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Hashimoto's Disease
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Hashimoto's disease is a disease of the thyroid gland, located in the front of your neck. Your thyroid gland is one of many endocrine glands you have and it regulates metabolism of all the cells of the body. When you have Hashimoto's disease, the immune system attacks your own thyroid cells. This causes a low thyroid condition. It is the most common low thyroid condition in the US. It is also called chronic lymphocytic thyroiditis.
There are no specific signs and symptoms of Hashimoto's thyroiditis. It looks like any other cause of hypothyroidism. The symptoms happen quite slowly and often you don't know you have it until it becomes more advanced and causes more symptoms.
The major signs of hypothyroidism include being tired and sluggish, having an increased sensitivity to the cold, having dry skin that is often pale, having constipation a puffy face and a hoarse voice. Your damaged thyroid gland can cause you to have an elevated thyroid gland and weight gain in spite of eating less food. You can feel muscle tenderness and aching, particularly in the hips and the shoulders although other body areas can be affected. There can be weakness in the lower extremities and knee pain. You can have excessive menstrual bleeding and depressive symptoms. These signs and symptoms eventually become so severe that you seek medical attention. Your thyroid gland can become enlarged, a condition called a "goiter".
To understand Hashimoto's thyroiditis, you need to understand how the thyroid gland works. The thyroid gland is under the instructions it receives from the pituitary gland. They pituitary gland is the master gland that secretes thyroid stimulating hormone or TSH. The pituitary gland is also under the dictum of the hypothalamus, which secretes thyrotropin releasing hormone or TRH. When the TSH is produced by the pituitary gland, it stimulates the thyroid to produce T4 and T3-the active thyroid hormones that influence the metabolism and other functions of our cells. If the T4 and T3 cannot be produced because of Hashimoto's thyroiditis, then the TSH rises and it can be detected in the bloodstream.
The most common way to diagnose a low thyroid condition is to do a blood test for the TSH level. If it is elevated, you likely have hypothyroidism. If it is low, you likely have hyperthyroidism. There is testing for T4 and T3 that is done along with the TSH level but the TSH level is the most sensitive of the tests for hypothyroidism. You can have hypothyroidism if you have an autoimmune disease, anti-thyroid medications, radiation to your head and neck, and treatment with radioactive iodine.
Your immune system plays a big role in determining whether or not you get Hashimoto's disease. Hashimoto's thyroiditis is an auto-immune disease in which your body makes antibodies against thyroid tissue, killing it off and suppressing its ability to make T4 and T3. The goiter comes from an elevation in TSH from the pituitary gland that is pushing the thyroid gland to make more thyroid hormone. The gland becomes enlarged but does not make up the amount lost due to thyroid gland destruction. Hashimoto's thyroiditis can be diagnosed by checking the thyroid hormones, TSH and an anti-thyroid antibody.
Complications of Hashimoto's thyroiditis include the development of a goiter, heart disease due to an elevation of LDL or "bad" cholesterol, and mental health problems including depression. Sexual desire can become reduced and in severe cases, you can develop myxedema-a life threatening condition that develops with severe hypothyroidism. Symptoms include lethargy and coma. It needs immediate medical attention in order to save a person's life and can be triggered by stressors on the body. Birth defects can happen with women who have Hashimoto's disease.
The treatment of Hashimoto's thyroiditis includes replacing thyroid hormones. T4 and/or T3 are prescribed and kept within normal range by watching the TSH level. There are several synthetic hormones containing levothyroxine. Levothyroxine can be poorly absorbed if taken along with soy products, iron supplements, aluminum hydroxide in antacids, sucralfate and calcium supplements.