Wiersinga and colleagues in a 2014 article identified 5 stages of Hashimoto’s.
Stage 1: Genetic Predisposition
In the initial stage, a person will have the genetic predisposition for Hashimoto’s, but they will not have been exposed to the necessary triggers thus, will have normal TSH, T4/T3 hormones, no thyroid antibodies and will not have any changes in their thyroid gland. Alternatively, this could be called Stage 0, as there are no manifestations of disease at this point.
If you have thyroid disease, then this may be the stage your relatives and children are currently in. Or if you have a family member with thyroid disease and you’re reading this, you could be in this stage. This stage is the best time to think about prevention. Here’s a post I wrote on preventing Hashimoto’s.