Hashimoto’s disease is an autoimmune condition in which the immune system attacks the thyroid gland. According to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), it is the most common cause of hypothyroidism in the US and occurs 4 to 10 times more frequently in women than in men. Diagnosis is based on medical history, physical examination, and blood tests.
Chronic fatigue, constant feeling of cold, or a few extra pounds are easy to blame on work, stress, or aging. However, some of these ailments may be related to hypothyroidism, and figuring it out usually starts with a visit to an internist—a conversation, physical exam, and blood tests.
A disease that develops quietly
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains that in Hashimoto’s disease, the immune system produces antibodies that attack the thyroid gland. Over time, the damaged gland produces too few hormones, leading to hypothyroidism. The disease most frequently develops in women aged 30–50, and the risk is increased by factors such as a family history of the disease and other autoimmune conditions (NIDDK on Hashimoto’s disease).
According to the institute, there are often no symptoms at the beginning of the disease, and thyroid damage can progress for years. As hypothyroidism develops, symptoms such as fatigue, weight gain, poor cold tolerance, joint and muscle aches, constipation, dry skin, dry and thinning hair, menstrual irregularities, or a slower heart rate may appear.
The NIDDK also draws attention to the thyroid gland itself: it may enlarge, forming a so-called goiter, which is usually painless. Among autoimmune diseases that increase the risk of Hashimoto’s, the institute lists celiac disease, lupus, rheumatoid arthritis, Sjögren’s syndrome, and type 1 diabetes, among others. Information about such conditions in the patient or their family can therefore be a valuable clue for the doctor.
The trouble is that each of these symptoms can also have other causes. Home remedies and internet advice will not settle much here—only medical tests can provide the answer.
What the diagnostic process looks like
Diagnosis begins with a medical history and physical examination. The NIDDK lists blood tests: levels of thyroid-stimulating hormone (TSH), thyroid hormones T4 and T3, and antibodies against thyroid peroxidase (anti-TPO), which are present in the majority of patients. If antibodies are absent and suspicion remains, the doctor may order a thyroid ultrasound.
Interpretation of the results belongs to the physician. A single laboratory value, evaluated out of context, easily leads to unnecessary anxiety or, conversely, to a false sense of security. The attending physician decides on potential treatment and its monitoring. It is a good idea to bring the results of previous tests, including those from other laboratories, to the visit—they allow for a comparison of how values have changed over time.
The thyroid is also connected to the heart. The National Heart, Lung, and Blood Institute lists thyroid hormone tests among the blood work performed during the diagnosis of heart rhythm disorders, and the NIDDK classifies a slower heart rate as a potential symptom of hypothyroidism.
General medical exams and internist care
Thyroid diseases—hypothyroidism, hyperthyroidism, and Hashimoto’s disease—are only part of the scope of internal medicine. At Maspeth Health Center, an internist also deals with asthma and respiratory infections, urinary and digestive tract diseases, osteoporosis and degenerative changes of the spine and joints, as well as diabetes and its complications.
The clinic also performs routine and preventive check-ups, routine vaccinations, and laboratory tests, as well as EKGs and Holter monitors when necessary. Such a general visit can be a good starting point: a single doctor sees the whole picture, can measure blood pressure, and discuss the results of previous tests.
Language also matters. Describing since when you have “lacked energy” and what exactly has changed is often simpler and more accurate in your native language than in a foreign one—and with symptoms this nonspecific, details matter.
At Maspeth Health Center on Grand Avenue, internal medicine conditions, including thyroid diseases, are treated by Dr. Adam S. Budzikowski, an internist and cardiologist. The scope of care is presented on the page Internal Medicine at Maspeth Health Center, office hours can be checked in the PolishPages directory under the clinic’s listing, and an appointment can be scheduled by calling 929-252-9330.
This article is for informational purposes only—it is general information, not medical advice, and does not replace a doctor’s visit. For individual health concerns, please consult a physician.
