What are the long-term consequences of untreated Hashimoto’s disease. How does Hashimoto’s affect overall health and mortality risk. Can Hashimoto’s disease lead to life-threatening complications if left unmanaged.

Understanding Hashimoto’s Disease: An Autoimmune Thyroid Condition

Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, is an autoimmune disorder that primarily affects the thyroid gland. In this condition, the immune system mistakenly attacks the thyroid, leading to inflammation and impaired function. While Hashimoto’s disease itself is not typically fatal, it can lead to serious complications if left untreated.

Key Facts About Hashimoto’s Disease

• Most common cause of hypothyroidism in the United States
• Affects approximately 5 in 100 Americans
• 4-10 times more prevalent in women than men
• Can occur at any age, but risk increases with age
• Has a genetic component, increasing risk in those with family history

Symptoms and Progression of Hashimoto’s Disease

Hashimoto’s disease typically progresses slowly over years, gradually impairing thyroid function. Many individuals may not notice symptoms in the early stages. As the condition advances, various symptoms may emerge.

Common Symptoms of Hashimoto’s Disease

• Goiter (enlarged thyroid gland)
• Fatigue and weakness
• Increased sensitivity to cold
• Modest weight gain
• Dry, coarse hair and skin
• Depression or mood changes
• Muscle aches and joint pain
• Irregular or heavy menstrual periods
• Slowed heart rate

Is goiter always present in Hashimoto’s disease? While goiter is a common symptom, not all patients with Hashimoto’s disease develop an enlarged thyroid. Some may experience thyroid atrophy instead.

Diagnosis and Treatment Options for Hashimoto’s Disease

Proper diagnosis and timely treatment are crucial for managing Hashimoto’s disease effectively and preventing potential complications.

Diagnostic Procedures

1. Physical examination and medical history review
2. Blood tests to measure thyroid hormone levels (T3, T4, TSH)
3. Antibody tests (TPO and antithyroglobulin antibodies)
4. Thyroid ultrasound (if necessary)

Treatment Approaches

While there is no cure for Hashimoto’s disease, hormone replacement therapy is the primary treatment method. Levothyroxine, a synthetic form of the thyroid hormone T4, is commonly prescribed to restore normal hormone levels and metabolic function.

How is the dosage of levothyroxine determined? The appropriate dose is based on factors such as age, weight, severity of hypothyroidism, overall health, and potential drug interactions. Regular monitoring and dose adjustments are often necessary to achieve optimal thyroid function.

Potential Complications of Untreated Hashimoto’s Disease

If left untreated, Hashimoto’s disease can lead to various health complications, some of which can be severe or life-threatening in rare cases.

Possible Complications

• Myxedema coma (severe hypothyroidism)
• Cardiovascular problems
• Infertility or pregnancy complications
• Mental health issues
• Increased risk of other autoimmune disorders

Can myxedema coma be fatal? Yes, myxedema coma is a rare but life-threatening complication of severe, untreated hypothyroidism. It requires immediate medical intervention and can be fatal if not properly managed.

The Link Between Hashimoto’s Disease and Other Autoimmune Conditions

Individuals with Hashimoto’s disease have an increased risk of developing other autoimmune disorders. Understanding these associations can help in early detection and management of potential comorbidities.

Associated Autoimmune Conditions

• Celiac disease
• Lupus
• Rheumatoid arthritis
• Sjögren’s syndrome
• Type 1 diabetes

Why are people with Hashimoto’s disease at higher risk for other autoimmune conditions? The exact mechanisms are not fully understood, but it’s believed that genetic predisposition and shared immune system dysregulation contribute to this increased risk.

Living with Hashimoto’s Disease: Long-Term Management and Prognosis

While Hashimoto’s disease is a chronic condition, proper management can lead to a good quality of life and normal life expectancy for most patients.

Key Aspects of Long-Term Management

1. Regular thyroid function monitoring
2. Medication adherence
3. Lifestyle modifications (diet, exercise, stress management)
4. Monitoring for associated conditions
5. Regular check-ups with healthcare providers

How often should thyroid function be monitored in Hashimoto’s patients? Initially, thyroid function tests may be performed every 6-8 weeks until stable hormone levels are achieved. Thereafter, annual testing is typically recommended, unless symptoms suggest the need for more frequent monitoring.

