Hashimoto's Thyroiditis

Hashimoto's Thyroiditis

Hyperthyroidism Slideshow

Medical Revising Author: Ruchi Mathur, MD, FRCP(C)
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

• Introduction to Hashimoto's thyroiditis
• What causes Hashimoto's thyroiditis?
• What are the symptoms of Hashimoto's thyroiditis?
• How is Hashimoto's thyroiditis diagnosed?
• What is the treatment of Hashimoto's thyroiditis?
• Should I be concerned if I have Hashimoto's thyroiditis and want to become pregnant?
• Conclusions
• Patient Discussions: Hashimoto's Thyroiditis - Symptoms At Onset Of Disease

Introduction to Hashimoto's thyroiditis

Hashimoto's thyroiditis is the most common cause of hypothyroidism in the United States. It is named after the first doctor who described this condition, Dr. Hakaru Hashimoto, in 1912.

What causes Hashimoto's thyroiditis?

Hashimoto's thyroiditis is a condition caused by inflammation of the thyroid gland. It is an autoimmune disease, which means that the body inappropriately attacks the thyroid gland--as if it was foreign tissue. The underlying cause of the autoimmune process still is unknown. Hashimoto's thyroiditis tends to occur in families, and is associated with a clustering of other autoimmune conditions such as Type 1 diabetes, and celiac disease. Hashimoto's thyroiditis is 5-10 times more common in women than in men and most often starts in adulthood. Blood drawn from patients with Hashimoto's throiditis reveals an increased number of antibodies to the enzyme, thyroid peroxidase an enzyme (protein) found within the thyroid gland. As result of the antibodies' interaction with the enzyme, inflammation develops in the thyroid gland, the thyroid gland is destroyed, and the patient ultimately is rendered hypothyroid (too little thyroid hormone).

What are the symptoms of Hashimoto's thyroiditis?

The symptoms of Hashimoto's thyroiditis are similar to those of hypothyroidism in general, which are often subtle. They are not specific (which means they can mimic the symptoms of many other conditions) and are often attributed to aging. Patients with mild hypothyroidism may have no signs or symptoms. The symptoms generally become more obvious as the condition worsens and the majority of these complaints are related to a metabolic slowing of the body. Common symptoms are listed below:

• Fatigue
  
  
• Depression
  
  
• Modest weight gain
  
  
• Cold intolerance
  
  
• Excessive sleepiness
  
  
• Dry, coarse hair
  
  
• Constipation
  
  
• Dry skin
  
  
• Muscle cramps
  
  
• Increased cholesterol levels
  
  
• Decreased concentration
  
  
• Vague aches and pains
  
  
• Swelling of the legs

As hypothyroidism becomes more severe, there may be puffiness around the eyes, a slowing of the heart rate, a drop in body temperature, and heart failure. In its most profound form, severe hypothyroidism may lead to a life-threatening coma (myxedema coma). In a severely hypothyroid individual, a myxedema coma tends to be triggered by severe illness, surgery, stress, or traumatic injury. This condition requires hospitalization and immediate treatment with thyroid hormones given by injection.

Properly diagnosed, hypothyroidism can be easily and completely treated with thyroid hormone replacement. On the other hand, untreated hypothyroidism can lead to an enlarged heart (cardiomyopathy), worsening heart failure, and an accumulation of fluid around the lungs (pleural effusion).

There are a few patients with Hashimoto's thyroiditis who may undergo a hyperthyroid phase (too much thyroid hormone), called hashitoxicosis, before eventually becoming hypothyroid. Other symptoms and signs include:

• Swelling of the thyroid gland (due to the inflammation), leading to a feeling of tightness or fullness in the throat
  
  
• A lump in the front of the neck, (the enlarged thyroid gland) called a goiter
  
  
• Difficultly swallowing solids and/or liquids due to the enlargement of the thyroid gland with compression of the esophagus

Hashimoto's Thyroiditis - Symptoms At Onset Of Disease

The MedicineNet physician editors ask:

The symptoms of Hashimoto's thyroiditis can vary greatly from patient to patient. What were your symptoms at the onset of your disease?

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