If you have hypothyroidism — there’s more than a 90 percent chance you have Hashimoto’s Disease. Hashi-what?

Hashimoto’s Disease is also referred to as Hashimoto’s Thyroiditis, Chronic Lymphocytic Thyroiditis, or Autoimmune Thyroiditis. Whatever you call it, Hashimoto’s is an autoimmune condition where the immune system treats the thyroid gland as a foreign invader…and attacks it.

When that happens, chronic damage and inflammation progressively destroy the thyroid gland. And that causes an underactive thyroid, called hypothyroidism.

Does Hypothyroidism Cause Hashimoto’s?

This is a common misconception and point of confusion. Hypothyroidism does not cause Hashimoto’s. Hashimoto’s causes hypothyroidism.

Getting a Hashimoto’s Diagnosis

Conventional doctors often miss a Hashimoto’s diagnosis.


Because most doctors don’t do enough testing.

Consider yourself lucky if your doctor even orders a TSH test, let alone a comprehensive panel of tests.

The average diagnosis for Hashimoto’s takes 10 years because of all the missed diagnoses. Mine took 16 years!

This is frustratingly crazy considering that one in eight people have hypothyroidism.

Of those, 90 percent have Hashimoto’s. And over half don’t know it.

So, you might suffer symptoms (see Thyroid Symptoms: 10 Signs You Have a Thyroid Problem) but your doctor chalks it up to depression. Or aging. Or says, “It’s all in your head.”

If you’re experiencing symptoms, don’t let anyone make you feel like you’re crazy. Push your doctor for more extensive testing. If they’re not willing to do the extensive testing, find someone else who is.

What Causes Hashimoto’s?

The important thing to understand is that Hashimoto’s is not your fault. Certain risk factors contribute to developing Hashimoto’s Disease:

  • Hashimoto’s is 8 times more common in women than men.
  • It can happen at any age, but most commonly occurs during middle age.
  • Heredity can play a factor — You’re at higher risk for Hashimoto’s if family members have thyroid or other autoimmune diseases.
  • Having another autoimmune disease — such as lupus, rheumatoid arthritis, or type 1 diabetes — increases your risk.
  • Anyone exposed to high levels of environmental radiation are at greater risk.

Often a stressful event or an infection like Epstein-Barr will trigger Hashimoto’s. For me, it was giving birth to my first child.

The TSH Test — Not the End All, Be All for Thyroid Problems

It’s not uncommon for a doctor to review your TSH (Thyroid-Stimulating Hormone) and proclaim your test “normal.” That’s because the reference range for TSH is skewed.

When scientists originally set the “normal” TSH ranges for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function.

In recent years, a new normal reference range was defined as 0.3-3.0. However, most labs have not adjusted that range.

It’s my opinion, and the opinion of many others, that even that should be considered way off.

Functional medical practitioners say that anything over 2.0 is a red flag. My doc uses 0.36-1.91 as optimal.

Back in 1998 I literally begged my doctor to send me for a TSH test. I wish I knew my original TSH number — I never had a copy of my labs. (Lesson learned — always request a copy of your test results.)

All I know is that the doctor called me to apologize for her reluctance to order “unnecessary tests.” Apparently the lab tech said my TSH was so high they couldn’t believe I made it to the medical office.

Ask Your Doctor for These Hashimoto’s Tests…

You need a comprehensive panel of tests that include:

  • TSH
  • Free T3
  • Free T4
  • TPO antibodies
  • TG antibodies.

Some people have no detectable abnormalities in their blood work. That’s why a thyroid ultrasound helps diagnose Hashimoto’s. Either the thyroid gland’s size or texture indicates Hashi’s, or growths, or nodules show up.

In hindsight, I was lucky to even get a hypothyroidism diagnosis.

My Hypothyroidism and Hashimoto’s Story

My doctor prescribed Synthroid for my hypothyroidism and sent me on my way. Synthroid — or the generic form, Levothyroxine — is most mainstream doctors’ knee-jerk reaction to treating hypothyroidism.