Emerging Research and Future Directions in Hashimoto’s Disease Treatment

While current treatments focus on hormone replacement, ongoing research aims to develop more targeted therapies and potentially find ways to prevent or reverse the autoimmune process.

Areas of Active Research

• Immunomodulatory therapies
• Gut microbiome interventions
• Personalized medicine approaches
• Stem cell therapies
• Novel drug delivery systems

Could future treatments potentially cure Hashimoto’s disease? While a cure is not currently available, ongoing research into the underlying mechanisms of autoimmune thyroid disease may lead to more effective treatments or even preventive strategies in the future.

Hashimoto’s Disease in Special Populations: Pregnancy and Pediatrics

Hashimoto’s disease can present unique challenges in certain populations, particularly during pregnancy and in pediatric patients.

Hashimoto’s Disease and Pregnancy

Proper management of Hashimoto’s disease is crucial during pregnancy to ensure the health of both mother and fetus. Untreated hypothyroidism can lead to complications such as preeclampsia, anemia, miscarriage, or impaired fetal development.

How does pregnancy affect thyroid hormone requirements? Thyroid hormone requirements typically increase during pregnancy, often necessitating adjustments to levothyroxine dosage. Close monitoring and collaboration between endocrinologists and obstetricians are essential.

Pediatric Hashimoto’s Disease

While less common in children, Hashimoto’s disease can occur in pediatric populations. Early detection and treatment are crucial to prevent impacts on growth and development.

• Symptoms may differ from adults
• Can affect physical and cognitive development
• May require careful medication adjustment as the child grows

How does Hashimoto’s disease affect a child’s growth? Untreated hypothyroidism in children can lead to stunted growth, delayed puberty, and impaired cognitive development. Proper management can help ensure normal growth and development.

Lifestyle Considerations for Hashimoto’s Disease Management

While medication is the cornerstone of Hashimoto’s disease treatment, lifestyle factors can play a significant role in managing symptoms and overall well-being.

Dietary Considerations

While no specific diet has been proven to treat Hashimoto’s disease, certain dietary approaches may help manage symptoms and support overall health:

• Balanced nutrition with adequate iodine intake
• Gluten-free diet (for those with celiac disease or gluten sensitivity)
• Anti-inflammatory foods
• Adequate selenium and zinc intake

Can dietary changes cure Hashimoto’s disease? While dietary modifications cannot cure Hashimoto’s disease, they may help manage symptoms, support thyroid function, and improve overall well-being in some individuals.

Exercise and Stress Management

Regular physical activity and stress reduction techniques can be beneficial for individuals with Hashimoto’s disease:

• Moderate exercise to support metabolism and mood
• Yoga or tai chi for stress reduction and flexibility
• Mindfulness meditation to manage stress and improve well-being
• Adequate sleep for hormone balance and overall health

How does stress affect Hashimoto’s disease? Chronic stress can exacerbate autoimmune conditions and may trigger flare-ups. Stress management techniques can help reduce inflammation and support overall immune function.

The Importance of Patient Education and Support in Hashimoto’s Disease

Empowering patients with knowledge about their condition and providing adequate support are crucial aspects of effective Hashimoto’s disease management.

Key Components of Patient Education

1. Understanding the nature of autoimmune thyroid disease
2. Recognizing symptoms and potential complications
3. Proper medication administration and adherence
4. Importance of regular follow-ups and monitoring
5. Lifestyle modifications and self-care strategies

How can patient support groups benefit individuals with Hashimoto’s disease? Support groups can provide emotional support, practical advice, and a sense of community for those living with Hashimoto’s disease. They can also be valuable sources of information and coping strategies.

The Role of Healthcare Providers

Healthcare providers play a crucial role in the management of Hashimoto’s disease:

• Providing accurate diagnosis and appropriate treatment
• Offering ongoing monitoring and medication adjustments
• Addressing patient concerns and questions
• Coordinating care with other specialists as needed
• Providing guidance on lifestyle modifications and self-care

What should patients discuss with their healthcare providers during follow-up visits? Patients should discuss any new or persistent symptoms, medication side effects, lifestyle changes, and any concerns or questions about their condition or treatment plan.

