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What foods trigger Hashimoto’s?

Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, is an autoimmune disorder that primarily affects the thyroid gland. While the exact cause of Hashimoto’s disease is unknown, it is believed to be a combination of genetic and environmental factors.

There is no single food that triggers Hashimoto’s disease, but there are some foods that people with Hashimoto’s disease may need to be cautious about. These foods are typically those that may exacerbate underlying autoimmune inflammation or impact thyroid hormone production or absorption.

Cruciferous vegetables such as broccoli, cauliflower, and kale contain compounds called goitrogens, which can interfere with the function of the thyroid gland. However, these vegetables are not likely to cause harm in moderate amounts and can be safely consumed when cooked. Soy and soy products can also be a potential issue, as they contain plant compounds called phytoestrogens which can affect thyroid function.

However, small amounts of soy are usually not a concern, and soy milk or tofu can be included in a balanced diet.

Gluten containing foods can also be a potential issue for individuals with Hashimoto’s disease. Some research suggests that gluten may trigger an immune response in individuals with Hashimoto’s disease, leading to increased inflammation and thyroid dysfunction. Therefore, some people with Hashimoto’s disease may choose to avoid gluten-containing foods.

Other potential trigger foods that may need to be monitored include sugar, processed foods, and processed oils. These foods can contribute to inflammation and oxidative stress within the body, further exacerbating autoimmune conditions like Hashimoto’s disease.

While specific trigger foods for Hashimoto’s disease may vary from person to person, individuals may benefit from following an anti-inflammatory diet that prioritizes whole, nutrient-dense foods while minimizing highly processed and inflammatory foods. Consulting with a registered dietitian or healthcare provider can also help in developing an individualized nutrition plan that supports optimal thyroid function and overall health.

What should you eat if you have Hashimoto’s?

Hashimoto’s thyroiditis is an autoimmune disorder that affects the thyroid gland, which results in the production of fewer thyroid hormones. The thyroid gland is responsible for producing hormones that regulate several body functions, including metabolism, growth, and development.

A healthy and balanced diet is essential for individuals with Hashimoto’s to support their body’s natural processes of hormone regulation, and also to minimize inflammation and optimize health.

A diet rich in whole and unprocessed foods, including fruits, vegetables, whole grains, lean protein sources, and healthy fats, is one of the best diets for individuals with Hashimoto’s. This diet provides the necessary nutrients, vitamins, and minerals for the body to function optimally and helps to increase energy levels and improve overall health.

It is important to include sources of omega-3 fatty acids in the diet as these can help reduce inflammation and support immune function. These can be found in fatty fish, walnuts, flaxseeds, and chia seeds. Foods that are high in fiber, such as legumes, whole grains, fruits, and vegetables, can also be beneficial to promote regular bowel movements, which can be a common issue among those with Hashimoto’s.

It is recommended that individuals with Hashimoto’s should limit their intake of foods that may contribute to inflammation or thyroid dysfunction, such as processed foods, refined sugars, and refined carbohydrates, as well as dairy products, gluten-containing grains, and soy, as some people with Hashimoto’s can have sensitivities to these foods.

A well-balanced diet that focuses on whole foods with an emphasis on sources of omega-3 fatty acids and fiber is important for individuals with Hashimoto’s thyroiditis. Limiting processed foods, refined sugars, and limiting dairy, gluten, and soy may be beneficial for some individuals with Hashimoto’s.

It is always essential to work with a healthcare professional, such as a registered dietitian or healthcare provider, to develop a personalized nutrition plan to meet the individual’s unique needs.

What can make Hashimoto’s worse?

Hashimoto’s disease is an autoimmune disorder that affects the thyroid gland. It is also known as chronic lymphocytic thyroiditis. In Hashimoto’s disease, the immune system attacks the thyroid gland, which leads to inflammation and damage to the gland. This results in an underactive thyroid, also known as hypothyroidism.

While Hashimoto’s disease is a chronic condition, it can worsen over time if not managed properly. Several factors can make Hashimoto’s worse, including:

1. Stress: Stress can have a significant impact on the immune system. Chronic stress can increase the level of cortisol, which can suppress the immune system’s response. This can lead to an increase in inflammation and a worsening of Hashimoto’s disease symptoms.

