You might not notice signs or symptoms of Hashimoto's disease at first, or you may notice a swelling at the front of your throat (goiter). Hashimoto's disease typically progresses slowly over years and causes chronic thyroid damage, leading to a drop in thyroid hormone levels in your blood. The signs and symptoms are mainly those of an underactive thyroid gland (hypothyroidism).
Signs and symptoms of hypothyroidism include:
Fatigue and sluggishness
Increased sensitivity to cold
Constipation
Pale, dry skin
A puffy face
Hoarse voice
Unexplained weight gain — occurring infrequently and rarely exceeding 10 to 20 pounds, most of which is fluid
Muscle aches, tenderness and stiffness, especially in your shoulders and hips
Pain and stiffness in your joints and swelling in your knees or the small joints in your hands and feet
Muscle weakness, especially in your lower extremities
Excessive or prolonged menstrual bleeding (menorrhagia)
Depression