Navigating Insurance and Healthcare Costs for Hashimoto’s Disease

Managing a chronic condition like Hashimoto’s disease can involve significant healthcare costs. Understanding insurance coverage and available resources is important for long-term management.

Insurance Considerations

• Coverage for thyroid function tests and medications
• Specialist visit coverage
• Potential need for prior authorizations
• Out-of-pocket costs and deductibles

Are there assistance programs available for thyroid medications? Some pharmaceutical companies offer patient assistance programs for individuals who cannot afford their thyroid medications. Additionally, generic versions of many thyroid medications are available at lower costs.

Cost-Saving Strategies

1. Comparing pharmacy prices for medications
2. Exploring generic medication options
3. Utilizing flexible spending accounts or health savings accounts
4. Investigating patient assistance programs
5. Discussing cost concerns with healthcare providers

How can patients minimize healthcare costs while ensuring proper management of Hashimoto’s disease? Open communication with healthcare providers about cost concerns, adherence to treatment plans to prevent complications, and exploring all available insurance and assistance options can help manage long-term healthcare costs.

The Future Landscape of Hashimoto’s Disease Research and Treatment

As our understanding of autoimmune thyroid disorders continues to evolve, the future holds promise for improved diagnostic tools, more targeted treatments, and potentially even preventive strategies for Hashimoto’s disease.

Emerging Areas of Research

• Genetic profiling for personalized treatment approaches
• Novel immunomodulatory therapies
• Biomarkers for early detection and disease monitoring
• Gut microbiome interventions
• Regenerative medicine approaches for thyroid repair

Could gene therapy play a role in future Hashimoto’s disease treatment? While still in early stages, gene therapy research shows potential for addressing the underlying genetic factors contributing to autoimmune thyroid disorders. However, significant research is needed before such approaches could become clinically available.

Potential Future Developments

1. More precise and individualized medication dosing
2. Improved long-acting thyroid hormone formulations
3. Advanced imaging techniques for early detection of thyroid changes
4. Artificial intelligence-assisted diagnosis and treatment planning
5. Integrative approaches combining conventional and complementary therapies

How might artificial intelligence impact Hashimoto’s disease management in the future? AI could potentially assist in analyzing complex patient data, predicting disease progression, and optimizing treatment plans, leading to more personalized and effective management strategies.

In conclusion, while Hashimoto’s disease is a chronic condition that requires ongoing management, it is rarely life-threatening when properly treated. With appropriate medical care, lifestyle modifications, and patient education, individuals with Hashimoto’s disease can lead healthy, productive lives. As research continues to advance our understanding of this complex autoimmune disorder, we can look forward to increasingly effective and personalized treatment approaches in the future.

Can You Die From Hashimoto’s Disease?

Content

• Overview
• Symptoms of Hashimoto’s disease
• Diagnosis and treatment options for Hashimoto’s disease
• What happens if Hashimoto’s disease isn’t treated?
• The lowdown

Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, is an autoimmune condition that affects the thyroid gland and can cause underactive thyroid or hypothyroidism. In rare cases, it can also lead to hyperthyroidism or overactive thyroid. 

Under Hashimoto’s disease, the immune system makes antibodies that attack the butterfly-shaped thyroid gland found at the bottom of the neck. 

With Hashimoto’s, vast amounts of white blood cells that form part of the immune system build up within the thyroid, affecting thyroid hormone production. Thyroid hormones regulate the metabolic activity, meaning they affect almost every organ in the body.  

The exact number¹ of people with Hashimoto’s disease is not known. However, it is the most common cause of hypothyroidism, affecting about 5 in 100 Americans.

Hashimoto’s is four to ten times more prevalent among women than men, and it might also appear in young women or teens, increasing in prevalence with age. 

Hashimoto’s disease has hereditary risks, which means you are more likely to develop the condition if a family member has genes associated with the disease. 