It worked. For a while.

But it was like putting a band-aid on a wound that was becoming progressively infected underneath. It stopped the bleeding but covered the Hashimoto’s root cause that continued to destroy my thyroid.

After my hypothyroidism diagnosis, I had my blood drawn every three months until we got the Synthroid dosage right. And then I was tested at my annual check-up.

After a few years, my symptoms returned with a vengeance.

I asked if my new doctor would consider changing my medication.

I wasn’t met with support. (Synthroid replaces T4 hormone only while many sufferers can improve on compound medications that also include T3.)

I also asked if I could be tested for Hashimoto’s. The answer was, “Why would we test you for Hashimoto’s when the treatment is the same?”

My research showed that people were finding success using nutrition and lifestyle strategies to improve their thyroid symptoms. I also discovered that when you have one autoimmune condition, you’re at greater risk for developing others.

I wanted to know.

My symptoms were getting progressively worse. It was affecting my family. I knew it was time to see a functional medicine specialist.

I flew from my home in Pittsburgh to see a naturopathic doctor specializing in thyroid problems.

In Phoenix. In August. In 111 degree heat.

I hate the heat, but I was desperate.

After reviewing a battery of tests, Dr. C started the consultation. He said, “To treat your Hashimoto’s…”

I stopped him. “I have Hashimoto’s?”

His reply:  “No one ever told you? It’s obvious.”

Tears sprang to my eyes. No one wants an autoimmune disease. Or any disease for that matter. But there is a sense of relief in knowing.

It took 16 years to get my Hashimoto’s diagnosis — 16 years is a long time.

Functional Versus Conventional Medicine

If you have an acute condition, the advances in conventional medicine can save you. If you suffer from a chronic disease, however, mainstream medicine generally focuses on masking the symptoms with pills.

Naturopathic doctors who practice functional medicine approach chronic disease much differently. They work to find and treat the root cause. Treatment is more likely to integrate nutrition, supplements, and lifestyle modifications to reverse disease.

Here’s the catch though: while a functional medicine specialist will likely run comprehensive tests and provide holistic treatment, it’s not covered by most medical insurance. At least, not yet.

So I spent a pretty penny finding answers. But I think of it this way — I was either paying with my health or paying with my wallet.

Do You Have Hashimoto’s?

If you suspect you have hypothyroidism or Hashimoto’s, you must be your own health advocate.

Demand tests. And do your research.

I decided to enroll in the Institute for Integrative Nutrition to find answers on how to heal myself. I never intended to become a health coach. But once I started to feel better, I knew I had to share what I learned.

Maybe others won’t have to suffer for as long as I did. Maybe I can save them the tens of thousands of dollars I spent on my journey.

Here’s the thing — whether you have hypothyroidism or Hashimoto’s or not, the strategies I learned will improve your health and wellbeing.

With hypo and Hashi’s, it’s critical to dial in your medication. You need to find the right prescription and the right dosage — for you. And that can change over time.

Doctors used to say that Hashimoto’s is permanent. Now, some functional medicine experts say you can reverse Hashi’s.

Stay tuned for the next posts in this thyroid series, when we explore nutrition and lifestyle changes to try.


So let’s sum up what you need to know about hypothyroidism and Hashimoto’s Disease:

1. If you suffer hypothyroidism symptoms, find a doctor who will prescribe comprehensive testing to determine if you have an underactive thyroid and whether Hashimoto’s is the root cause.

2. With a diagnosis, you need a doctor or endocrinologist who will work with you to optimize your medication and check your blood levels every three months.

3. Food is medicine. Work to heal your body. Check out the rest of this blog post series for guidance.

Back when I was first diagnosed with hypothyroidism, I used to think I had it “good.” If I had a medical issue, thank goodness it was hypothyroidism which I thought could be solved by taking a little pill every day.

How foolish. Little did I realize my body was attacking my thyroid and progressively destroying it.

When you know better, you do better. Take back your life.

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