Hashimoto's Disease: Information on Causes, Diagnosis & Treatments

Thyroid Disease Hashimoto Hashimoto’s disease (Hashimoto’s thyroiditis) affects the autoimmune system where the body attacks the thyroid gland. The disease was first identified in 1912 by Dr. Hakaru Hashimoto. Scientists have determined that most individuals with hypothyroidism – when the thyroid gland fails to produce sufficient levels of thyroid hormone – and goiter have Hashimoto’s disease.

The disease can cause chronic lymphocytic thyroiditis, especially in middle-age women. The sooner the symptoms are recognized, the quicker the patient can begin receiving effective treatment to minimize the inflammation associated with the disease. The thyroid, a small gland located below the Adam’s Apple at the base of the neck coordinates many body functions through the body’s endocrine system.

At every stage of Hashimoto’s thyroiditis, the body’s immune cells attack healthy thyroid tissue causing the development of a goiter where the affected gland becomes enlarged and inflamed. Often, the initial warning signs of an enlarged thyroid gland can be painless. However, without treatment, the progression of the disease can add significant pressure on the neck that in its advanced age can interfere with normal swallowing and breathing.

What Causes Hashimoto’s Disease?

Doctors, researchers, and scientists have yet determined the exact cause of Hashimoto’s disease. However, it is thought that many factors play a significant role in its development and progression. These factors include:

  • Hormones – Women are seven times more likely to develop Hashimoto’s disease compared to men. This suggests that female hormones play a significant role in its development. Additionally, women who develop thyroid issues during the first year after giving birth have an increased potential risk of developing Hashimoto’s in the years ahead.

  • Genetics – Researchers have found a correlation of inherited genes and Hashimoto’s disease. If the patient is related to someone who was diagnosed with an autoimmune disease or thyroid disease, they have a greater chance of inheriting the gene that causes Hashimoto’s thyroiditis.

  • Radiation Exposure – Individuals exposed to high levels of radiation tend to have an increased potential of developing Hashimoto’s thyroiditis. The increased cases were detected in individuals who were in the Chernobyl nuclear accident or the atomic bomb dropped on Japan. Patients treated for Hodgkin’s disease are also at greater risk due to the radiation used to manage the condition.

  • Excessive Iodine Levels – The intake of too much iodine and taking certain medications can trigger the development of thyroid disease. Iodine is essential to the development of normal levels of thyroid hormones. However, excessive amounts can be dangerous.

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Common Symptoms

Many of the comments symptoms associated with Hashimoto’s thyroiditis are undetectable at first. In many cases, the patient will not know there is something wrong until they develop a goiter, where the thyroid becomes significantly enlarged. A swollen thyroid can make swallowing difficult and the underactive gland can produce a variety of symptoms that include:

  • Unexpected weight gain

  • Forgetfulness and confusion

  • Muscle and joint pain

  • Swollen feet and hands

  • Puffiness and paleness to the face

  • Fatigue

  • Depression

  • Diminished perspiration (sweating)

  • Heavy or irregular menstrual periods

  • Diminished heart rate

  • Brittle, thinning hair

  • Hair loss

  • Sleepiness

  • Brittle nails

  • Menorrhagia (prolonged or excessive menstrual bleeding)

  • Diminished reflexes

  • Constantly feeling cold

  • Difficulty in becoming pregnant

Many of these symptoms can be associated with other medical conditions. Because of that, it is essential to ensure that the doctor has an accurate diagnosis before receiving any treatment to ensure the problems are not exacerbated.

Hashimoto’s and Pregnancy

Pregnant women suffering from Hashimoto’s disease often up their dosage levels of levothyroxine, the hormone replacement drug that helps regulate metabolism and energy in the body to ensure a successful pregnancy. This is because infants born to women suffering from uncontrollable hypothyroidism while pregnant have a much higher risk of developing birth defects compared to children in normal pregnancies.

Researchers have correlated hypothyroidism with congenital defects including kidney and brain anomalies and cleft palate. Clinical studies reveal that many children born with a defect caused by uncontrolled hypothyroidism in their mother have an increased potential risk of suffering from developmental and intellectual problems.

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Diagnosing Hashimoto’s

Accurately diagnosing Hashimoto’s disease usually requires a physical examination and a comprehensive family and personal medical history. Usually, the doctor will recommend diagnostic tests to determine the severity of the thyroid disorder. These tests include:

  • Thyroid-Stimulating Hormone Test (TSH) – This blood test can accurately diagnose hypothyroidism, that is usually caused by Hashimoto’s disease. The test can accurately determine if the body’s thyroid stimulating hormone levels are within the normal range. While the stimulating hormones are produced in the pituitary gland and not in the thyroid gland, any diminished output level of the thyroid stimulating hormone can decrease the production of thyroid hormones and cause problems.

  • Anti-Thyroid Antibodies Test (ATA) – The thyroid peroxidase antibodies test (microsomal antibody test) are commonly used to identify Hashimoto’s thyroiditis. The test detects the presence of known antibodies. The results of the test can typically confirm that Hashimoto’s thyroiditis caused the hypothyroidism problem.

  • Free Thyroxine T4 Test – This test measures the levels of free active thyroid hormones in the bloodstream to verify the diagnosis of Hashimoto’s thyroiditis. When the condition is present in the patient, the pituitary gland will secrete more thyroid stimulating hormones because the body is responding to lower levels of thyroid hormone that may or may not be produced in the thyroid gland. This test is beneficial when a thyroid stimulating hormone test produces normal results and there truly is a problem with thyroid gland hormone production.

  • Ultrasound – The doctor may recommend the patient undergo an ultrasound to see the thyroid gland has enlarged to the point where it is compressing the airway (trachea) or food tube (esophagus).

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Treating Hashimoto’s Disease

Doctors, scientists, and researchers have not found a cure for Hashimoto’s disease, nor can the accurately determine the length of time the autoimmune process will continue to cause serious inflammation. However, doctors will often prescribe thyroid hormone drugs to replace those the thyroid is unable to produce because of inflammation. This includes replacement of T3 and T4 thyroid hormones that are known to alleviate the common symptoms associated with the disease.

Doctors prescribe thyroxine (levothyroxine) sold under the brand names Levothroid, Levoxyl, and Synthroid that is taken indefinitely to successfully treat hypothyroidism or minimize its signs and symptoms. If the condition is left untreated, there is only a minimal chance that the thyroid gland can maintain normal hormone levels. A lack of treatment can worsen the symptoms of hypothyroidism. Usually, the dosage will be adjusted in women who become pregnant to minimize the potential other child being born with a serious life-threatening birth defect.

Prognosis

With effective treatment and ongoing monitoring, the prognosis is excellent for individuals suffering from Hashimoto’s thyroiditis when receiving proper treatment and ongoing care. Thyroid hormone levels are restored, many of the signs and symptoms associated with hypothyroidism can be reversed. Alternatively, if the treatment is ineffective, the condition can worsen in the months or years ahead and cause serious illness or organ damage.

Today, there is no scientific evidence that proves this condition can be prevented. This is because the disease is an autoimmune condition where the body mistakenly attacks its own tissue as a reaction to it being perceived as a foreign object.

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Sources:

https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease

http://www.mayoclinic.org/diseases-conditions/hashimotos-disease/home/ovc-20269762

https://medlineplus.gov/ency/article/000371.htm

https://www.cdc.gov/nceh/radiation/hanford/htdsweb/guide/thyroid.htm

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