Additionally, an individual is more likely to have Hashimoto’s disease if they have other autoimmune disorders, such as 

• Celiac disease: which is a digestive disorder that damages the small intestine

• Lupus: a long-term, chronic disorder that can affect the whole body

• Rheumatoid arthritis: a condition that affects the joints

• Sjogren’s syndrome: usually associated with dry mouth and eyes

• Type 1 diabetes: a condition marked by high blood sugar levels

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We make it easy for you to participate in a clinical trial for Hashimoto’s disease, and get access to the latest treatments not yet widely available – and be a part of finding a cure.

Check your eligibility

Hashimoto’s disease usually progresses slowly for years with gradual loss of thyroid function until you notice symptoms of the disease. Most people miss the signs and symptoms during the initial stages of the disease. 

As thyroid hormone production declines, the first sign you might experience is goiter, an enlarged thyroid. Goiter is characterized by a swollen area in front of the neck, making it a challenge to swallow. 

Other symptoms of Hashimoto’s disease are similar to other medical conditions, so it is critical to see a physician for a diagnosis. 

Here are some of the signs and symptoms associated with the disease:

• Metabolic: Less ability to tolerate cold, modest weight gain (due to fluid retention and decreased metabolism), hypothermia

• Neurologic: Forgetfulness, tingling, or prickling in the hands and feet

• Psychiatric: Personality changes, depression, dull facial expression, dementia or frank psychosis (myxedema madness)

• Dermatologic: Facial puffiness, myxedema (swelling of skin or tissues), sparse, coarse, and dry hair, rough, dry, scaly, and thick skin, yellowish skin hue (particularly notable on the palms and soles of feet)

• Ocular: Swollen or puffy area around the eyes, droopy eyelids

• Gynecologic: Changes in menstruation

• Cardiovascular: Slow heart rate, enlarged heart shown on examination and imaging

Unfortunately, there is no known cure for Hashimoto’s thyroiditis, but replacing hormones with medication can help manage the hormone levels and restore normal metabolism.  

Levothyroxine (Synthroid®, Levothyroid®, Levoxyl®), or T4, is the most common medication used to treat this condition.

The recommended prescription dose depends on age, weight, the severity of hypothyroidism, underlying health condition, or other medications that could interact with synthetic thyroid hormones. 

Before treatment, the physician will ensure the proper diagnosis of Hashimoto’s disease based on:

Physical exam and medical history

The physician will check the individual’s medical record and perform physical exams. Apart from exams and history, the doctor will also check your neck for goiter, a common disease symptom.

Blood tests

The doctor could also request blood tests to confirm hypothyroidism and its possible cause. Some of the tests include measuring levels of the thyroid hormones T4 (thyroxine) and T3 (triiodothyronine), thyroid-stimulating hormone (TSH), antithyroglobulin antibodies (AB), and thyroid peroxidase antibodies (TPO), a type of thyroid antibody that is present in most individuals with the disease.

Most diagnoses only need two tests (T4 and TSH/TPO) and a physical exam to confirm Hashimoto’s disease. Still, if a physician suspects you have the condition but cannot spot any antithyroid antibodies in your blood, they might request an ultrasound of your thyroid. 

The ultrasound images show the size of the thyroid and other features of Hashimoto’s disease. It is also great at ruling out other causes of an enlarged thyroid, such as small lumps in the thyroid gland (thyroid nodules).   

After diagnosis, the physician will prescribe treatment depending on whether the thyroid is damaged and causing hypothyroidism. If not currently hypothyroid, the doctor will typically check your thyroid hormone levels and symptoms regularly. 

The most commonly prescribed medication for managing Hashimoto’s disease is levothyroxine which is similar to the thyroid hormone thyroxine.    

The physician will conduct a blood test about six to eight weeks after you start taking levothyroxine and adjust the dose as needed.  

Note that you have to have a blood test every time you change the dosage. Once a perfect balanced dose is reached, the rate of blood tests slows down. 

Before stopping or increasing your dose, consult with your doctor to avoid complications. 

The issue with Hashimoto’s disease is that it has no obvious symptoms in the initial stages. Therefore, regular diagnostic testing is recommended, especially if your physician suspects you might have the condition or there is a family history of Hashimoto’s.

