Early on, symptoms may not be noticed. Hashimoto’s disease typically progresses slowly over years and causes chronic thyroid damage, leading to a drop in thyroid hormone levels in the blood. Over time, the thyroid gland may enlarge, forming a painless goiter. The signs and symptoms of hypothyroidism usually include:

• Unexplained weight gain
• Swelling or a puffy face
• Fatigue
• Sluggishness
• Constipation
• Pale, dry skin
• Increased sensitivity to cold
• Muscle aches, cramping or joint pain
• Hoarseness

*** In some patients, only low thyroid hormone levels are detected without presenting clinical symptoms (known as subclinical hypothyroidism).

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