Hashimoto's disease

Description

Hashimoto's disease is an autoimmune disorder that affects the thyroid gland. The thyroid is a butterfly-shaped gland located at the base of the neck just under the Adam's apple. The thyroid produces hormones that help regulate many functions in the body.

An autoimmune disease is a disease caused by the immune system attacking healthy tissues. In Hashimoto's disease, the cells of the immune system lead to the death of the thyroid gland, the hormone-producing cells. The disease usually results in a decrease in hormone production (hypothyroidism).

Although any person can develop Hashimoto's disease, is more common among middle-aged women. The main treatment is thyroid hormone replacement.

Hashimoto's disease, also known as Hashimoto hashimoto thyroiditis, chronic lymphocytic thyroiditis and chronic autoimmune thyroiditis.

Symptoms

Hashimoto's disease slowly progresses over the years. You may not notice signs or symptoms of the disease. Finally, the decrease in thyroid hormone production may result in any of the following:

  • Fatigue and sluggishness
  • Increased sensitivity to cold
  • The increase drowsiness
  • Dry skin
  • Constipation
  • Muscle weakness
  • Muscle aches, tenderness and stiffness
  • Joint pain and stiffness
  • Irregular or excessive menstrual bleeding
  • Depression
  • Problems with memory or concentration
  • Inflammation of the thyroid gland (goiter)
  • A puffy face
  • Brittle nails
  • The loss of hair
  • The enlargement of the tongue

When to see a doctor

The signs and symptoms of Hashimoto's disease vary widely and are not specific to the disorder. Because these symptoms can be the result of any number of disorders, it is important that you consult your health care provider as soon as possible for a timely and accurate diagnosis.

Causes

Hashimoto's disease is an autoimmune disorder. The immune system creates antibodies that attack cells of the thyroid as if they were bacteria, viruses, or any foreign body. The immune system mistakenly enlists to fight diseases of the agents that damage cells and lead to cell death.

What causes the immune system to attack the thyroid cells is unclear. The onset of the disease may be related to:

  • Genetic factors
  • Environmental triggers, such as infections, stress, or exposure to radiation
  • The interactions between environmental and genetic factors

Risk factors

The following factors are associated with an increased risk of Hashimoto's disease:

  • Sex. Women are much more likely to get the disease Hashimoto's.
  • Age. Hashimoto's disease can occur at any age, but most commonly occurs during the middle ages.
  • Other autoimmune diseases. Have another autoimmune disease, such as rheumatoid arthritis, type 1 diabetes, or lupus — increases the risk of developing Hashimoto's disease.
  • Genetics and family history. You are at greater risk for Hashimoto's disease if other members of your family have disorders of the thyroid or other autoimmune diseases.
  • Pregnancy. Typical of the changes in immune function during pregnancy may be a factor in Hashimoto's disease, which begins after the pregnancy.
  • An excessive consumption of iodine. Also the amount of iodine in the diet can work as a trigger among people who are already at risk of Hashimoto ddiseases.
  • The exposure to radiation. People who are exposed to excessive levels of environmental radiation are more likely to develop Hashimoto's disease.

Complications

The thyroid hormones are essential to the healthy functioning of many systems of the body. Therefore, when the Hashimoto's disease and hypothyroidism is left without treatment, many complications can occur. These include:

  • The goiter. A goiter is an enlarged thyroid gland. As the production of thyroid hormone is decreased due to Hashimoto's disease, the thyroid gland receives signals from the pituitary gland to produce more. This cycle can result in a goiter. Usually is not uncomfortable, but a large goiter can affect your appearance and may interfere with swallowing or breathing.
  • The problems of the heart. Hypothyroidism can result in poor function of the heart, an enlarged heart and irregular heart beats. It can also result in high levels of low-density lipoprotein (LDL) cholesterol-the "bad" cholesterol — which is a risk factor for cardiovascular disease and heart failure.
  • Mental health problems. Depression or other mental health disorders can occur early in the disease, Hashimoto's thyroiditis, and can become more severe over time.
  • Sexual and reproductive health and dysfunction. In women, hypothyroidism can result in a decrease in sexual desire (libido), an inability to ovulate, and irregular and heavy menstrual bleeding. Men with hypothyroidism may have a reduced libido, erectile dysfunction and a decrease in the sperm count.
  • Poor pregnancy outcomes. The hypothyroidism during pregnancy can increase the risk of a spontaneous abortion or premature labor. Babies born to women with hypothyroidism without treatment are at risk of diminished intellectual capacity, autism, speech delays and other developmental disorders.
  • Myxedema (miks-uh-DEE-muh). This is a rare, life-threatening withextradition can develop due to long-term, severe, untreated hypothyroidism. Its signs and symptoms include drowsiness followed by profound lethargy and unconsciousness. A myxedema coma may be triggered by exposure to cold medicine, sedatives, infection or other types of stress oryour body. Myxedema requires emergency medical treatment.

Hashimoto's disease

Diagnosis

A number of conditions that can lead to the signs and symptoms of Hashimoto's disease. If you are experiencing any of these symptoms, your health, carand provider will perform a complete physical examination, review your medical history and ask questions about your symptoms.