Over time, if Hashimoto’s disease goes untreated, it can cause several additional health problems. 

Complications

Subclinical hypothyroidism/thyroid antibodies² are linked to increased risks during pregnancy, particularly high blood pressure, miscarriage, and congenital disabilities. 

Here are more potentially severe conditions resulting from untreated Hashimoto’s disease:

• Heart disease: The condition could either lead to high blood pressure or congestive heart failure

• Kidney disease: People with hypothyroidism have a high increase in kidney dysfunction  

• Peripheral neuropathy: Untreated Hashimoto’s disease could damage your peripheral nerves because of excess pressure

• Myxedema coma: This life-threatening condition can occur when the levels of thyroid hormones get too low and symptoms get worse

• Hashimoto encephalopathy: A rare disease that involves impaired brain function

So, can you die from Hashimoto’s disease? It is possible but a rare outcome. However, Hashimoto’s is a risk factor for some severe conditions that are among the leading causes of death in America. 

Women are more likely to suffer from Hashimoto’s disease, mainly due to hormones. It’s important to seek medical attention if you develop any symptoms such as goiter or if there is a strong family history of Hashimoto’s disease.

Death by unnatural causes, mainly suicide, is increased in patients with Hashimoto’s thyroiditis. A nationwide Danish register study

. 2019 Sep;65(3):616-622.

doi: 10.1007/s12020-019-01946-5.

Epub 2019 May 7.

Thomas Heiberg Brix 
¹
, Charlotte Ferløv-Schwensen 
¹
, Marianne Thvilum 
²
, Laszlo Hegedüs 
¹

Affiliations

Affiliations

• ¹ Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, DK-5000, Odense, Denmark.
• ² Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, DK-5000, Odense, Denmark. [email protected].

• PMID:

  31065912

• DOI:

  10.1007/s12020-019-01946-5

Thomas Heiberg Brix et al.

Endocrine.

2019 Sep.

. 2019 Sep;65(3):616-622.

doi: 10.1007/s12020-019-01946-5.

Epub 2019 May 7.

Authors

Thomas Heiberg Brix 
¹
, Charlotte Ferløv-Schwensen 
¹
, Marianne Thvilum 
²
, Laszlo Hegedüs 
¹

Affiliations

• ¹ Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, DK-5000, Odense, Denmark.
• ² Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, DK-5000, Odense, Denmark. [email protected].

• PMID:

  31065912

• DOI:

  10.1007/s12020-019-01946-5

Abstract

Purpose:

Hashimoto’s thyroiditis (HT) is associated with excess psychiatric in addition to reduced quality of life. However, little is known about risk of unnatural manners of death in HT. We investigated the risk of death by accidents, suicide, violence/homicide, and unknown causes in patients with HT, compared to a matched control population.

Methods:

Register study covering all adult Danes diagnosed with HT during 1995-2012. In total, 111,565 HT cases were identified and matched for age and sex with four euthyroid controls. The hazard ratios (HR) for mortality were calculated using Cox regression analyses, adjusted for pre-existing morbidity. Median follow-up time was 5.9 years (range 0-17.5).

Results:

Compared to controls, HT patients had an increased frequency of death by suicide (0.10% vs 0.07%, p < 0.001) and unknown manners (0.05% vs 0.02%, p < 0.001). There were no significant differences between controls and HT patients in risk of death by accidents (0.36% vs 0.37%, p = 0.384) or violence (0.004% vs 0.005%, p = 0.749). After adjustment for pre-existing somatic and psychiatric morbidity HT patients still had an increased risk of suicide and death by unknown causes, whereas risk of death caused by accidents was reduced.

Conclusions:

Mortality due to suicide and unknown causes, but not accidents and violence, was increased in HT. This indicates that HT may have a significant role in the pathophysiological mechanisms of suicidal behavior. This suggests that physicians caring for HT patients should be vigilant when facing expressions of suicidal ideation or signs and symptoms of self-harm as a first step towards prevention.

Keywords:

Hashimoto’s thyroiditis; Hypothyroidism; Mortality; Population-based; Suicide; Unnatural death.