2. Poor Diet: A diet high in processed and refined foods can cause inflammation in the body. This can trigger the autoimmune response and worsen Hashimoto’s disease symptoms. Additionally, a diet low in nutrients can impact thyroid function and worsen hypothyroidism.

3. Exposure to Environmental Toxins: Environmental toxins such as pesticides, heavy metals, and chemicals can impact the immune system and lead to inflammation. This can exacerbate Hashimoto’s disease symptoms.

4. Lack of Sleep: Sleep plays a critical role in regulating the immune system. Chronic sleep deprivation can lead to an increase in inflammation and worsen Hashimoto’s disease symptoms.

5. Poor Gut Health: The gut microbiome plays a crucial role in regulating the immune system. An imbalance in gut bacteria, called dysbiosis, can lead to an increase in inflammation and worsen autoimmune diseases such as Hashimoto’s.

6. Hormonal Imbalances: Hormonal imbalances, such as estrogen dominance, can impact thyroid function and worsen Hashimoto’s disease symptoms.

Hashimoto’S disease can be worsened by several factors such as stress, poor diet, exposure to environmental toxins, lack of sleep, poor gut health, and hormonal imbalances. It is crucial to manage these factors to prevent the worsening of Hashimoto’s disease symptoms. Working with a healthcare provider to develop a personalized treatment plan is essential for managing this chronic condition.

Are eggs OK for Hashimoto’s?

Eggs can be a healthy part of a balanced diet for individuals with Hashimoto’s, but it is important to understand the potential impact they can have on the autoimmune condition. Eggs are a rich source of protein, vitamins, and minerals, and can provide important nutrients that are often lacking in the typical Western diet.

However, while eggs themselves are not a problem for Hashimoto’s, the way they are cooked and consumed can have an impact. For example, some individuals with Hashimoto’s may be sensitive to certain proteins found in eggs, which can trigger an autoimmune response and exacerbate symptoms.

Moreover, the cooking method can also play a significant role in how well the body tolerates eggs. For example, some individuals may find that they experience adverse reactions to eggs that are fried or scrambled, but can tolerate eggs that are boiled or poached.

Additionally, it is important to note that a diet high in processed foods, including those that contain eggs, can contribute to inflammation and exacerbate symptoms of Hashimoto’s. Therefore, it is important to focus on consuming whole, nutrient-dense foods, including eggs, rather than relying on processed and packaged options.

The key to incorporating eggs into a diet for Hashimoto’s is to pay attention to your body’s response and make adjustments as necessary. If you experience symptoms after consuming eggs, speak with your healthcare provider about potential sensitivities or allergies. Additionally, consider experimenting with different cooking methods and limiting processed foods to minimize inflammation and support optimal thyroid health.

What is a good breakfast for Hashimoto’s?

Hashimoto’s disease is an autoimmune disease that affects the thyroid gland. It can lead to hypothyroidism, a condition where the thyroid gland produces an insufficient amount of thyroid hormone. Therefore, it is important to eat a healthy and balanced breakfast to support the thyroid gland and regulate the metabolism.

A good breakfast for Hashimoto’s should be low in inflammation and high in nutrients such as protein, healthy fats, and fiber. Here are some options:

1. Eggs: Eggs are a great source of protein and healthy fats. They are also a rich source of selenium, which is important for thyroid function. You can prepare them in several ways such as omelets, scrambled, boiled or fried.

2. Greek Yogurt: Greek yogurt is high in protein and low in sugar. It is also a good source of iodine which is important for thyroid function. You can top it with fruits or nuts for additional nutrients.

3. Smoothies: Smoothies are an excellent way to pack in several nutrients in one meal. You can use ingredients such as spinach, kale, berries, almond milk, and protein powder to make a healthy and delicious smoothie.

4. Avocado Toast: Avocado toast is a popular breakfast option that is filling and nutrient-dense. Avocado is a great source of healthy fats and fiber. You can add a boiled egg or smoked salmon for additional protein.

5. Oatmeal: Oatmeal is a great source of fiber and complex carbohydrates, which helps to regulate blood sugar levels. You can add nuts, seeds, and fruits for additional nutrients.

It is also important to avoid inflammatory foods such as processed foods, refined sugars, gluten, and dairy. These foods can cause inflammation in the body, which can worsen Hashimoto’s symptoms. It is best to consult with a registered dietitian who specializes in autoimmune diseases to create a customized nutrition plan based on individual needs and health goals.

