Hashimoto’s thyroiditis is the most common form of thyroiditis (a chronic inflammation of the thyroid gland) and one of the most difficult forms to diagnose. It is named after Hakaru Hashimoto, the doctor who discovered it, and is also known as chronic lymphocytic thyroiditis.
The disease can manifest in several ways as it develops, and differently in each patient. Those affected may suffer varying levels of symptoms for many years, and mistakenly be labelled as having chronic fatigue syndrome, ME, pharyngitis, depression, anxiety disorder or even hypochondria before a correct diagnosis is finally made. Many of the symptoms, such as fatigue, constipation and dry skin are non-specific, making diagnosis especially difficult.
Who is Likely to Have Hashimoto’s?
The disease is thought to run in families, and occurs around ten times more often in women than men. Women aged 30–50 are most at risk from the disease, while men tend to develop it around 10–15 years later (the prevalence of all forms of thyroiditis and hypothyroidism increases with age). Hashimoto’s is the most frequent cause of hypothyroidism in children over the age of 6 years. The cause of the disease remains unknown.
What is the Thyroid?
The thyroid gland is a butterfly-shaped gland that sits near the base of the neck. It is part of the endocrine system, which produces hormones within the body – the chemical “messengers” that tell other glands, organs or tissues what to do. The thyroid gland works together with the hypothalamus and the pituitary gland to control metabolism, or energy; its hormones act to regulate the energy release within every cell of our body, and within the body as a whole.
If the thyroid becomes overactive (hyperthyroidism), the body becomes overactive: symptoms include rapid heartbeat, restlessness, trembling hands, sweating, panic attacks and weight loss.
If the thyroid becomes underactive (hypothyroidism), the opposite occurs: the body slows down, and the sufferer feels cold, depressed, lethargic, and less able to remember things. Weight gain is common.
What Happens in Hashimoto’s Disease?
When the body is under attack by foreign “invaders” (bacteria or viruses), our immune system produces antibodies to fight them off. For unknown reasons, this process can begin to go wrong in some people, causing the body to produce antibodies when there is no foreign invader – and putting part of the body itself under attack.
In Hashimoto’s, the body produces specific antibodies that attack the thyroid gland. The thyroid enlarges, due to inflammation caused by the antibody attack, and the damaged cells cease to produce thyroid hormone. This leads at first to mild hypothyroidism, and if left untreated, eventually leads to destruction of the thyroid gland, and full-blown hypothyroidism.
What are the Symptoms of Hashimoto's?
Some patients experience a period of hyperthyroidism (known as hashitoxicosis) for a short period, as thyroid hormone can be rapidly released into the bloodstream while the thyroid is under attack. The thyroid may then function normally before a short period, allowing the patient to experience a brief and blissful period of normal energy levels before mild hypothyroidism sets in.
Most people are only aware of the disease once they have become mildly hypothyroid, and this may in fact be the first presentation of the disease. If left untreated, the hypothyroidism will gradually worsen.
The initial, mild hypothyroidism tends to cause feelings of tiredness and slight depression, and may lead to weight gain. As the condition worsens – usually over a period of several years – sufferers feel a general “slowing down” of the body and mind: the brain slows down, leading to depression and a loss of concentration and memory; the bowel slows down, leading to constipation; and the body slows down, leading to extreme fatigue and weight gain.
Headaches, a constant feeling of coldness, dry skin, and hair loss are also common symptoms. Many people develop a “goitre” or lump in their neck (within the thyroid), and may also develop nodules within the gland. Some people develop a hoarse voice, and experience a sense of pressure in the neck. Menstrual irregularities are common.
Can I Be Tested for Hashimoto’s?
Doctors can diagnose Hashimoto’s through blood tests. A general, routine thyroid function test will confirm the levels of thyroid hormones (T4, T3 and TSH – Thyroid Stimulating Hormone). However, it is possible to have normal thyroid hormone levels (known as being “clinically euthyroid”) while suffering from Hashimoto’s.
The disease is usually pinpointed through blood tests to measure the antithyroid antibodies: antithyroid peroxidase (anti-TPO), and antithyroglobulin (anti-Tg). These antibodies are not normally present in the blood, but can extend into the thousands in people with Hashimoto’s, so they are good indicators of the disease. Very rarely, sufferers may be antibody negative.
Imaging (such as ultrasound and CT scans) is not necessary for diagnosis, but may be used to establish the size or spread of the gland or any goitre.
Can I be Treated for Hashimoto’s?
If thyroid hormone levels (T3 and T4) are normal, no treatment is considered necessary. Where a goitre is present, thyroid hormone levels are low, or there are signs of mild thyroid failure (raised TSH levels), thyroid hormone replacement treatment is given. This is usually in the form of thyroxine tablets, which can provide fast relief, and dramatically slow down progression of the disease. In most cases treatment is lifelong, but effective. However, many people experience problems in taking this medicine, and adjusting dosage and drug type can be an exhaustive process.
Associated Conditions
It is said that only 8% of people with Hashimoto's disease only have Hashimoto's. As an autoimmune condition, it is associated with many other forms of autoimmune disease, including Sjogren syndrome, rheumatoid arthritis, SLE, type 1 diabetes (T1D), celiac disease, rheumatoid arthritis, multiple sclerosis (MS), vitiligo, ataxia (memory loss), encephalopathy (stroke-like episodes, myoclonus, and cognitive impairment), and it confers an increased risk of lymphoma.
Find out more about this complicated condition.
Read more:
Minerals and Supplements for Hashimoto’s Disease
 |