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References

1. 1. Brain Behav Immun. 2014 Oct;41:261-6

      –

      PubMed

2. 1. Stroke. 2008 Jul;39(7):1938-44

      –

      PubMed

3. 1. Nature. 2008 Oct 16;455(7215):894-902

      –

      PubMed

4. 1. Eur J Endocrinol. 2006 Jan;154(1):21-8

      –

      PubMed

5. 1. Thyroid. 2017 Dec;27(12):1475-1480

      –

      PubMed

MeSH terms

Autoimmune thyroiditis of the thyroid gland

Many are sure that the cause of fatigue and chronic fatigue syndrome is in “malfunctions” with the thyroid gland. Namely – in chronic inflammation of the tissues of the thyroid gland (autoimmune thyroiditis). But is it?

Doctor’s consultation

You can get the consultation of the necessary specialist online in the Doctis application

Laboratory

You can undergo a comprehensive examination of all major body systems

• Signs of autoimmune thyroiditis?
• Autoimmune thyroiditis – as a cause of chronic fatigue
• Diagnosis of autoimmune thyroiditis
• Causes of autoimmune thyroiditis
• Treatment of autoimmune thyroiditis

Autoimmune thyroiditis accounts for 20-30% of all thyroid diseases. Occurs in women
10-20 times more often than in men. What you need to know about this disease – signs
autoimmune thyroiditis and possible consequences?

Symptoms of autoimmune thyroiditis

What are the signs of autoimmune thyroiditis? Is it true that at the first stage the disease proceeds
no symptoms?

In fact, autoimmune thyroiditis is not one, but several diseases that are united by
inflammation in the thyroid gland. The classic variant is chronic autoimmune thyroiditis, or thyroiditis.
Hashimoto. It can lead to a persistent decrease in thyroid function – hypothyroidism.
I emphasize – maybe. But not always.

Autoimmune thyroiditis itself does not have any clinical
signs. Manifestations can only be in violation of the function of the thyroid gland. And then not immediately. Usually,
chronic thyroiditis leads to hypothyroidism years later, often even decades later.

Diagnosis of chronic fatigue syndrome

It is believed that autoimmune thyroiditis is the cause of rapid fatigue, weakness, syndrome
chronic fatigue.

Is it so?

Since autoimmune thyroiditis does not manifest itself in any way with intact thyroid function, let’s immediately
talk about its possible consequence – hypothyroidism. Hypothyroidism can indeed be accompanied
asthenia-like symptoms. Symptoms such as menstrual irregularities, constipation,
anemia, increased
cholesterol levels. However, similar manifestations occur in many diseases. That’s the problem
diagnosis of hypothyroidism, since even at advanced stages it does not have
specific signs.

Fatigue, weakness and drowsiness in some cases may be
associated with decreased thyroid function. But they can be a trail of other chronic diseases. And what
As for chronic fatigue syndrome, this is a beautiful, but not quite definite concept.

What tests to take to confirm (or rule out) autoimmune thyroiditis?

Search for autoimmune thyroiditis, in most cases, does not make much sense. A person can live a lifetime with
signs of autoimmune thyroiditis and die from another disease. But hypothyroidism is really
should not be ignored, since thyroid hormones (thyroxine and triiodothyronine) regulate
supply of oxygen to cells. With a deficiency of thyroid hormones, all cells without exception function.
in power saving mode. They seem to run out of batteries. They cannot adequately exercise their
functions.

Accurate and simple test for diagnosing hypothyroidism – TSH (thyroid stimulating hormone) level determination
in blood. With a decrease in thyroid function, it rises.

Why does autoimmune thyroiditis develop? I read that there are many provoking factors. For example,
pregnancy, lack of iodine in food.

A question for the Nobel Prize – no less! We do not know exactly the root causes of autoimmune diseases.
Even when it comes to the most common autoimmune disease – autoimmune thyroiditis. For some reason
cause, in predisposed persons, the normal functioning of the immune system is disrupted, and it attacks its own
cells. In this case, thyroid cells. Any autoimmune disease in general
significantly more common in women than in men. Sometimes – 10-20 times.