Can I eat cheese with Hashimoto?

Hashimoto’s thyroiditis is an autoimmune disorder that affects the thyroid gland, leading to its destruction by the immune system. It causes hypothyroidism, which means that the thyroid gland doesn’t produce enough thyroid hormone to keep the body functioning properly. Hashimoto’s thyroiditis commonly affects women, and the risk of developing it increases with age.

Diet may play a role in managing the symptoms of Hashimoto’s. Some people with Hashimoto’s thyroiditis may find that certain foods exacerbate their symptoms, while others may not.

Cheese is a dairy product that contains high amounts of calcium, protein, and fat. If you are lactose intolerant, consuming dairy products such as cheese may cause digestive problems such as bloating, stomach cramps, and diarrhea. However, if you are not lactose intolerant, consuming cheese in moderation may provide some health benefits.

Cheese is a source of iodine, which is an essential mineral that the thyroid gland needs to produce thyroid hormones. However, the amount of iodine in cheese varies depending on the type of cheese, and some types may contain more iodine than others. People with Hashimoto’s thyroiditis may need to regulate their iodine intake, and it’s important to talk to a healthcare provider about how much iodine you need in your diet.

Whether or not you can eat cheese with Hashimoto’s thyroiditis depends on your individual situation. It’s essential to work with your healthcare provider and a registered dietitian to determine which foods are best for managing your symptoms and overall health. They can also help you create an individualized meal plan that meets your nutritional needs.

Can I eat eggs if I have hypothyroidism?

Yes, you can eat eggs if you have hypothyroidism. In fact, eggs can be a great addition to your diet if you have an underactive thyroid. Eggs are an excellent source of protein, which is essential for maintaining muscle mass, supporting a healthy metabolism, and keeping you feeling full and satisfied.

In addition to protein, eggs also contain important nutrients like vitamin D, selenium, and iodine. Vitamin D is crucial for maintaining healthy bones and muscles, while selenium and iodine are vital for supporting thyroid function.

However, if you have hypothyroidism, it’s important to eat eggs in moderation. While eggs are a healthy food, they are also high in cholesterol. If your cholesterol levels are already high, you may want to limit your intake of eggs to one or two per day. Additionally, you should make sure to eat a variety of other healthy foods as part of a balanced diet to ensure you get all the nutrients your body needs.

Eggs can be a healthy and delicious addition to your diet if you have hypothyroidism. Just make sure to eat them in moderation and as part of a balanced diet that includes a variety of other nutritious foods.

Are eggs good or bad for hypothyroidism?

The answer to whether eggs are good or bad for hypothyroidism is not as straightforward as a simple ‘yes’ or ‘no’ answer. Eggs are a protein-rich food that is known for its numerous health benefits. However, when it comes to hypothyroidism, the devil is in the details.

On one hand, eggs contain a high level of iodine, which is an essential nutrient for the proper functioning of the thyroid gland. The thyroid gland requires iodine to produce thyroid hormones, which help regulate metabolism in the body. People with hypothyroidism have an underactive thyroid gland, and the deficiency of thyroid hormones can lead to a slow metabolism, weight gain, and other side effects.

Therefore, consuming foods rich in iodine, like eggs, can help support the thyroid gland and boost thyroid hormone levels, making them good for hypothyroidism.

On the other hand, some people with hypothyroidism are sensitive to food allergens, including eggs. Food allergens can cause inflammation in the body, leading to autoimmune dysfunction. People with hypothyroidism who also have food sensitivities may experience symptoms such as weight gain, fatigue, brain fog, and joint pain.

In addition, the way eggs are cooked can also impact their effects on hypothyroidism. For instance, an autoimmune response to proteins in egg whites indicates that people with autoimmune conditions and hypothyroidism may be best suited to consuming only cooked egg yolks, as egg whites are commonly allergenic.

Overcooking eggs can also destroy vital nutrients, including iodine, making them less beneficial for those with hypothyroidism.

Therefore, the answer to whether eggs are good or bad for hypothyroidism is that it depends on a person’s individual health status and diet. If you have a sensitivity to eggs, then it would be best to avoid them. However, if you do not have any food sensitivities, then eating eggs moderately as part of a balanced diet could be helpful, especially if you have a high iodine intake to support thyroid function.

