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May 23, 2024

What Does a Hashimoto's Attack Feel Like? 11 Signs You're Experiencing One

Learn to recognize the 11 telltale signs that you’re experiencing a Hashimoto’s attack as well as ways to calm your symptoms and prevent future flares.
Written by
Taylor Foster
Medically Reviewed by
Betty Murray

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Hashimoto’s disease is an autoimmune disorder in which the immune system flags the thyroid gland as an invader and attacks it accordingly. The thyroid, a butterfly shaped gland located in the lower half of the neck, is responsible for regulating hormones and metabolism to keep your body functioning optimally. Hashimoto’s disease affects 5 out of 100 people in the United States and is just one of many possible diseases of the thyroid. As with any chronic illness, symptom flares and attacks may come and go with stressful events or toxic environmental exposures. In this article we’ll focus on what a Hashimoto’s attack feels like, and 11 signs you’re experiencing one. (Source)

What Is Hashimoto’s Disease?

Hashimoto’s disease, also known as Hashimoto’s thyroiditis, chronic lymphocytic thyroiditis, and chronic autoimmune thyroiditis, is caused by the immune system producing antibodies that target healthy thyroid tissue. This results in the gland not producing enough of its hormones, which are needed to support proper hormonal and metabolic function throughout the body. 

When an autoimmune attack on the thyroid gland begins, it may first respond by overproducing its hormones, causing elevated thyroid hormone levels. As the disease progresses, though, thyroid function is impaired and hormone production falls. Although autoimmune thyroid diseases can affect anyone, Hashimoto’s is most common among middle-aged women. (Source)

Causes of Hashimoto’s

We know that Hashimoto’s is an autoimmune condition and we know how it affects the thyroid gland, but we don’t know why the condition develops. However, certain risk factors are known.

close up of a person's neck from the side

Risk Factors for Developing Hashimoto’s

Risk factors that may make you more susceptible to developing physical symptoms of Hashimoto’s disease include the following.

Being Female

As stated previously, women are more susceptible than men to developing autoimmune thyroid diseases. Women are 4 times more at risk for developing any autoimmune disease, which may be due to females having more circulating antibodies than males. As a woman, the higher amount of antibodies may be the factor that increases your risk of thyroid disorders, but conditions such as pregnancy may also tip off symptoms of hypothyroidism. (Source)

Being Older

Though Hashimoto’s disease can develop early on, it most commonly occurs between the ages of 40 and 60 years.

Having a Genetic Predisposition

There is not a specific gene for Hashimoto’s disease, but genetic factors for disease do run in families. 

Having Another Autoimmune Disease 

Having one autoimmune condition will increase your chance of developing another. You are at a higher risk of developing Hashimoto’s if you already have:

(Source, Source)

Symptoms of Hashimoto’s 

Hashimoto’s disease symptoms can present differently for everyone, but possible symptoms may include:

  • goiter (thyroid swelling)
  • fatigue and low energy levels
  • muscle weakness
  • joint pain
  • weight gain
  • constipation
  • mood disorders such as depression and anxiety
  • body temperature dysregulation, specifically cold intolerance
  • dry skin
  • brittle nails
  • hair loss
  • puffy face
  • rapid heart rate
  • sweating
  • weight loss
  • tremors
  • irregular menstrual bleeding

Symptoms of Hashimoto’s may not present for many years after disease onset, and then may progress slowly over time. The above listed symptoms are not unique to this disease, but could also be signs of other chronic illnesses. If you are unsure whether your symptoms are related to Hashimoto’s or to something else, see a health care practitioner for an accurate diagnosis. This is essential for you to move forward successfully with a disease management plan that improves your quality of life. (Source, Source)

person lying down on a bed, staring into space

What Is a Hashimoto’s Attack?

With any autoimmune disease, it’s common to have attacks, or flare-ups, of symptoms triggered by periods of high stress, traumatic events, or even certain environmental exposures. A Hashimoto’s attack can be defined as a sudden and somewhat severe onset of symptoms. If you are aware of what triggers Hashimoto’s flare-ups for you, you can do your best to avoid those triggers to keep flares at a minimum and reduce symptom severity. (Source, Source)

Our Care Team has Hashimoto’s, too.
At WellTheory, we believe sustainable healing starts with your practitioner's ability to relate to your circumstances.

“I’m not sure when it all started. Looking back, I can identify my Hashimoto's  symptoms all the way back in my teens. After years of feeling sick and tired, I was finally diagnosed in 2009, at the age of 26. While I was relieved to have a name and valid reason for all my debilitating symptoms (I really wasn’t crazy!), it didn’t fix anything.

Traditional medications never relieved my symptoms or aches and pains, and my dosages continued to increase. I tried doing all the 'right' things to get healthier, but I was still stuck in one constant flare up. I got hives every time I tried to exercise, had horrible hip and joint pain, couldn’t get out of bed, experienced uncontrollable weight-gain, bounced between anxiety and depression, and was living in a constant state of brain fog.”

