Hashimoto’s disease

Hashimoto’s disease or Hashimoto’s thyroiditis is a disease that affects the thyroid gland. The disease is also known as chronic autoimmune thyroiditis and chronic lymphocytic thyroiditis.

The name Hashimoto comes from a pathologist who first described the characteristics of the disease under a microscope. The disease is the most common cause of hypothyroidism in iodine-sufficient areas such as the United States.

The progression of the disease is characterized by a gradual loss of thyroid function, often accompanied by swelling of the gland – a condition more popularly known as a goiter.

Hashimoto’s thyroiditis most often affects middle-aged women, and in most cases there is a hereditary predisposition.

In short, the function of the thyroid gland is the synthesis of hormones that control and participate in a number of metabolic functions such as body temperature, regulation of heart rate and metabolism.

What are the symptoms?

The signs and symptoms of the disease are the same as hypothyroidism. The disease progresses slowly and it may take several years for true hypothyroidism to develop.

What are the causes?

The cause of Hashimoto’s thyroiditis is thought to be complex. There is a genetic predisposition and an environmental trigger that causes the autoimmune destruction process to begin .

But what this environmental trigger is is still unknown. Additional factors such as gender and age are also believed to influence the development of the disease.

Usually, the immune system serves as the body’s shield against viruses, bacteria and foreign substances /antigens/ that invade the body. In an autoimmune disease, the immune system mistakenly attacks an organ, system, or part of the body.

In the case of Hashimoto’s thyroiditis, the immune system attacks the thyroid gland. The autoimmune process causes inflammation of the thyroid gland /thyroiditis/, which leads to disruption of the function of the gland to synthesize hormones, and this becomes the cause of hypothyroidism.

The pituitary gland responds by increasing the release of thyroid stimulating hormone /TSH/ and tries to influence the thyroid gland to restore its normal function. This can lead to an increase in the size of the gland or goiter.

Treatment of Hashimoto’s disease

If no hormone deficiency is found, but only the antibody test is positive, the use of drugs should be discussed by the patient and the doctor. Other clinical conditions, patient preferences and the presence of any complaints are taken into account when deciding on the treatment method.

If thyroid hormone deficiency is found, then treatment is prescribed, which includes daily intake of synthetic thyroid hormones.

The hormones can be in the form of levothyroxine, which is synthetic T4, or in the form of liothyronine sodium – a synthetic form of the T3 hormone.

Other types of thyroid hormones are available commercially, such as Armor thyroid, which is a combination of the two hormones – T3 and T4.

Oral medications can restore normal hormone levels and suppress the symptoms of hypothyroidism but must be taken regularly and long-term.

The dose is adjusted based on the concentration of T3 and T4 hormones in the blood. Follow-up tests are usually done every 6-12 weeks if hormone levels are elevated and every 6-12 months if levels are stable and normal.

Side effects are similar to symptoms of hyperthyroidism and may include palpitations, tremors, nervousness, sweating, and anxiety.

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