It is also important to cook eggs in healthy ways that preserve their nutrients and not overcook them. it is essential to consult a healthcare professional about dietary changes, especially if you have hypothyroidism, to ensure that you are appropriately managing your condition.

Should people with hypothyroidism eat eggs?

Hypothyroidism is a condition in which the thyroid gland doesn’t produce enough hormones that regulate metabolism. The prevalence of hypothyroidism is increasing worldwide, with women and elderly people at higher risk. Diet has a significant impact on thyroid function, and it is important to choose the right food to manage the condition.

When it comes to eggs, they are generally considered a highly nutritious food rich in high-quality protein, healthy fats, vitamins, and minerals. However, for people with hypothyroidism, there are certain considerations to be kept in mind.

Eggs are a good source of iodine, which is essential for thyroid hormone synthesis. However, the amount of iodine in eggs is relatively low, and it might not be sufficient to address the deficiency in people with hypothyroidism. Therefore, it is important to include other iodine sources such as seaweed, fish, and iodized salt in the diet.

Another consideration is the way eggs are prepared. Some people with hypothyroidism are sensitive to cholesterol, and excessive cholesterol intake may worsen their condition. Therefore, it is recommended to limit the consumption of egg yolks and opt for egg whites instead. Moreover, it is crucial to avoid frying eggs in oil or butter, as it can increase the calorie and fat content and raise cholesterol levels.

Besides the iodine and cholesterol content, eggs are also rich in other nutrients like vitamin D, selenium, and zinc. These nutrients are essential for thyroid function and can help manage symptoms of hypothyroidism. However, people with hypothyroidism need to be mindful of their intake, as excessive supplementation can lead to adverse health effects.

Eggs can be a healthy food choice for people with hypothyroidism, provided that they are consumed in moderation and prepared in a healthy way. A well-balanced diet that includes a variety of food sources can help manage hypothyroidism symptoms and support overall health. It’s always recommended to consult a healthcare professional or a registered dietitian to get advice tailored to individual needs.

Do eggs interfere with thyroid?

There is some evidence to suggest that consuming large amounts of eggs may interfere with thyroid function in certain individuals. This is because eggs, like many other foods, contain compounds known as goitrogens, which can interfere with the production of thyroid hormones. Goitrogens work by inhibiting the uptake of iodine, which is a key nutrient required for the production of thyroid hormones.

In people who are already deficient in iodine, consuming large amounts of goitrogens like those found in eggs can exacerbate the problem and cause further problems with thyroid function.

However, it is important to note that the link between eggs and thyroid function is not a direct one. While goitrogens are found in eggs, the levels are relatively low, and most people can consume eggs without any negative effects on their thyroid function. It is also worth noting that cooking can reduce the levels of goitrogens in eggs, so those who are concerned about their impact on thyroid function can try cooking their eggs thoroughly to reduce the amount of these compounds.

In addition, eating a varied, balanced diet that includes a range of nutrient-rich foods like fruits, vegetables, and lean protein sources is key to maintaining optimal thyroid function. Ensuring that you are getting enough iodine, as well as other key nutrients like selenium and zinc, can also help to support optimal thyroid health.

If you are concerned about your thyroid function or have a history of thyroid problems, it is always best to speak with your healthcare provider, who can provide personalized guidance based on your individual needs and concerns.

What vegetables should be avoided with Hashimoto’s?

Hashimoto’s disease is an autoimmune disorder in which the immune system attacks the thyroid gland, leading to an underactive thyroid gland (hypothyroidism). While the exact cause of Hashimoto’s disease is unknown, it is believed to be a combination of genetic and environmental factors. There is no known cure for Hashimoto’s disease, but the symptoms can be managed through dietary changes, medication, and lifestyle modifications.

When it comes to managing Hashimoto’s disease through diet, it is essential to focus on nutrient-dense foods that help support the immune system and reduce inflammation. Many health experts recommend avoiding certain vegetables that may interfere with thyroid function, exacerbate inflammation, or disrupt the absorption of essential nutrients, such as iodine.

One vegetable that should be avoided with Hashimoto’s disease is cruciferous vegetables, such as broccoli, cauliflower, cabbage, and kale. These vegetables contain goitrogens, which are compounds that can interfere with thyroid function, especially in people with an iodine deficiency. Goitrogens can block the thyroid’s ability to absorb iodine, leading to an enlarged thyroid gland (goiter) and worsening hypothyroidism symptoms.

