Hashimoto’s

What is Hashimoto's Thyroiditis?

This is the most commonly suffered thyroid complication in the US, and is named after the doctor who first discovered it, Dr Hakaru Hashimoto, and was the first disease to be recognized as autoimmune.

An inflammation of the thyroid gland is often the cause, and the gland is attacked by the body as if it were a foreign tissue.

It tends to occur in families, and can be associated with other autoimmune diseases such as type 1 diabetes and celiac disease. It is also more likely by up to 10 times, to occur in women as opposed to men, and will more often start in adulthood.

Symptoms of hashimoto thyroiditis

The symptoms are very similar as to what would be expected in a case of hypothyroidism in general. However these can often be attributed to other causes of even aging in general.

Common symptoms are fatigue, depression, weight gain, cold intolerance, excessive sleepiness, dry, coarse hair, constipation, dry skin, muscle cramps, high cholesterol, decreased concentration, vague aches and pains, swelling in the legs.

The thyroid gland will also become enlarged. The disease can be detected clinically by looking for certain antibodies in the blood.

Treatment of Hashimoto thyroiditis

There is no cure for hashimoto thyroiditis, and there is also no way to know how long the autoimmune process and inflammation will continue. The usual thyroid hormone medication can replace the hormones that are not being produced due to the inflammation.

Replacing either T3 or T4 can alleviate any symptoms.

Surgery may also be needed should complications arise such as a malignant nodule, or lymphoma.

Conditions linked with hashimoto thyroiditis

There are several other autoimmune diseases that have been associated with hashimoto thyroiditis such as addison’s disease, diabetes mellitus, hyogonadism, pernicious anaemia, alopecia areata, chronic active hepatitis, giant cell arteritis, primary billary cirrhosis, rheumatoid arthritis, vitiligo and others.

There has also been a controversial link with thyroid cancer, with reports saying those suffering from hashimoto thyroiditis may be three times more likely to have thyroid cancer.

Conclusion

Hyperthyroidism can be caused by hashimoto thyroiditis but the main difference is that hyperthyroidism is seen as a condition and hashimoto thyroiditis is considered a disease.

By treating the lack of T3 or T4 which is caused by the body attacking the thyroid gland, many of the symptoms should be resolved in the case of hashimoto thyroiditis. Surgery may sometimes be needed in the case of large goitre which are obstructing other bodily functions, a malignant nodule may be present, or a lymphoma may be diagnosed.

Complications may arise from over replacement of thyroxine which can cause bone loss or increased heart rate. Should a myxoedema coma occur and the correct treatment cannot be introduced there is a high mortality rate of up to 60%. Early diagnosis and replacement therapy should give an excellent prognosis.

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