Pregnancy can indeed be a provoking factor. And more precisely –
period. The fact is that during pregnancy, the activity of the immune system is suppressed (this is necessary,
to carry an immunologically foreign fetus), and after childbirth is activated. Sometimes – excessively, causing autoimmune
processes.

Dietary iodine deficiency does not lead to autoimmune thyroiditis. And in general, you shouldn’t
associate thyroid disease only with iodine deficiency. Dozens of diseases have been described
thyroid gland – completely different in causes, course and prognosis – and only
some of them are directly or indirectly related to iodine deficiency.

Treatment of autoimmune thyroiditis

Is it true that hypothyroidism is the only indication for treatment
autoimmune thyroiditis, and in other cases, treatment is not required?

When it comes to chronic
autoimmune thyroiditis – absolutely right. Specifically affect the autoimmune process
modern medicine, alas, does not yet know how. Moreover, autoimmune thyroiditis, as already noted, is far from always
has an adverse effect on the body. Its only significant consequence is a decrease in function
thyroid gland.

And hypothyroidism is fairly easy to control. Replacement therapy for hypothyroidism involves taking daily
levothyroxine tablets. The dose is selected and
supervised by an endocrinologist
when determining the level of TSH. Any restrictions compensated patients with hypothyroidism,
usually do not experience.

The author of the article: Valentin Viktorovich Fadeev

Doctor’s consultation

You can get the consultation of the necessary specialist online

Laboratory

You can undergo a comprehensive examination of all major body systems

Autoimmune thyroiditis – causes, symptoms and diagnosis, indications for visiting a doctor

A typical representative of a large group of autoimmune diseases is autoimmune thyroiditis. This is an inflammation of the thyroid gland that occurs from the destruction of its cells by the immune system. It proceeds for a long time, often becomes chronic, therefore it is also found under the wording Hashimoto’s thyroiditis (Hashimoto) in honor of the scientist who, at 19In 12, he studied and described the disease, and as “chronic thyroiditis” (although there is another form of chronic inflammation – Riedel’s thyroiditis). This is the most common type of inflammation in the thyroid gland, among the four main forms of pathologies. Let’s take a closer look at what causes inflammation, how to diagnose, treat, and avoid it.

What is Hashimoto’s thyroiditis

This is inflammation that results from damage or destruction of thyroid follicles by cells of the immune system (T-lymphocytes). At the same time, infiltrates appear in the gland, and the activity of the gland and the amount of thyroid hormones in the body decrease. Hypothyroidism develops slowly.

The disease is diagnosed in 3% of all thyroid pathologies. Most of the patients are women. In them, this diagnosis occurs 10-20 times more often than in men. There is also a dependence on age – Hashimoto’s thyroiditis rarely occurs in people under thirty years of age. Most patients are middle-aged women (30-50 years).

Symptoms of autoimmune thyroiditis of the thyroid gland

The clinical picture largely depends on the form of the disease. In autoimmune thyroiditis, there are:

• Atrophic course – the gland retains its former dimensions, but as the cells die, the glandular tissue is replaced by fibrous tissue.
• Hypertrophic – a dense goiter is formed.

This is a slowly progressive inflammation, which is rarely characterized by exacerbations and signs of damage to the body as a whole (fever, increased ESR).

A typical picture at the beginning of the inflammatory process is implicit. Usually there are no symptoms.

Approximately 10% of women and 5% of men are carriers of antibodies to TPO or TG, while thyroid dysfunction may develop in 3-6%. Later, the production of TSH increases, the diagnosis is made according to the results of the tests. A sign of the next stage is hypothyroidism – the growth of the gland and a significant decrease in the hormones T3 and T4. As a result of the inflammatory process in the thyroid gland, it is destroyed and it stops producing hormones.

