of the hormone bound to certain proteins so it doesn’t enter the tissue; healthcare professionals don’t use Bound T4 as a measure of thyroid health.
  • Free T4 is an active form of Thyroxine released into the tissue when and where it is needed to support metabolic functions.

Thyroid Peroxidase Antibodies

Thyroid Peroxidase is an enzyme normally found in the thyroid gland–the presence of antibodies indicates that you have an autoimmune disorder like Hashimoto’s or Graves’ disease.


A thyroid scan is a specialized imaging procedure that examines your thyroid gland. Between six and 24 hours before the scan, you will ingest a (safe) small amount of radioactive material called a “tracer.” The material releases a certain type of gamma-ray that your healthcare provider will use to measure your thyroid function.

Differential Diagnoses: Understanding Similar Conditions

“Thyroiditis” refers to a group of thyroid disorders with several common symptoms. Nobody wants a misdiagnosis, but because Hashimoto’s is an autoimmune disorder, it’s critical to get the correct diagnosis so you can get the right treatment. 

  • Graves’ Disease: Graves’ Disease is another autoimmune disorder that causes the body to produce too many thyroid hormones. This leads to hyperthyroidism, though many of the symptoms are similar to Hashimoto’s.
  • Simple Goiter: This is just a growth under the skin where the thyroid gland sits, but there is no underlying cause. It is usually not cancerous or harmful in any way and is commonly caused by an iodine deficiency. 
  • DeQuervain's Thyroiditis: Also known as “giant cell thyroiditis,” DeQuervain’s may develop after a viral infection, and generally, symptoms flare up much more quickly. One defining characteristic of giant cell thyroiditis is that it spontaneously resolves itself, so doctors rarely prescribe medication.

Due to the similarities in symptoms, the proper tests are crucial in making the correct diagnosis. Additionally, a thorough medical exam, including your family and personal medical history, imaging and several other tests, can help your healthcare provider cancel out any other possible underlying conditions.

Beyond Diagnosis: Next Steps After Testing 

The good thing about getting tested is once you know what’s going on with your body, there are treatment options. The most commonly prescribed treatment is a synthetic hormone called levothyroxine. Most people with Hashimoto’s will need to take the medication for the rest of their life. You can also make additional lifestyle changes to help manage your symptoms, such as eating an anti-inflammatory diet, lowering stress levels, getting enough quality sleep, and regularly exercising. 

The most important thing to note is that no two people are the same, so your treatment plans should not be the same. For example, if your blood tests show the presence of thyroid antibodies but you have normal levels of TSH and T4, you most likely won’t need medication. 

Working with a healthcare professional who understands that treatment plans should be personalized will yield the best possible outcome. At Allara, we support women post-diagnosis with a holistic health strategy. We offer tailored nutrition plans by board-certified dietitians, access to endocrinologists, and lifestyle coaching. 

Check now and see if Allara’s treatment options are right for you.


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