Hashimoto’s disease affects the thyroid gland. It’s also called Hashimoto’s thyroiditis, chronic lymphocytic thyroiditis or autoimmune thyroiditis. Hashimoto’s disease is an autoimmune disease, a disorder in which the immune system turns against the body’s own tissues. In people with Hashimoto’s, the immune system attacks the thyroid. This can lead to hypothyroidism, a condition in which the thyroid does not make enough hormones for the body’s needs.
Some people may not have any symptoms at first. As the disease slowly progresses, the thyroid gland becomes enlarged (a condition called a goiter). A goiter is a common first sign of Hashimoto’s disease. A goiter is painless, but can create a feeling of fullness in the throat, and can make the front of your neck look swollen.
Other symptoms of Hashimoto’s disease that develop over time include:
• Tiredness (fatigue).
• Weight gain.
• Feeling cold.
• Joint stiffness and muscle pain.
• Constipation (trouble having a bowel movement).
• Puffy eyes/face.
• Dry skin.
• Thinning hair/hair loss.
• Heavy or irregular periods.
• Difficulty becoming pregnant.
• Memory problems/difficulty thinking or concentrating.
• Slow heartbeat.
Hashimoto’s disease is an autoimmune disorder. The immune system creates antibodies that attack thyroid cells as if they were bacteria, viruses or some other foreign body. The immune system wrongly enlists disease-fighting agents that damage cells and lead to cell death.
What causes the immune system to attack thyroid cells is not clear. The onset of disease may be related to:
• Genetic factors
• Environmental triggers, such as infection, stress or radiation exposure
• Interactions between environmental and genetic factors
The following factors are associated with an increased risk of Hashimoto’s disease:
Women are much more likely to get Hashimoto’s disease.
Hashimoto’s disease can occur at any age but more commonly occurs during middle age.
• Other autoimmune disease.
Having another autoimmune disease — such as rheumatoid arthritis, type 1 diabetes or lupus — increases your risk of developing Hashimoto’s disease.
• Genetics and family history.
You’re at higher risk for Hashimoto’s disease if others in your family have thyroid disorders or other autoimmune diseases.
Typical changes in immune function during pregnancy may be a factor in Hashimoto’s disease that begins after pregnancy.
• Excessive iodine intake.
Too much iodine in the diet may function as a trigger among people already at risk for Hashimoto’s disease.
• Radiation exposure.
People exposed to excessive levels of environmental radiation are more prone to Hashimoto’s disease.
If left untreated, Hashimoto’s thyroiditis can cause complications, some of which can be severe. These can include:
• heart problems, including heart failure
• confusion and loss of consciousness
• high cholesterol
• decreased libido
• Hashimoto’s can also cause problems during pregnancy. women with this condition are more likely to give birth to babies with heart, brain, and kidney defects.
Laboratory tests to determine thyroid function include –
• Free T4 test
• Serum TSH
• Total T3
• Thyroid autoantibodies
Imaging studies and fine needle biopsy are generally not needed to diagnose Hashimoto thyroiditis.
There is no cure for Hashimoto’s, but replacing hormones with medication can regulate hormone levels and restore your normal metabolism
Most people with Hashimoto’s disease take medication to treat hypothyroidism. If you have mild hypothyroidism, you may have no treatment but get regular TSH tests to monitor thyroid hormone levels.
T-4 hormone replacement therapy
Hypothyroidism associated with Hashimoto’s disease is treated with a synthetic hormone called levothyroxine (Levoxyl, Synthroid, others). A levothyroxine pill is usually taken in the morning before you eat. The synthetic hormone works like the T-4 hormone naturally produced by the thyroid. You will need this treatment for the rest of your life.
Once the best dosage is determined, you will continue to take the medication once a day. You’ll need follow-up tests once a year to monitor TSH levels or any time after your provider changes your dosage.
Things to consider –
Some supplements and medications can affect your body’s ability to absorb levothyroxine. Some products that are known to cause problems with levothyroxine include:
• Soy products
• High-fiber foods
• Iron supplements, including multivitamins that contain iron
• Cholestyramine (Prevalite), a medication used to lower blood cholesterol levels
• Aluminum hydroxide, which is found in some antacids
• Sucralfate, an ulcer medication
• Calcium supplements
You may need to adjust the time of day you take your thyroid medication when taking other medicines. Certain foods may also affect absorption of this drug.
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