In an acute form of inflammation or as the disease develops, symptoms of destructive thyroiditis appear – palpitations, trembling in the hands, sweating.
This process usually takes 3 to 6 months. Subsequently, it turns into hypofunction of the thyroid gland, which is characterized by:

• The induration on the neck is rather hard in structure, but painless on palpation and pressure (only 10% of patients complain of pain on palpation). Over time, iron, on the contrary, significantly decreases in volume.
• As the gland grows, the neighboring structures of the neck are compressed, there is a feeling of a foreign body in the throat, lack of air, hoarseness of the voice.
• Pain in the joints, rarely in the muscles.
• General weakness.
• Weight gain.
• Constipation or indigestion.
• Loss of hair, including on the eyebrows.
• Dryness, unhealthy pallor of the skin, brittle nails.
• Mental disorders of depressive type.
• Frequent feeling of cold, chilliness.
• Deterioration of memory and attention.
• Edema of the face.
• Bradycardia.
• Decreased sex drive.

Many of the symptoms are associated not so much with inflammation, but with already developing hypothyroidism.

The characteristic symptoms of autoimmune thyroiditis in women are: irregular menstruation, prolonged absence of pregnancy with regular sexual activity, spontaneous miscarriages.

Causes of autoimmune thyroiditis

The disease occurs due to a malfunction in the immune system, which leads to the fact that gland cells are mistakenly perceived as foreign organisms. Why such a failure occurs is not exactly established. But there are a number of factors that can be considered risk factors and causes of autoimmune thyroiditis of the thyroid gland:

• Hereditary predisposition at the gene level – dependence is confirmed by the fact that often the disease is familial and occurs in representatives of several generations. In such patients, often thyroiditis is complemented by such diseases as: vitiligo, rheumatism and others.
• Infections of the nasopharynx, tonsils and oral cavity: laryngitis, pharyngitis and others, as well as untreated caries. The most dangerous are chronic diseases or acute forms of infection with complications in neighboring organs.
• Severe or chronic stressful situations.
• Polluted ecology (for example, excess chlorine in water, air).
• An excess of iodine in the body for a long time.
• Radiation exposure or a course of radiation therapy in the treatment of oncology.
• Thyroid tumors of a benign nature (eg endemic goiter).
• UV exposure, frequent and long exposure to the sun without protection during the hours when it is most active.
• Uncontrolled or on the recommendation of a doctor (if necessary) intake of immunomodulators (for example, Interferon).
• Long-term treatment with certain medications.
• Blood diseases.

Complications

The main complications of thyroiditis include hypothyroidism and thyrotoxicosis.

Thyroid dysfunction may adversely affect:

• Nervous, digestive, respiratory and cardiovascular systems.
• Kidneys.
• Skin and its appendages – nails and hair.
• Musculoskeletal system.
• Organs of the reproductive system.
• Disorders of growth and mental development.
• Metabolism.

Diagnosis

If you suspect thyroiditis or other pathologies of the thyroid gland, you should contact an endocrinologist. It is this doctor who prescribes examinations, finds out the possible causes of thyroid dysfunction and decides how to treat the patient. At the appointment, the doctor will examine the patient and assess the condition of his skin, enlargement and soreness of the thyroid gland, learn about complaints, family history, concomitant diseases. Depending on the clinical picture, certain examinations may be prescribed.

Help with diagnosis:

• Blood test – general, for TSH, T3, T4 hormones and antibodies to them.
• Ultrasound is an affordable, quick and informative examination to assess the condition of the gland, its size, uniformity of structure, the presence of nodes, seals, fibrous areas and other pathologies.
• Scintigraphy will help distinguish thyroiditis with thyrotoxicosis from other diseases with similar signs. It is based on the property of the affected gland not to accumulate a contrast agent in large quantities.

After clarification of the diagnosis by the endocrinologist, the method of therapy is selected.

Treatment

In the early stages, when there are no disorders in the thyroid gland, no specific treatment is required. The doctor will recommend leading a healthy lifestyle, normalizing nutrition, giving up bad habits and monitoring your well-being. Regular annual consultations and examinations are necessary in order not to miss the further development of the disease.

If the function of the gland is already impaired, then in most cases hormone replacement therapy is prescribed.

Against the background of maintenance therapy, it is recommended to undergo periodic examinations to monitor the dynamics of changes and, if necessary, change the dosage of the drug.

It is not recommended to self-medicate, use folk remedies, take vitamins on your own or increase the dose of iodine in the diet.