Carly Michelson
Learn How We Work With Hashimoto's

What Triggers a Hashimoto’s Attack?

A Hashimoto’s attack may be triggered by a number of internal and external factors that impact the health of your thyroid, such as diet, stress, and lifestyle.


What you eat — or what you don’t eat, for that matter — plays a role in how your thyroid functions. Inflammatory foods may increase thyroid inflammation or your risk of developing Hashimoto’s thyroiditis. Dietary toxins and nutritional deficiencies from a lack of whole foods can affect the integrity of your gut lining and microbiome, resulting in dysbiosis and poor immune function, all of which can lead to decreased thyroid function.

Research has shown that following an anti-inflammatory diet rich in nutrient-dense foods packed with vitamins and minerals can improve symptoms and prevent disease flares in those with Hashimoto’s thyroiditis. The thyroid gland is one of the most frequently affected organs in autoimmune disease, but the following dietary issues may increase your risk of an attack:

  • high iodine intake 
  • nutrient deficiencies, specifically iron and selenium
  • low protein consumption
  • low fatty acid consumption 
  • low fiber intake



Managing your stress with Hashimoto's is important in preventing and managing disease attacks. Internal stressors may include thoughts and feelings that stem from relationships, trauma, deadlines, unrealistic expectations, the future, and low self-esteem, to name a few. Stress is liable to affect everyone from time to time, but it all comes down to how you cope under the pressure. (Source)

Although stress has not yet been recognized as a risk factor for developing Hashimoto’s, chronic stress can impact your health and lead to flares. Chronic stress may increase your risk of an attack due to:

  • high inflammation
  • lowered immune response
  • poor thyroid function 

When you are stressed, your body releases high levels of cortisol into the bloodstream, which can lead to a decrease in the production of thyroid hormones. In addition to the physical effects of stress, the mental effects of poor stress management may lead to depression and anxiety, lack of motivation, and poor recovery and resilience. (Source)

Environment and Lifestyle

Your environment may be affecting your thyroid function in general, but may also affect your risk of an autoimmune flare-up. For example, if you have come into contact with contaminants or been exposed to radiation, the toxins may increase your risk of thyroid impairment and Hashimoto’s attacks. 

The onset of autoimmune illnesses is attributed to a string of events as well as general risk factors including age, heredity, and other autoimmune conditions. However, in 20%–30% of autoimmune thyroid disease cases, disease onset is thought to be triggered by environmental exposures. These toxic exposures may overlap the previously mentioned triggers above and include:

  • radiation
  • environmental toxins from work or hobbies
  • certain medications such as amiodarone and interferon
  • smoking
  • stress
  • iodine intake
  • underlying infections


11 signs you're experiencing a hashimoto's attack

11 Signs You’re Experiencing a Hashimoto’s Attack

Experiencing a sudden onset of symptoms may be a red flag that a Hashimoto’s attack is flaring up. If your symptoms have been greatly reduced or in remission for some time and you have an acute onset of moderate to severe symptoms, you could be experiencing an attack. In addition, if your normal symptoms have become worse or heightened, that could also mean you are experiencing a disease attack.

The following 11 symptoms are signs you are experiencing a Hashimoto’s attack: 

  • goiter
  • unexplained weight gain
  • fatigue
  • sensitivity to cold 
  • constipation
  • puffy face
  • muscle aches
  • joint pain
  • hair loss
  • depression
  • fertility issues


Calming a Hashimoto’s Attack

A Hashimoto’s attack can be debilitating, reducing your quality of life and causing stress and anxiety over when the next attack will hit. Thankfully, Hashimoto’s disease flare-up symptoms may be prevented or managed in everyday life by keeping your thyroid gland healthy through proper diet and lifestyle techniques.

If you are in a current flare or experience Hashimoto’s attacks regularly, the following may help calm your symptoms and prevent future flares and autoimmune activity. (Source)


Follow an anti-inflammatory, thyroid-friendly diet rich in vitamins and nutrients to combat deficiencies and meet your dietary needs for optimal thyroid function.

Stress Management

Manage stress levels on a daily basis with diaphragmatic breathing exercises, yoga, tai chi, or a healthy hobby you love.

Reducing Toxins

Reduce environmental exposures and toxins as much as possible through healthy diet and lifestyle choices.

The Bottom Line

If you’ve ever experienced a Hashimoto’s attack, you know it can make you feel physically and mentally drained. As with any autoimmune disease, flare-ups are possible and even more likely if you don’t know how to care for your thyroid health effectively. If you have or are experiencing symptoms of a Hashimoto’s attack and need support for a treatment plan, WellTheory’s Certified Nutritionists and Registered Dietitians are here to help in supporting your body for the long haul. Consider a WellTheory membership to support your health with Hashimoto’s disease.

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