The symptoms of Hashimoto's thyroiditis are similar to those of hypothyroidism in general, which are often subtle. They are not specific (which means they can mimic the symptoms of many other conditions) and are often attributed to aging. Patients with mild hypothyroidism may have no signs or symptoms. The symptoms generally become more obvious as the condition worsens, and the majority of these complaints are related to a metabolic slowing of the body. Common symptoms are:

• Fatigue.
• Depression.
• Modest weight gain.
• Cold intolerance.
• Excessive sleepiness.
• Dry, coarse hair.
• Constipation.
• Dry skin.
• Muscle cramps.
• Increased cholesterol levels.
• Decreased concentration.
• Vague aches and pains.
• Swelling of the legs.

As hypothyroidism becomes more severe, there may be puffiness around the eyes, a slowing of the heart rate, a drop in body temperature, and heart failure. In its most profound form, severe hypothyroidism may lead to a life-threatening coma (myxedema coma). In a severely hypothyroid individual, a myxedema coma tends to be triggered by severe illness, surgery, stress, or traumatic injury. This condition requires hospitalization and immediate treatment with thyroid hormones given by injection.

Properly diagnosed, hypothyroidism can be easily and completely treated with thyroid hormone replacement. On the other hand, untreated hypothyroidism can lead to an enlarged heart (cardiomyopathy), worsening heart failure, and an accumulation of fluid around the lungs (pleural effusion).

There are a few patients with Hashimoto's thyroiditis who may undergo a hyperthyroid phase (too much thyroid hormone), called hashitoxicosis, before eventually becoming hypothyroid. Other symptoms and signs include:

• Swelling of the thyroid gland (due to the inflammation), leading to a feeling of tightness or fullness in the throat.
• A lump in the front of the neck, (the enlarged thyroid gland) called a goiter.
• Difficultly swallowing solids and/or liquids due to the enlargement of the thyroid gland with compression of the esophagus.

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