Chronic infections are one of the most overlooked factors in thyroid dysfunction. Research shows that 60-80% of people with Hashimoto's have evidence of at least one chronic infection. Epstein-Barr virus, cytomegalovirus, HHV-6, mycoplasma, and chlamydia pneumoniae have all been linked to autoimmune thyroid disease. Gut pathogens such as H. pylori, Klebsiella, and Blastocystis add another layer. Lyme disease and its co-infections have also been associated with Hashimoto's in the clinical literat