Thyroid function tests

To determine whether the hypothyroidism is the cause of your symptoms, your doctor will order blood tests that can bee the following:

  • TSH test. Thyroid-stimulating hormone (TSH) is produced by the pituitary gland. When the pituitary gland detects low thyroid hormones in the blood, it sends a TSH to the thyroid to request an increase in the production of thyroid hormone. High levels of TSH in the blood indicates that the hypothyroidism.
  • T-4 tests. The main hormone of the thyroid gland is thyroxine (T-4). A low blood level of T-4 confirms the findings of a TSH test and indicates that the problem is within the thyroid gland itself.

Antibody tests

More of a disease process can cause hypothyroidism. To determine whether Hashimoto's disease is the cause of hypothyroidism, your doctor will order a test for antibodies.

The purpose of an antibody to the flag that causes the illness of foreign agents that need to be destroyed by other players in the immune system. In an autoimmune disease, the immune system produces rogue antibodies that attack healthy cells or proteins in the body.

Usually in Hashimoto's disease, the immune system produces antibodies to thyroid peroxidase (TPS), a protein that plays an important role in the production of thyroid hormone. Most people with Hashimoto's disease have TPO antibodies in your blood. Laboratory tests for other antibodies associated with Hashimoto's disease may need to be done.

Treatment

Most of the pin people with Hashimoto's disease taking medication to treat hypothyroidism. If you have hypothyroidism, mild, there may not be any treatment, but you get to regulate the thyroid-stimulating hormone (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). The synthetic hormone works as thyroxine (T-4) and the hormone produced naturally by the thyroid gland.

The goal of treatment is to restore and maintain the proper level of the T-4 levels of the hormone and improve the symptoms of hypothyroidism. You will need this treatment for the rest of your life.

Dose monitoring

Your doctor will determine the dose of levothyroxine that is appropriate for their age, weight, current production of the thyroid, other medical conditions, and other factors. Your healthcare provider will examine your TSH levels approximately 6 to 10 weeks later and adjust the dose as needed.

Once the best dose is determined, you will continue to take the medicine once a day. You will need follow-up tests once a year to monitor the levels of TSH, or at any time after your provider changes in the dose.

A levothyroxine pill that is usually taken in the morning before you eat. Talk with your doctor if you have any questionsabout when or how to take the pill. Also, ask what to do if you accidentally miss a dose. If your health insurance requires you to switch to a generic drug or a different brand, talk with your doctor.

Precautions

Because levothyroxine acts as a natural T-4 in the body, there are usually no side effects as long as the treatment is the result of "natural" levels of T-4 to your body.

Too much thyroid hormone can worsen bone loss that causes weak, brittle bones (osteoporosis) or cause an irregular heartbeat (arrhythmias).

Effects of other substances

Certain medicines, supplements and foods can affect the ability of absorption of levothyroxine. It may be necessary to take levothyroxine at least four hours before these substances. Talk with your doctor about any of the following:

  • Soy products
  • Foods rich in fiber
  • Iron supplements, including multivitamins that contain iron
  • Cholestyramine (Prevalite), a drug used to reduce cholesterol levels in the blood
  • Aluminum hydroxide, which is found in some antacids
  • Sucralfate, an ulcer, Idication
  • Calcium supplements

T-3 hormone replacement therapy

Naturally produced T-4 converts to another thyroid hormone called triiodothyronine (T-3). The T-4 hormone replacement also becomes T-3, and for the majority of the people of the T-4 replacement of therapy results in an adequate supply of (T-3) to the body.

For people who need a better control of the symptoms, the doctor may also prescribe a synthetic T-3 hormone (Cytomel) or a synthesis of the T-4 and T-3 combination. Side effects of the T-3 hormone replacement include rapid beat of the heart, insomnia, and anxiety. These treatments can be tested with a test period of 3 to 6 months.

Alternative medicine

Products with triiodothyronine (T-3) and thyroxine (T-4) hormones derived from pigs or other animals are available as drugs or as dietary supplements, such as the Armor of the Thyroid, in the united States. The concerns about these products include the following:

  • The balance of the T-4 and T-3 in animals is not the same as in humans.
  • The exact amount of the T-4 and T-3 in each batch of a natural extract product may vary, which leads to unpredictable levels of these hormones in the blood.

Preparing for your appointment

It is likely to start by seeing your primary care provider, but you may be referred to a specialist in hormone disorders (endocrinologist).

Be prepared to answer the following questions:

  • What symptoms do you have?
  • When did you start experiencing them?
  • Did your symptoms begin suddenly or develop gradually over time?
  • Have you noticed changes in your energy level, or your mood?
  • Has their appearance changed, including the increase of weight, or dryness of the skin?
  • Have your bowel habits changed? How?
  • Do you have muscle or joint pain? Where?
  • Have you noticed a change in your sensitivity to cold?
  • Have you felt more forgetful than usual?
  • Has andour diminished interest in sex? If you are a woman, you have your menstrual cycle changed?
  • What medications do you take? What are these medications for the treatment?
  • What herbal remedies, vitamins and diet supplements do you take?
  • There is a history of thyroid disease in your family?
Symptoms and treatment of Hashimoto's disease