The Most Common Symptoms of Hashimoto’s Flare-Ups and What Causes Them

exhausted woman on bed with Hashimoto’s flare-up symptoms

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The Most Common Symptoms of Hashimoto’s Flare-Ups and What Causes Them

Hashimoto’s thyroiditis is the leading cause of hypothyroidism in the United States, affecting between 1 to 2 percent of people. One of over 100 autoimmune disorders, Hashimoto’s primarily targets women between 30 and 50. For those living with this condition, symptoms of a Hashimoto’s flare-up occur despite treatment, traditionally the thyroid replacement hormone, Levothyroxine. 


What is the Functional Medicine Approach to Hashimoto’s?

The most crucial step in treating Hashimoto’s is identifying it. Conventional doctors may fall short in diagnosing the disease because they limit their diagnosis based on levels of TSH (thyroid stimulating hormones). Traditional treatment is rendered on finding an impaired thyroid function and is the same for both pituitary hypothyroidism and Hashimoto’s.


But having Hashimoto’s doesn’t necessarily mean that you have hypothyroidism, and hypothyroidism isn’t always because of Hashimoto’s. 


Thyroid function tests don’t necessarily give a complete picture of an individual’s thyroid health. Functional medicine doctors test for traditional thyroid levels but understand that Hashimoto’s is an autoimmune disorder. Confirming a diagnosis of Hashimoto’s includes testing for antibodies too.


Having Hashimoto’s doesn’t necessarily mean that you have hypothyroidism, nor does having hypothyroidism mean that you have Hashimoto’s thyroiditis. Although Hashimoto’s is the most common cause of hypothyroidism, other factors may be at play too:


  • Certain medications
  • Congenital diseases
  • Viral thyroiditis
  • A lack of iodine in the diet


Only comprehensive testing, specifically antibody tests, can uncover Hashimoto’s.


Functional medicine doctors understand that the imbalance in one hormone affects all the hormones in your body. Additional hormone testing is necessary, along with thyroid function, before treatment and recovery can begin.


Functional medicine doctors use a balanced approach in treating Hashimoto’s by using medications (if indicated) alongside dietary and lifestyle changes. Your treatment plans will uncover your triggers and include ways to eliminate them to reduce flare-ups.


What Causes Symptoms of a Hashimoto’s Flare-Up?

Having Hashimoto’s doesn’t necessarily mean that you have hypothyroidism. Because traditional medicine focuses on treating this disorder like hypothyroidism, some symptoms remain despite medication.


This condition’s flare-ups are related to the gut, and the symptoms of Hashimoto’s flare-ups are identical to those of other gut-related disorders. When the gut-thyroid link is dysfunctional, symptoms appear. While there is a genetic predisposition to all autoimmune diseases, including Hashimoto’s, the key to controlling flare-ups is to restore and maintain optimal gut health.


Common Symptoms of a Hashimoto’s Flare-Up and Why They Occur

Like other autoimmune diseases, the symptoms of a Hashimoto’s flare-up include vague symptoms frequently misdiagnosed as other illnesses. 


You will often find that the symptoms are all closely related. If you’re fatigued, you won’t have the energy to stay active, and you may see weight gain. Painful muscles and joints also restrict your activity levels. Depression is a common symptom caused by both the physical effects of Hashimoto’s on your thyroid function and your discomfort and exhaustion.



Thyroid disorders, including Hashimoto’s, can cause depression and anxiety because of a deficiency in thyroid hormones and the condition’s negative impact on your quality of life.


Reproductive issues

Decreased thyroid hormones cause problems with ovulation.


Thinning hair

Inflammation causes the body to use stored biotin, an essential vitamin for hair growth.


Changes in skin’s appearance

Lower levels of thyroid hormones restrict the body’s ability to absorb nutrients, resulting in dull or dry skin, rashes, and hives.


Weight gain

Weight gain in a Hashimoto’s flare-up is the result of slowed metabolism.



Hashimoto’s flare-ups slow your metabolism and leave you sluggish and exhausted.



Gastric motility (the ability to move food through the digestive tract) slows significantly during a flare-up.


Pain in the muscles and joints

T4 deficiency causes fluid buildup in joints and soft tissues, leading to inflammation and pain, while elevated creatinine levels contribute to your discomfort.


Intolerance to cold

In a Hashimoto’s flare-up, you won’t produce the thyroid hormones that your body uses to regulate your body’s temperature.


Another common symptom of a Hashimoto’s flare-up is a goiter.


What is a Goiter?

A goiter is a noticeable swelling on the neck, usually resulting from an enlarged thyroid gland. While not dangerous, goiters may cause problems with swallowing. If left untreated, the goiter may grow enough to affect your breathing.


Your thyroid requires iodine to produce hormones, and if it’s not getting the iodine it needs from your diet, it may begin to swell to attempt to absorb more. One Hashimoto’s flare-up symptom is the goiter warning that your immune system is actively attacking your thyroid gland.


The size of a goiter ranges from a small nodule to a large lump on your neck.


Symptoms of Early-Stage Goiters

Contact your doctor immediately if you have early warning signs of developing a goiter. Some of the most common symptoms include the following:


  • Pain in your neck around your thyroid glands
  • Difficulty swallowing food
  • Breathing problems
  • Persistent cough
  • Hoarseness
  • Swelling in the neck


The sooner your functional medicine doctor begins treatment for goiter, the better your recovery will be.


Why Are My Hashimoto’s Symptoms Flaring Up?

Your Hashimoto’s flare-up symptoms are usually caused by one of four things:


  • Medical reasons and gut health imbalances: GI pathogens such as the ulcer-producing H. pylori can trigger a flare-up, as can illnesses, infections, and hormonal imbalances.
  • Dietary: Diets high in gluten and salt are common Hashimoto flare-up triggers, as is too much or too little iodine in your diet.
  • Environmental: Exposure to heavy metals, pollutants, pesticides, and other chemicals can cause flare-ups.
  • Lifestyle factors: A sedentary lifestyle, high stress levels, and poor sleep quality contribute to Hashimoto’s flare-ups.


Of course, these factors frequently overlap and increase your odds of flare-ups.


True Life Medicine provides comprehensive diagnosis and treatment for symptoms of Hashimoto’s flare-ups. Our holistic approach uncovers the causes of your flare-ups and provides the tools and knowledge to help you avoid triggers. Can you picture your life without Hashimoto’s flare-ups? True Life Medicine has made this a reality for many of our patients, and we can help you too.


Contact us for your free no-obligation 15-minute discovery call and let us show you how functional medicine can reduce or eliminate your Hashimoto’s flare-up symptoms.

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