Another vegetable to avoid with Hashimoto’s disease is spinach. Spinach contains oxalates, which can bind to calcium and prevent its absorption by the body. Calcium is essential for proper thyroid function, and a deficiency can worsen hypothyroidism symptoms. Additionally, spinach is high in vitamin K, which can interfere with blood thinning medications that some people with Hashimoto’s may take.

Nightshade vegetables, such as tomatoes, potatoes, peppers, and eggplants, are also recommended to be avoided with Hashimoto’s disease. These vegetables contain solanine, a compound that can trigger inflammation and autoimmune reactions in some people.

People with Hashimoto’s disease should avoid cruciferous vegetables, spinach, and nightshade vegetables, as they can interfere with thyroid function, disrupt nutrient absorption, and exacerbate inflammation. Instead, it is recommended to focus on a varied, nutrient-dense diet that includes lean protein, healthy fats, whole grains, and plenty of fruits and vegetables that are not goitrogenic or high in oxalates.

Consulting with a registered dietitian can be helpful to develop a personalized nutrition plan that aligns with the individual’s health needs and goals.

Is broccoli good for Hashimoto?

Broccoli is a nutrient-dense vegetable that is packed with numerous vitamins and minerals, such as vitamin C, vitamin K, folate, fiber, and iron. These nutrients are essential in maintaining overall health and wellbeing, especially for individuals diagnosed with Hashimoto’s disease.

Hashimoto’s disease is an autoimmune disorder that primarily affects the thyroid gland, resulting in hypothyroidism, or an underactive thyroid. This condition causes the thyroid gland to produce fewer hormones than necessary, leading to various symptoms like fatigue, weight gain, and depression.

One particular nutrient found in broccoli that makes it beneficial for individuals with Hashimoto’s disease is selenium. Studies have shown that consuming foods rich in selenium can reduce inflammation in the thyroid gland and improve thyroid function, which is essential for individuals with Hashimoto’s disease.

Additionally, broccoli contains compounds called glucosinolates, which possess antioxidant and anti-inflammatory properties. These compounds help reduce inflammation and oxidative stress, both of which can exacerbate the symptoms of Hashimoto’s disease.

Broccoli is also rich in fiber, which promotes healthy digestion and supports gut health. A healthy gut is crucial for people with Hashimoto’s disease because it helps reduce inflammation in the body, which can trigger autoimmune reactions.

Finally, broccoli is low in calories and high in fiber, making it an excellent choice for people with Hashimoto’s disease who want to maintain a healthy weight. Obesity and excess weight can increase the risk of complications in people with Hashimoto’s disease, so incorporating broccoli and other nutrient-dense vegetables into their diet can help them achieve their weight loss goals.

Broccoli is an excellent vegetable for people with Hashimoto’s disease. It is rich in nutrients, such as selenium and fiber, that are essential for maintaining overall health and supporting thyroid function. By incorporating broccoli into their diet regularly, individuals with Hashimoto’s disease can promote healthy digestion, reduce inflammation, and achieve a healthy weight.

What is the diet to reverse Hashimoto’s?

Hashimoto’s disease is an autoimmune disorder that affects the thyroid gland. In this disease, the immune system attacks the thyroid gland, causing inflammation and damage. As a result, the thyroid gland may produce too little thyroid hormone, leading to hypothyroidism.

While there is no cure for Hashimoto’s disease, there are certain dietary changes that can help reduce inflammation, improve thyroid function, and slow down the progression of the disease. Here are some key dietary guidelines that can help reverse Hashimoto’s disease:

1. Eliminate Gluten from Your Diet: Many people with Hashimoto’s disease have gluten intolerance or celiac disease. Therefore, it is recommended to avoid gluten-containing foods like wheat, barley, and rye. Gluten can cause inflammation in the gut, which can exacerbate Hashimoto’s disease.

2. Increase Your Intake of Nutrient-Dense Foods: Eating a diet rich in nutrient-dense foods is essential for reversing Hashimoto’s disease. Foods such as leafy greens, colorful vegetables and fruits, nuts, seeds, and legumes should be incorporated into your diet.

