The following symptoms and complaints may indicate Hashimoto’s thyroiditis:
Patients with Hashimoto’s thyroiditis are symptom-free for a long time. Initially, symptoms of hyperthyroidism (overactive thyroid) are occasionally prominent. The so-called “Hashitoxicosis” is an initial phase in which mild hyperthyroidism usually occurs, which then gradually changes to chronic hypothyroidism (underactive thyroid).
Leading symptoms
Basal metabolic rate
- Drop in body temperature → feeling cold, cold intolerance/cold hypersensitivity.
- Decreased sweating
- Doughy, cool-dry skin especially on the face and hands and feet
- Dull shaggy hair / dry, brittle hair.
- Dry, brittle nails
- Weight gain (with poor appetite).
Cardial (cardiovascular)
- Bradycardia – pulse slowing (< 60 beats/minute) [HMV ↓, cyanosis]
Gastrointestinal (gastrointestinal tract).
- Constipation (constipation)
Nervous system and psyche
- Depression
- Fatigue, listlessness, weakness (increased need for sleep).
- Muscle weakness
- Decreased visual reflexes
Further
- Hypercholesterolemia (lipid metabolism disorder; too high cholesterol in the blood).
- Hypertriglyceridemia (lipid metabolism disorder; excessive triglyceride levels in the blood).
- Myxedema – pasty (puffy; bloated) skin showing non-push-in, doughy edema (swelling) that is not position-dependent; facial and peripheral; occurring primarily on the lower legs
- Peripheral edema – swelling of the legs due to water retention.
- Rough and deep voice due to vocal fold edema.
- Cervical (“belonging to the throat”) pressure sensation occasionally; cervical pain (< 5%).
Associated symptoms
- Anemia (anemia)
- Alopecia diffusa (diffuse hair loss)
- Dyspnea (shortness of breath)
- Dysphonia (hoarse voice)
- Hypacusis (hearing loss)
- Hypertension (high blood pressure)
- Hyporeflexia (lowered intensity of one or more reflexes).
- Hypoventilation (restricted pulmonary ventilation) and respiratory insufficiency/disruption of external (mechanical) breathing denotes, resulting in inadequate ventilation of the alveoli (myxedema coma; hypothyroid coma).
- Carpal tunnel syndrome – nerve compression syndrome on the hand.
- Lack of concentration
- Menorrhagia – increased and prolonged menstruation.
- Myopathy of the skeletal muscles (Ck and myoblobin ↑).
- Oligo- or amenorrhea – infrequent to no menstrual bleeding.
- Muscle cramps, stiffness
- Paresthesias (sensory disturbances)
- Pericardial effusion (pericardial effusion)
- Right, left ventricular dilatation (permanent expansion of the ventricle) with possible hydropericardium/accumulation of serous fluid in the pericardium [ECG: low voltage of P- and T-wave and QRS complex].
- Goiter (enlargement of the thyroid gland).
- Hearing loss
- Increased incidence of abortions (miscarriages).
- Decreased libido (sex drive).
- Confusion
- Cerebellar ataxia (disorders of movement coordination (ataxia) triggered by pathological changes in the cerebellum).
