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Hashimoto's thyroiditis is an autoimmune condition that affects the thyroid gland. The thyroid gland is a butterfly-shaped gland near the base of the neck, directly below the Adam's apple. The thyroid gland generates hormones that aid in the regulation of various bodily functions.
An autoimmune condition is a disease in which the immune system attacks healthy tissues. Immune cells in Hashimoto's disease cause the thyroid's hormone-producing cells to die. The condition usually causes a decrease in hormone production (hypothyroidism).
Although Hashimoto's disease can affect anyone, it is most frequent among middle-aged women. Thyroid hormone replacement is the major treatment.
Hashimoto's thyroiditis, chronic lymphocytic thyroiditis, and chronic autoimmune thyroiditis are all names for Hashimoto's disease.
WHAT ARE THE SYMPTOMS OF HASHIMOTO'S DISEASE?
Hashimoto's disease develops slowly over time. It is possible that you will not notice any indications or symptoms of the condition. Thyroid hormone production reduction can eventually lead to any of the following:
- Sluggishness and fatigue
- heightened cold sensitivity
- Increased drowsiness
- Thyroid swelling (goiter)
- Face puffiness
- Nails that are brittle
- Loss of hair
- Increased tongue size
- Dry skin
- Constipation
- Muscle fatigue
- Aches, soreness, and rigidity in the muscles
- Joint stiffness and discomfort
- Menstrual bleeding that is irregular or profuse
- Depression
- Memory or concentration issues
WHAT ARE THE CAUSES OF HASHIMOTO'S DISEASE?
Hashimoto's illness is a type of autoimmune disease. The immune system produces antibodies, which attack thyroid cells as if they were germs, viruses, or other foreign entities. The immune system incorrectly recruits disease-fighting molecules, causing cell damage and death.
It is unclear what causes the immune system to target thyroid cells. The following factors may contribute to the start of disease:
- Genetic factors
- Environmental factors, such as infection, stress, or radiation exposure
- The interactions of environmental and genetic factors
WHAT ARE THE RISK FACTORS OF HASHIMOTO'S DISEASE?
The following factors are linked to a higher incidence of Hashimoto's disease:
- Sex: Women are far more prone than men to have Hashimoto's disease.
- Age: Hashimoto's illness can strike at any age, but it is most frequent in middle life.
- Other autoimmune diseases: If you have another autoimmune condition, such as rheumatoid arthritis, type 1 diabetes, or lupus, you are more likely to acquire Hashimoto's disease.
- Family history and genetics: If you have a family history of thyroid issues or other autoimmune diseases, you are more likely to develop Hashimoto's disease.
- Pregnancy: Changes in immunological function that occur during pregnancy may play a role in Hashimoto's disease that develops after pregnancy.
- Excessive iodine consumption: Too much iodine in the diet may act as a trigger in persons who already have Hashimoto's disease.
- Exposure to radiation: People who are exposed to high levels of environmental radiation are more likely to develop Hashimoto's disease.
WHAT ARE THE COMPLICATIONS OF HASHIMOTO'S DISEASE?
Thyroid hormones are required for the proper functioning of numerous physiological systems. As a result, if Hashimoto's disease and hypothyroidism are not addressed, various issues might arise. These are some examples:
- Goiter: A goiter is a thyroid enlargement. As thyroid hormone production decreases owing to Hashimoto's disease, the pituitary gland sends signals to the thyroid to produce more. This cycle has the potential to develop in a goiter. Although it is normally not painful, a large goiter can impair your look and may impede with swallowing or breathing.
- Heart issues: Hypothyroidism can cause heart failure, an enlarged heart, and irregular heartbeats. It can also cause high levels of low-density lipoprotein (LDL) cholesterol, also known as "bad" cholesterol, which is a risk factor for cardiovascular disease and heart failure.
- Problems with mental health: Depression and other mental health concerns may appear early in Hashimoto's disease and worsen with time.
- Sexual and reproductive problems: Hypothyroidism in women can cause decreased sexual desire (libido), failure to ovulate, and irregular and heavy menstrual flow. Men with hypothyroidism may experience decreased libido, erectile dysfunction, and sperm count.
- Pregnancy complications: During pregnancy, hypothyroidism may raise the risk of miscarriage or premature birth. Babies born to mothers who have untreated hypothyroidism are at risk of developing autism, speech impairments, and other developmental abnormalities.
- Myxedema: Long-term, severe, untreated hypothyroidism can lead to the development of this rare, life-threatening illness. Drowsiness is followed by deep lethargy and unconsciousness as indications and symptoms. A myxedema coma can be caused by exposure to cold, sedatives, illness, or other physical stress. Myxedema necessitates rapid medical attention.