3. Eat Iodine-Rich Foods: Iodine is essential for the production of thyroid hormones. Therefore, adding iodine-rich foods to your diet can help support thyroid function. Foods such as seaweed, fish, eggs, and dairy products are excellent sources of iodine.

4. Support Gut Health: A healthy gut is essential for optimal thyroid function. Eating foods that are high in fiber can help to improve gut health. Fermented foods like kimchi, sauerkraut, and yogurt can also help to improve gut health.

5. Avoid Processed Foods: Processed and refined foods can contribute to inflammation and may exacerbate Hashimoto’s disease. Therefore, it is recommended to avoid processed and refined foods like refined sugar, white flour, and packaged snacks.

6. Reduce Stress: Stress can negatively affect thyroid function and exacerbate Hashimoto’s disease. Incorporating stress-reducing practices like yoga, meditation, and deep breathing can help to reduce stress and support thyroid health.

A balanced and nutrient-dense diet that is rich in whole, unprocessed foods and devoid of gluten is essential for reversing Hashimoto’s disease. Supporting gut health and reducing stress levels are also important factors to consider when trying to reverse Hashimoto’s disease.

What vegetables are thyroid friendly?

The thyroid gland is an essential part of the endocrine system that plays a vital role in regulating metabolism and various bodily functions. Although there is no specific vegetable that can directly support thyroid health, certain vegetables can be beneficial for thyroid function by providing essential nutrients.

One of the best vegetables for thyroid health is leafy greens, such as spinach, kale, collard greens, and lettuce. These vegetables contain high levels of minerals such as magnesium, calcium, and potassium, which are essential for maintaining optimal thyroid function.

Broccoli, cauliflower, and brussels sprouts are also great vegetables to incorporate into your diet for thyroid health. These cruciferous vegetables contain glucosinolates that convert into a compound called sulforaphane, which helps to support the body’s natural detoxification process and reduce inflammation.

Other vegetables that can benefit thyroid function include sweet potatoes, carrots, mushrooms, and asparagus. Sweet potatoes and carrots are rich in beta-carotene, which is a precursor to vitamin A, an essential nutrient for thyroid health. Mushrooms are high in selenium, a mineral that supports proper thyroid function, and asparagus contains high levels of iodine, another crucial nutrient for thyroid health.

Incorporating a variety of vegetables into your diet can help support thyroid function by providing essential nutrients such as magnesium, calcium, potassium, selenium, and iodine. Eating a balanced and varied diet is essential for overall health and wellness, and it is especially beneficial for thyroid health.

Does Hashimoto’s disease get worse over time?

Hashimoto’s disease is a chronic autoimmune disorder that affects the thyroid gland, which is responsible for producing hormones that regulate the body’s metabolism. The main feature of Hashimoto’s disease is the gradual destruction of thyroid tissue by the immune system, leading to an underactive thyroid, also known as hypothyroidism.

While the severity of symptoms may vary from person to person, Hashimoto’s disease typically progresses gradually over time, and in some cases, it may get worse. When left untreated or poorly managed, the disease can lead to permanent damage to the thyroid gland, resulting in a decrease in the production of thyroid hormones that regulate various bodily functions.

The progression of Hashimoto’s disease can be influenced by various factors such as age, gender, genetics, environmental factors, and the overall health of the person. In some individuals, the disease may progress rapidly, while in others, it may remain stable for an extended period. Women are more likely to develop Hashimoto’s disease than men, and the risk increases with age.

The symptoms of Hashimoto’s disease may range from mild to severe and may include fatigue, weight gain, cold intolerance, constipation, dry skin, thinning hair, irregular menstrual periods, and depression. In advanced cases, symptoms such as myxedema coma, heart problems, infertility, and neurological abnormalities may develop.

The treatment for Hashimoto’s disease typically involves the use of synthetic thyroid hormone replacement therapy, which helps to control the symptoms by replacing the hormone that the body is no longer producing. Other treatment options may include anti-inflammatory medications to reduce the inflammation caused by the immune system, and dietary changes that help support thyroid health.

Managing Hashimoto’s disease requires close monitoring and regular checkups to assess the progression of the disease and adjust the treatment accordingly. While the disease may progress over time, proper treatment and management can help prevent permanent damage to the thyroid gland and improve the quality of life for those living with the disease.