Thyroid UK
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Hashi's but no goitre!

Hi there, suspected Hashimoto's sufferer here diagnosed hypothyroid in May and on 125mcg Levo. Blood test in November was TSH 4.3 (0.27-4.2) and FT4 15.3 (12-22). I can post past results on here if needed.

Whilst I'm waiting on my endo referral to come through and the blood test results I thought I would post this question as it's been playing on my mind ever since last year: is it possible for someone with Hashi's to not have a goitre? Or to perhaps have one that has since gone down?

At the start of last year the front of my neck swelled up - I put it down to a very bad throat infection and stocked up on cold and flu remedies. This was before a thyroid problem was flagged up.

By the time a thyroid problem was thought of, the swelling at the front of my neck went down and an ultrasound revealed the gland was in the sonographer's words "a little bulky". The GP who I was with at the time mislaid this report and so no more action was taken.

Exactly a year later when I changed to another GP I was told I had high thyroid antibodies in a blood test result but I was not told which ones were high. I have since had my blood retested for this as well as folates, iron, Vitamin D, Vitamin B12, plasma viscosity, coeliac and autoimmune profile, the results of which I'm expecting next week.

I keep examining my neck despite my boyfriend telling me to leave it alone, but it has not since swelled up and feels fine. I'm wondering if I have got Hashi's at all.

My symptoms seem to be a mishmash. My GP fully appreciates the symptoms as well hence the referral.

My symptoms are:

* Migraines

* Constipation (although I've been getting some diarrhoea)

* Cold intolerance - my BBT readings say otherwise

* Sweating/flushing a lot more

* Fatigue

* Trouble sleeping/insomnia

* Mood swings

* Problems with periods - painful, heavy, early, short and spotting

* Muscle/joint pain

* Cramps

* Weight loss - finding it hard to put on any weight despite eating more.

Would an endo order another ultrasound to be done and is there anyone else out there with a similar issue?


Jo xxx

6 Replies

Sorry you have had no replies - hopefully someone wit the relevant knowledge will pick this up from Latest Activity...




In short, yes it is possible to have Hashi's without a goitre (to my knowledge). My cousin also has Hashi's (verified by antibody tests) but the size of her gland is normal (however it's still pretty beat up according to her ultrasound). I think antibody tests are a more accurate diagnostic indicator than the presence of a goitre.

I had a similar experience. Before I was diagnosed with Hashi's I noticed my neck got "bigger." I had an ultrasound which proved it to be a goitre. After being medicated (I take ERFA) for a few months my doctor ordered another ultrasound and the swelling had gone down considerably and I now have a much "smaller" goitre. It's not as noticeable visibly, but I still get weird pains in my throat/neck and have trouble swallowing sometimes. Mine is still there and yours probably is too - just smaller. Also, I think when I'm having a flare up the swelling increases, but everyone is different.


Hi Symon, thanks for your answer.

I figured Hashi's might still be possible without a goitre. I also get weird pains in my throat/neck and the food I swallow takes ages to go down properly. It's probably a strange thing to say! I feel around my throat/neck and although I haven't noticed any difference when I have flares I do get incredibly itchy around there. Not sure if that counts as a flare.

Thanks!! :)

Jo xxx


The original research by Hashimoto showed damaged thyroids which were to some extent goitrous.

For many years, many doctors have restricted the term Hashimoto's to those with a goitre. However, as the damage to the thyroid seems to be the same whether or not there is a goitre, that distinction appears rather artificial. So much so that many doctors are comfortable using the term with or without a goitre.

Some doctors still make the distinction and call the non-goitrous form Autoimmune Thyroid Disease. Almost no-one ever mentions that it has been called Ord's in the past.

I believe that if the underlying disease process is the same, it would be far more sensible to keep to one name - something like Hashimoto's disease with goitre, or without goitre. Especially as I have never read any solid explanation of why some people develop goitres and others do not.


Thanks Helvella.

Even when my goitre went down I still had nurses telling me I had one. I went to my GP after 2 nurses told me I had a goitre and the GP told me I did not. They also went on to say nurses don't see what doctors see which I thought was a bit arrogant.

I just didn't know why my goitre went down and I have high antibodies. I thought once someone has a goitre, it doesn't go away until treated with Levo. I wasn't on any thyroid meds when I had the goitre - it went down on its own which I thought was odd.

Jo xxx


Hi Jo I understand exactly what you mean about your symptoms being a mishmash. hashimotos can be confusing..This is taken from the book "stop the thyroid madness"

It says " The early stages of hashimotos disease can be symptomless. As the attack progresses, the damaged cells of your thyoid become inefficient in converting iodine to thyroid hormones. Thus, your thyroid will compensate by becoming larger, also called a goiter. Eventually you will start to notice the symptoms of hypothyroidism, including ......(list of usual symptoms).....As it progresses you may feel hypo one day and hyper another which is caused by the destruction of your thyroid.Thoses symptoms can include anxiety, a racing heart and palpitations. The hyper is caused by the release of thyroid hormones into your blood due to the destruction. The hypo is caused by the lessening function of your thyroid due to the destruction" later in the paragraph it says " Dr Hakaru Hashimoto described a newly revealed condition in which the thyroid enlarged called a goiter and later atrophied" Dont worry I can touchtype so this didnt take me long!!

So hashimotos does cause a mishmash of symptoms. Weight loss can also be caused by cortisol/adrenal fatigue problems which often come along with hashimotos so might be worth having that checked. good luckx


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