HOW IS HASHIMOTO'S DISEASE DIAGNOSED?
A variety of illnesses might cause the symptoms of Hashimoto's disease. If you have any of these symptoms, your doctor will perform a complete physical exam, check your medical history, and ask you questions about your symptoms.
Thyroid function testing
Your provider will request blood tests to evaluate if hypothyroidism is the source of your symptoms, which may include the following:
- TSH test: The pituitary gland produces thyroid stimulating hormone (TSH). When the pituitary gland recognizes low thyroid hormone levels in the blood, it delivers TSH to the thyroid to stimulate thyroid hormone production. TSH levels in the blood that are too high indicate hypothyroidism.
- T-4 tests: Thyroxine is the primary thyroid hormone (T-4). A low T-4 level in the blood validates the results of a TSH test and suggests that the problem is within the thyroid itself.
Antibody tests
Hypothyroidism can be caused by more than one disease condition. Your doctor will perform an antibody test to see if Hashimoto's disease is the cause of your hypothyroidism.
An antibody's intended function is to identify disease-causing foreign invaders that must be removed by other immune system actors. The immune system produces rogue antibodies that attack healthy cells or proteins in the body in an autoimmune illness.
Typically, in Hashimoto's disease, the immune system generates an antibody against thyroid peroxidase (TPO), a protein involved in thyroid hormone production. TPO antibodies are found in the blood of the majority of persons with Hashimoto's disease. Other antibodies related with Hashimoto's illness may necessitate lab testing.
WHAT ARE THE TREATMENTS FOR HASHIMOTO'S DISEASE?
The majority of persons with Hashimoto's disease take hypothyroidism medication. If you have moderate hypothyroidism, you may not need medication, but you should have regular TSH testing to monitor your thyroid hormone levels.
T-4 hormone replacement therapy
Levothyroxine, a synthetic hormone, is used to treat hypothyroidism caused by Hashimoto's disease (Levoxyl, Synthroid, others). The synthetic hormone functions similarly to the T-4 hormone generated naturally by the thyroid.
The therapy goal is to restore and maintain adequate T-4 hormone levels while also improving hypothyroidism symptoms. This treatment will be required for the rest of your life.
Dosage monitoring
Your doctor will prescribe a dose of levothyroxine based on your age, weight, current thyroid production, other medical conditions, and other considerations. Your TSH levels will be retested 6 to 10 weeks later, and the dosage will be adjusted as needed.
You will continue to take the drug once a day once the appropriate dosage has been found. Follow-up tests will be required once a year to monitor TSH levels or if your practitioner changes your dosage.
A levothyroxine pill is often taken before breakfast. If you have any doubts regarding when or how to take the pill, consult your doctor. Inquire about what to do if you forget to take a dose. Speak with your doctor if your health insurance compels you to switch to a generic or a different brand of medication.
Precautions
Because levothyroxine functions in the body like natural T-4, there are usually no side effects as long as the medication results in "natural" amounts of T-4 for your body.
Too much thyroid hormone can exacerbate bone loss, resulting in thin, brittle bones (osteoporosis), or induce irregular heartbeats (arrhythmias).
The effects of other substances
Certain drugs, supplements, and meals may impair the absorption of levothyroxine. Levothyroxine should be taken at least four hours before these substances. Discuss with your doctor any of the following:
- Products made from soy
- Foods high in fiber
- Iron supplements, including iron-containing multivitamins
- Cholestyramine (Prevalite), a cholesterol-lowering drug.
- Some antacids contain aluminum hydroxide.
- Sucralfate, which is an ulcer treatment.
- Calcium supplements
T-3 hormone replacement therapy
T-4 is naturally created and transformed into triiodothyronine, another thyroid hormone (T-3). T-4 replacement hormone is likewise transformed into T-3, hence T-4 replacement therapy usually results in an appropriate amount of T-3 for the body.
A doctor may also give a synthetic T-3 hormone (Cytomel) or a synthetic T-4 and T-3 combination for those who need improved symptom control. T-3 hormone replacement might cause fast heartbeat, sleeplessness, and anxiety. These treatments could be tested for three to six months.
ALTERNATIVE MEDICINES FOR HASHIMOTO'S DISEASE
In the United States, products containing T-3 and T-4 hormones originating from pigs or other animals, such as Armour Thyroid, are available as prescriptions or as dietary supplements. The following are some of the concerns concerning these products:
- The balance of T-4 and T-3 in animals differs from that in humans.
- The precise amount of T-4 and T-3 in each batch of a natural extract product can vary, resulting in unpredictability of these hormone levels in your blood.