You probably know that Hashimoto’s symptoms can vary drastically from person to person, but did you also know that one person’s Hashimoto’s symptoms can change from year to year, month to month, week to week, and even day to day?
Flare ups due to your personal triggers are certainly a factory but environmental, dietary, and emotional triggers aren’t the only factors influencing how you feel on any given day, week, month, or year. We wanted to dive into some of the reasons Hashimoto’s thyroiditis can present in so many different ways – even in a single patient.
The Stages of Hashimoto’s
Hashimoto’s is often diagnosed after a initial diagnosis of hypothyroidism – which only manifests after the immune system has caused significant damage to the thyroid. But autoimmunity takes root silently, meaning your body has already mounted an immune response to the thyroid long before a clear laundry list of symptoms ever emerges. Which makes diagnosing Hashimoto’s early kind of tough!
It does, however, explain why the symptoms of Hashimoto’s change over the long-term. While some experts have identified five distinct stages and others see only three, it’s widely accepted that autoimmunity is progressive. Your experience with Hashimoto’s may have involved a slow decline that began with vague feelings of ill health that grew into a more acute illness. But even though your initial symptoms were relatively mild, they were still caused by Hashimoto’s.
TSH and T4 Fluctuations
As your body’s autoimmune response targets the thyroid, there are changes to and fluctuations in the levels of thyroid hormones. Also keep in mind that the thyroid is interconnected with pretty much all the body’s other systems. That means that other health changes and also our reproductive cycles can influence the amount of thyroid hormones being produced and how those hormones impact the body.
Women may find that their hormonal cycles have a strong impact on their Hashimoto’s symptoms. And all patients have probably noticed changes that obviously correlated to illnesses, inflammation in the body, or periods of stress. And dietary and lifestyle changes cause change how the thyroid functions, too.
Some people can swing between hypothyroid and hyperthyroid symptoms for years before receiving a diagnosis of Hashimoto’s. That’s because the thyroid responds to autoimmune attacks in different ways in different people and at different stages of the disease. These ups and downs can cause huge variations in how you feel at any given time. Eventually, most Hashimoto’s patients will find their thyroid hormone levels reach a hypothyroid state but periods of hyperthyroidism can cause a confusing array of symptoms.
Even patients who are successfully managing the symptoms of Hashimoto’s with medication or lifestyle changes or both may find that now and then, they crash hard. These flare ups can be due to triggers most of us aren’t even aware of. Some of us are acutely sensitive to chemicals in our environment or certain foods. Some of us react strongly to stress. The end result of exposure may be an inflammatory cascade in the body or a disruption to the hormone levels that are normal for you (or both) that leaves you feeling awful for a period of time.
Treating changing Hashimoto’s symptoms usually involves a multi-pronged approach that takes hormone levels into account but also looks at what is going on in a patient’s life. With that in mind, you can give your providers more to work with as you design and update your treatment plan by keeping a diary of your symptoms as well as any other information you feel might be relevant.
The bottom line is that looking at how your Hashimoto’s symptoms have changed over time and are changing in the present can give you a lot of information about your overall health.