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Hashimoto's disease is an autoimmune disorder affecting the thyroid gland. The thyroid is a butterfly-shaped gland located at the base of the neck just below the Adam's apple. The thyroid produces hormones that help regulate many functions in the body. An autoimmune disorder is an illness caused by the immune system attacking healthy tissues. In Hashimoto's disease, immune-system cells lead to the death of the thyroid's hormone-producing cells. The disease usually results in a decline in hormone production hypothyroidism. Although anyone can develop Hashimoto's disease, it's most common among middle-aged women. The primary treatment is thyroid hormone replacement. Hashimoto's disease is also known as Hashimoto's thyroiditis, chronic lymphocytic thyroiditis and chronic autoimmune thyroiditis. The thyroid gland is located at the base of the neck, just below the Adam's apple. Hashimoto's disease progresses slowly over the years. You may not notice signs or symptoms of the disease. Eventually, the decline in thyroid hormone production can result in any of the following:. Signs and symptoms of Hashimoto's disease vary widely and are not specific to the disorder. Because these symptoms could result from any number of disorders, it's important to see your health care provider as soon as possible for a timely and accurate diagnosis. Hashimoto's disease is an autoimmune disorder. The immune system creates antibodies that attack thyroid cells as if they were bacteria, viruses or some other foreign body. The immune system wrongly enlists disease-fighting agents that damage cells and lead to cell death. What causes the immune system to attack thyroid cells is not clear. The onset of disease may be related to:. Thyroid hormones are essential for the healthy function of many body systems. Therefore, when Hashimoto's disease and hypothyroidism are left untreated, many complications can occur. These include:. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. On this page. When to see a doctor. Risk factors. Thyroid gland. Eventually, the decline in thyroid hormone production can result in any of the following: Fatigue and sluggishness Increased sensitivity to cold Increased sleepiness Dry skin Constipation Muscle weakness Muscle aches, tenderness and stiffness Joint pain and stiffness Irregular or excessive menstrual bleeding Depression Problems with memory or concentration Swelling of the thyroid goiter A puffy face Brittle nails Hair loss Enlargement of the tongue. Request an appointment. From Mayo Clinic to your inbox. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview. To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. The onset of disease may be related to: Genetic factors Environmental triggers, such as infection, stress or radiation exposure Interactions between environmental and genetic factors. The following factors are associated with an increased risk of Hashimoto's disease: Sex. Women are much more likely to get Hashimoto's disease. Hashimoto's disease can occur at any age but more commonly occurs during middle age. Other autoimmune disease. Having another autoimmune disease — such as rheumatoid arthritis, type 1 diabetes or lupus — increases your risk of developing Hashimoto's disease. Genetics and family history. You're at higher risk for Hashimoto's disease if others in your family have thyroid disorders or other autoimmune diseases. Typical changes in immune function during pregnancy may be a factor in Hashimoto's disease that begins after pregnancy. Excessive iodine intake. Too much iodine in the diet may function as a trigger among people already at risk for Hashimoto's disease. Radiation exposure. People exposed to excessive levels of environmental radiation are more prone to Hashimoto's disease. These include: Goiter. A goiter is enlargement of the thyroid. As thyroid hormone production declines due to Hashimoto's disease, the thyroid receives signals from the pituitary gland to make more. This cycle may result in a goiter. It's generally not uncomfortable, but a large goiter can affect your appearance and may interfere with swallowing or breathing. Heart problems. Hypothyroidism can result in poor heart function, an enlarged heart and irregular heartbeats. It can also result in high levels of low-density lipoprotein LDL cholesterol — the 'bad' cholesterol — that is a risk factor for cardiovascular disease and heart failure. Mental health issues. Depression or other mental health disorders may occur early in Hashimoto's disease and may become more severe over time. Sexual and reproductive dysfunction. In women, hypothyroidism can result in a reduced sexual desire libido , an inability to ovulate, and irregular and excessive menstrual bleeding. Men