What is Hashimoto’s Disease?

Hashimoto’s disease, also known as “Hashimoto’s thyroiditis,” is an autoimmune disease, a disorder in which the immune system rebels against the body’s tissues it is meant to protect.  In this disease, the immune system attacks the thyroid gland, a small gland at the base of your neck, below Adam’s apple. The thyroid gland is part of the endocrine system, which produces hormones that regulate most of the body’s functions.  In Hashimoto’s disease, the immune system attacks the thyroid, resulting in an underactive thyroid gland (hypothyroidism). As a result, the thyroid does not produce enough hormones for the body’s needs.  Hashimoto’s disease is also medically known as “chronic lymphocytic thyroiditis.” 

Risk Factors 

Risk factors of Hashimoto’s disease include:

• Sex

Women are most likely to develop the sickness. About 7 women to one man (7:1) suffer from the disease.

• Age

Hashimoto’s disease occurs in all ages but is more commonly seen among the middle-aged.

• Hereditary or Genetics
• Other Autoimmune Diseases

Having another autoimmune disease such as arthritis, diabetes type 1, or lupus, may increase the risk of developing Hashimoto’s disease.

• Radiation Exposure

People exposed to radiation are at high risk of Hashimoto’s disease.

• Pregnancy 

During pregnancy, developing the disease is high due to a change in immune function.

• Excessive iodine intake

Consuming too much iodine in the diet makes developing the disease higher in high-risk patients.

Complications of Hashimoto’s Disease

Hashimoto’s disease causes the underactive thyroid gland (hypothyroidism). If left untreated, hypothyroidism can result in several complications, such as:

• Goiter

A large goiter(enlargement of the thyroid gland) can interfere with swallowing and breathing.

• Heart problems

High levels of LDL cholesterol (bad cholesterol) can occur in people with an underactive thyroid(hypothyroid) gland. Hypothyroidism can result in an enlarged heart and possibly heart failure if left untreated.

• Myxedema

This is a medically rare, life-threatening condition which develops due to severe long-term hypothyroidism. Signs and symptoms include drowsiness, lethargy, and unconsciousness. Myxedema coma can be triggered by exposure to colds, sedatives, infections, or stress. It requires emergency medical treatment.

• Mental health issues

The condition can cause a depression that may become severe over time. The disease can also cause a decrease in libido in both men and women and can lead to slowed mental functioning.

• Congenital disabilities

Babies born to women with untreated hypothyroidism due to Hashimoto’s disease are more prone to intellectual and developmental problems than babies of healthy mothers.  It seems there may be a link between hypothyroidism pregnancies and congenital disabilities, such as cleft palate. In addition, heart, brain, and kidney problems in infants may also be connected to hypothyroidism during pregnancies.

• Sexual and reproductive dysfunction [1].

Hashimoto’s Disease Diagnosis

You need the following to conduct Hashimoto’s disease test:

• Medical history.
• Physical examination.
•  On physical examination, the doctor palpates the thyroid gland to check if the gland is enlarged or not. Blood tests, including:
  • Thyroid-stimulating hormone (TSH) test.

A high TSH level primarily indicates that the thyroid gland is not producing enough T4 hormones.

• Free T4 test.

A low T4 level shows that the person has hypothyroidism.

• Anti-thyroid antibody test.

Positive antibody results indicate a higher risk of having Hashimoto’s disease.

• An ultrasound of the thyroid gland.

This is carried out to know the size and appearance of the thyroid and if there are any nodules or growths in the neck area.

• Fine Needle Aspiration Cytology (FNAC)

This process involves removing a small sample of fluid or tissue from the thyroid gland to examine the type of cells present in the gland.

Hashimoto’s Disease Treatment

If Hashimoto’s thyroidism progresses to hypothyroidism, you will require the following treatment:

• T4 hormone replacement therapy: A synthetic form of thyroid hormone called levothyroxine (Synthroid, Tirosint, Levoxyl, Levothroid, Unithroid, etc.).

This drug restores the normal function of the thyroid. You will need to take medication daily for the rest of your life. Consulting the doctor regularly helps monitor the thyroid levels and keep them under control.

Hashimoto’s Disease Diet

There is no special diet for Hashimoto’s disease. However, some foods, medications, and supplements may likely affect your ability to absorb levothyroxine (thyroid medication). These include:

• Iron and calcium supplements.
• The ulcer medicine is sucralfate, cholestyramine, and aluminum hydroxide (found in some antacids).

Take these four hours before or after levothyroxine to eliminate their effect on the thyroid medication. 

Conclusion

Hashimoto’s disease cure is undetermined. However, you can manage the disease by using medications. You do not require surgery. Eating well and having a healthy lifestyle (sleeping well, exercising, and controlling stress) is the best way to help your immune system. Nevertheless, keeping to your daily dosage of hypothyroidism medications is the management control for those diagnosed with hypothyroidism.

Symptoms

HASHIMOTO’S DISEASE SYMPTOMS

The symptoms of Hashimoto’s disease may be mild initially or take years to develop. These symptoms may include:

• Dry skin.
• Constipation.
• Paleness of the face.
• Joint and muscle pain.
• Weight gain (obesity).
• Hair loss or brittle hair.
• Enlarged thyroid (goiter).
• Fatigue and sluggishness.
• Depression.
• Slow heart rate.
• Memory lapses.
• Sensitivity to cold.
• Muscle weakness.
• Inability to get warm.
• Tongue enlargement.
• Unable to get pregnant.
• Irregular or heavy menstrual periods.

Causes

HASHIMOTO’S DISEASE CAUSES

The exact Hashimoto’s disease cause is not known, but scientists believe that some factors might have played a role. They include:

• Genetics

People with Hashimoto’s disease often have family members who suffer from thyroid disease or other autoimmune diseases.

• Hormones

Hashimoto’s disease affects about seven women to one man (7:1), indicating that sex hormones might have played a role. Most women also develop thyroid problems during the first year of having a baby, and about 20% of them develop Hashimoto’s disease years later.

• Radiation Exposure

Many thyroid diseases have been reported in people who have been exposed to radiation, the atomic bombs in Japan.

• Excessive Iodine

Research suggests that excess iodine can trigger thyroid disease in susceptible people.

FAQ

• What is the cause of Hashimoto’s disease?

Doctors do not know the exact cause of Hashimoto’s disease. However, a combination of factors including sex, age, and heredity may determine your likelihood of developing this disorder.

• What does a Hashimoto’s disease attack feel like?

When Hashimoto’s thyroidism flares up, you may begin to feel some symptoms of hypothyroidism, including fatigue, aching, and pain in the muscles and joints.

• How severe is Hashimoto’s disease?

Hashimoto’s disease can be fatal. If left untreated, it can cause coma or heart problems. However, the general outlook of Hashimoto’s patients is good.

• What triggers Hashimoto’s disease?

The cause of Hashimoto’s disease is not precisely known, but factors such as genetics, exposure to radiation, sex, and age seem to play a significant role. 

• What is the best treatment option for Hashimoto’s hypothyroidism?

A man-made thyroid hormone can restore the function of the thyroid gland. This hormonal thyroid medication called levothyroxine can be found in Synthroid, Tirosint, Levoxyl, Levothroid, and Unithroid.

 

References:

1. mayoclinic