Written by Dr. Sanjana V.B Bhms,dbrm,cdn

Founder & medical director of siahmsr wellness.in

All rights reserved with siahmsr digital healthcare[siahmsr wellness]

Reviewed by SIAHMSR medical team.

What is Hashimoto’s thyroiditis ?

   Hashimoto’s thyroiditis is an autoimmune disease causing thyroid dysfunction gradually. It causes under active thyroid or hypothyroid state. However, the disease has an initial phase of overactive thyroid state or normal thyroid status. This type of thyroid disease is also known as chronic lymphocytic thyroiditis.

  Hashimoto thyroiditis is an autoimmune disease that destroys thyroid cells by cellular and antibody-mediated immune processes. In this disease, immune system of your body reacts against thyroid cell receptors.

  In this thyroid disease, antibodies [thyroid peroxidase (TPO) and/or thyroglobulin (Tg) antibodies] are formed by the body these can damage your thyroid gland. These antibodies cause inflammation within the thyroid gland. Over time, the inflammation can cause thyroid gland enlargement, fibrosis within the gland tissue and reduced production of thyroid hormone (hypothyroidism).In short, underactive thyroid state develops gradually.

Who are affected more by Hashimoto’s thyroiditis?

It is the most common cause of hypothyroidism in developed countries. Hashimoto’s thyroiditis often runs in families. Although it can also affect men, it is more common in women. It can occur at any age but the chances of occurrence of Hashimoto’s thyroiditis increases with ageing. This autoimmune thyroiditis is found in adolescent children also.

What are the signs & symptoms of Hashimoto’s thyroiditis?

· Skin may become scaly and dry

· Rate of hair growth slows, and hair can be dry, coarse, dull, and brittle.

· Fatigue, exertional breathlessness, and exercise intolerance

· Muscle weakness and myopathy

·  Constipation

·  fatigue, cold and dry skin

·  weight gain.

· Slow pulse

· drowsiness

· Swelling or edema of hands and feet.

· High blood pressure in some people.

· Depressive mood, anxiety.

· Menstrual irregularities in women

· Cold intolerance in severe hypothyroidism. 

How to diagnose Hashimoto’s thyroiditis?

The most common lab tests for diagnosing thyroiditis include:

· TFT or thyroid function tests which include TSH , free t3, free t4.

In people having thyroiditis elevated thyroid-stimulating hormone (TSH) and low levels of free thyroxine (fT4) may be found. 

In some people ,earlier on in the course of the disease, signs, symptoms, and laboratory findings of hyperthyroidism or normal values for the test may occur.

· Anti TPO antibodies

 Antithyroid peroxidase (TPO) antibodies may be elevated in Hashimoto’s thyroiditis. However,it can be elevated in other conditions also.

The presence of anti-thyroid peroxidase and anti-thyroglobulin antibodies suggests Hashimoto thyroiditis. However, 10%  of patients may be antibody negative.

· Prolactin levels may be elevated in the blood.

· Elevated total cholesterol, LDL, and triglyceride levels can occur.

· A thyroid ultrasound [USG] assesses thyroid size, echotexture or some characteristics or parameters of thyroid tissue, and whether thyroid nodules are present. 

What are the other diseases that may coexist with Hashimoto’s thyroiditis?

Hashimoto thyroiditis is also related to several other autoimmune diseases, such as pernicious anemia, adrenal insufficiency, and celiac disease.

How can you manage hypothyroidism?

The main treatment for hypothyroidism or under active thyroid  is thyroid hormone replacement. The drug of choice is titrated levothyroxine sodium administered orally. It has a half-life of 7 days and can be given daily.

 Complementary and alternative systems of medicine

Homeopathy

Homeopathy offers treatment for autoimmune thyroiditis. Some common remedies include lycopodium, iodum, spongia , cacarea carbonicum ,thyroidinum etc.

Frequently asked questions

1. Can Hashimoto’s thyroiditis be found associated with gastric diseases?

 About 40% of patients with autoimmune gastritis also present with Hashimoto thyroiditis. Chronic autoimmune gastritis (CAG) is characterized by the partial or complete disappearance of parietal cells of stomach, leading to impairment of hydrochloric acid and intrinsic factor production which may cause pernicious anemia and severe gastric atrophy. 

2. What are the causes of Hashimoto’s thyroiditis?

Exact cause of this autoimmune thyroiditis is not clear yet. Genetic as well as environmental factors play a conjoint role in the causation. 

3. Can Hashimoto's Thyroiditis be Prevented?

   No. there is no scientifically proven basis. However, a well balanced diet and life style modifications ,stress reduction may help.

4. What are the  causes of flare up of Hashimoto’s or autoimmune thyroiditis?

Infections, stress, sleep deprivation, any new change in life may cause flare up even while on medications. 

5. What are the complications of Hashimoto’s thyroiditis?

It may raise bad cholesterol LDL and increases the risk for heart attack. 

6. Can Hashimoto’s thyroiditis cause sexual problems?

Yes.it may cause low sex drive, infertility and erection problems. 

7. Can Hashioto’s thyroiditis cause pregnancy related problems?

Underactive thyroid state may cause miscarriage if left untreated with medications. 

8. Can Hashimoto’s thyroiditis raise prolactin hormone levels?

Yes.it is true. It may cause pregnancy related problems if not treated properly.

  copyright of the article- dr sanjana vb 

References

1. https://pubmed.ncbi.nlm.nih.gov/27913607/ Autoimmune comorbidities in Hashimoto's thyroiditis: different patterns of association in adulthood and childhood/adolescence.

2. Yoo WS, Chung HK. Recent Advances in Autoimmune Thyroid Diseases. Endocrinol Metab (Seoul). 2016 Sep;31(3):379-385 https://pubmed.ncbi.nlm.nih.gov/27586448/

3. https://www.ncbi.nlm.nih.gov/books/NBK459262/ 

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766941/