Autoimmune Thyroid Disease

Overview

Autoimmune thyroid disease (AITD) occurs when the body’s immune system mistakenly attacks the thyroid gland — a small organ in the neck that regulates metabolism, energy, and hormone balance.
Two main forms exist: Hashimoto’s thyroiditis, which typically leads to an underactive thyroid (hypothyroidism), and Graves’ disease, which causes an overactive thyroid (hyperthyroidism).

At The Royal Buckinghamshire Hospital, we see patients who experience both the direct effects of thyroid hormone imbalance and the secondary neurological or systemic complications it can trigger — including fatigue, weakness, tremors, and cognitive or mood changes.

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Common Symptoms

Symptoms depend on whether the thyroid is underactive or overactive, but may include:

Hypothyroidism (Hashimoto’s):

• Persistent tiredness or fatigue
• Weight gain despite normal eating
• Feeling cold or sluggish
• Dry skin and hair loss
• Low mood or brain fog
• Muscle aches and joint pain

Hyperthyroidism (Graves’):

• Unexplained weight loss
• Heat intolerance or sweating
• Rapid or irregular heartbeat
• Anxiety, irritability, or sleep disturbance
• Tremors or muscle weakness
• Eye discomfort or bulging eyes (Graves’ ophthalmopathy)

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Associated Neurological and Functional Symptoms

Autoimmune thyroid disease can contribute to neurological and functional presentations, including:

• Muscle weakness and coordination problems
• Tremor or movement disorders
• Memory or concentration difficulties
• Fatigue and sleep disturbance
• Mood instability or anxiety
• In some cases, functional neurological disorder (FND)–type symptoms, due to autoimmune-related inflammation affecting brain and nerve regulation

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Diagnosis

Diagnosis typically involves a combination of:

• Blood tests to measure thyroid hormone levels (T3, T4) and thyroid-stimulating hormone (TSH)
• Antibody tests (anti-TPO, anti-thyroglobulin, or TSH receptor antibodies) to confirm autoimmune activity
• Ultrasound scanning of the thyroid gland where structural changes are suspected

At The Royal Buckinghamshire Hospital, we can arrange fast access to thyroid blood testing and endocrine consultation, alongside neurological review if symptoms overlap with functional or neuroinflammatory presentations.

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Treatment and Management

Treatment aims to restore hormone balance and manage symptoms:

• Thyroxine replacement therapy for hypothyroidism
• Antithyroid medication or radioactive iodine therapy for hyperthyroidism
• Beta-blockers to control tremors or palpitations in hyperthyroidism
• Multidisciplinary rehabilitation for persistent fatigue, cognitive symptoms, or functional overlay

Our multidisciplinary team — including neurologists, endocrinologists, and rehabilitation specialists — provides tailored treatment and neurorehabilitation programmes to help patients manage complex autoimmune and neurological symptoms.

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When to Seek Medical Advice

If you are experiencing persistent fatigue, changes in mood, unexplained weight changes, or new neurological symptoms, early assessment can prevent complications and identify autoimmune thyroid disease before it progresses.

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How The Royal Buckinghamshire Hospital Can Help

At our specialist rehabilitation centre, we combine medical expertise with functional rehabilitation to support patients affected by autoimmune and neuroinflammatory conditions.
Our team can help you manage symptoms such as fatigue, weakness, balance problems, and cognitive changes through a holistic, personalised care plan.