with hypothyroidism may have a reduced libido, erectile dysfunction and a lowered sperm count. Poor pregnancy outcomes. Hypothyroidism during pregnancy may increase the risk of a miscarriage or preterm birth. Babies born to women with untreated hypothyroidism are at risk for decreased intellectual abilities, autism, speech delays and other developmental disorders. Myxedema miks-uh-DEE-muh. This rare, life-threatening condition can develop due to long-term, severe, untreated hypothyroidism. Its signs and symptoms include drowsiness followed by profound lethargy and unconsciousness. A myxedema coma may be triggered by exposure to cold, sedatives, infection or other stress on your body. Myxedema requires immediate emergency medical treatment. By Mayo Clinic Staff. Jan 15, Show References. Hashimoto's thyroiditis lymphocytic thyroiditis. American Thyroid Association. Accessed Oct. Davies TF. Pathogenesis of Hashimoto's thyroiditis chronic autoimmune thyroiditis. Hypothyroidism underactive. Accessed Sept. Melmed S, et al. Hypothyroidism and thyroiditis. In: Williams Textbook of Endocrinology. Elsevier; Ralli M, et al. Hashimoto's thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation. Autoimmunity Reviews. Lee SY, et al. Testing, monitoring, and treatment of thyroid dysfunction in pregnancy. Thyroid function tests. Thyroid hormone treatment. Goldman L, et al. In: Goldman-Cecil Medicine. Ad Choices. Mayo Clinic Press. Mayo Clinic on Incontinence. The Essential Diabetes Book. Mayo Clinic on Hearing and Balance. Your gift holds great power — donate today! Find a doctor. Explore careers. Sign up for free e-newsletters. About Mayo Clinic. About this Site. Contact Us. Health Information Policy. Media Requests. News Network. Price Transparency. Medical Professionals. Clinical Trials. Mayo Clinic Alumni Association. Refer a Patient. Executive Health Program. International Business Collaborations. Supplier Information. Admissions Requirements. Degree Programs. Research Faculty. International Patients. Financial Services. 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Bisyunabe(Sake Hot Pot) | Our Regional Cuisines
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Announcements Top. Policies Top. Data Top. Sake hot pot is a simple dish made by cooking chicken, gizzard, pork, and vegetables with a straightforward seasoning of salt, pepper, and sake. It's light and lets you enjoy the natural flavors of the ingredients. It's said to have originated as a staff meal invented by a sake brewer in Nishijo, Hiroshima City, to satisfy hunger during breaks from sake-making. The simple seasoning is designed to not affect the ability to taste sake. Because the alcohol evaporates when heated, even people who aren't fond of alcohol and a wide range of age groups can enjoy it. The name comes from the Japanese word 'bisho', meaning wet, referring to brewery workers who often got soaked with water due to their work. Since they would eat this hot pot, it became known as 'bisho nabe. Nishijo, known for its sake brewing, is a renowned brewing area comparable to 'Nada of Hyogo' and 'Fushimi of Kyoto. It's also famous for being called the 'New Sake Capital' by the poet Kawahigashi Hekigoto, who visited Nishijo at the beginning of the Showa era. It was originally eaten as a staff meal during sake brewing's winter period. Nowadays, it's enjoyed as a specialty dish of Hiroshima City all year round. It's also served during the annual 'Sake Festival' held in October. Gradually add sake. Season with salt and pepper, then eat. Don't overcook the vegetables. Instead of making all at once, prepare everything again after finishing the contents of the pot. Sometimes konjac and thick-fried tofu are added. Seasonal vegetables can be used. During the October 'Sake Festival,' you can enjoy various types of sake hot pot created by different sake breweries and shops. In Hiroshima City, it's served during the annual 'Sake Festival' held in October and has become a local specialty. It's also available at restaurants around Nishijo Station, and you can enjoy it regardless of the season. Cut the napa cabbage into bite-sized pieces, slice the carrot, diagonally cut the white scallions, and cut the onions into comb shapes. Tear the konjac into small pieces and boil it. Cut the tofu into bite-sized pieces. Slice the garlic thinly. Cut the chives to about 5cm in length. Gradually add sake and cook, adding the ingredients that take longer to cook. Skip to main content. Announcements Top Close. Policies Top Close. Data Top Close. Term of use. Image source: Hiroshima City Tourism Association. How to cook 1. Once cooked, season with salt and pepper before eating. Address : ,Kasumigaseki,Chiyoda-ku,Tokyo ,Japan.
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