From the Guidelines
Hashimoto's thyroiditis is an autoimmune disorder where the immune system mistakenly attacks the thyroid gland, causing inflammation and gradual destruction of thyroid tissue, leading to reduced thyroid hormone production (hypothyroidism) over time, as noted in studies such as 1 and 1.
Definition and Causes
Hashimoto's thyroiditis is characterized by the immune system's attack on the thyroid gland, resulting in inflammation and damage to the thyroid tissue. This condition is often associated with genetic susceptibility and environmental triggers, which can cause T-cells to attack the thyroid tissue, as mentioned in 1.
Symptoms and Diagnosis
Common symptoms of Hashimoto's thyroiditis include:
- Fatigue
- Weight gain
- Cold intolerance
- Dry skin
- Constipation
- Depression
- A swollen neck (goiter) Diagnosis is typically made through blood tests measuring thyroid hormone levels (TSH, T4) and thyroid antibodies (TPO and thyroglobulin antibodies), as discussed in 1.
Treatment and Management
Treatment for Hashimoto's thyroiditis usually involves daily synthetic thyroid hormone replacement, most commonly levothyroxine (brand names include Synthroid, Levoxyl), with starting doses between 25-125 mcg depending on age, weight, and severity, as noted in 1 and 1. Medication should be taken on an empty stomach, 30-60 minutes before breakfast or 3-4 hours after the last meal of the day. Regular blood tests every 6-12 months are necessary to monitor hormone levels and adjust dosage as needed.
Risk Factors and Complications
Hashimoto's thyroiditis is more common in women, particularly middle-aged women, and often runs in families, suggesting a genetic component to the disease, as mentioned in 1. The condition can also increase the risk of other autoimmune diseases, such as systemic lupus erythematosus, type 1 diabetes mellitus, and asthma, as discussed in 1 and 1.
From the Research
Definition of Hashimoto's Disease
- Hashimoto's disease, also known as Hashimoto's thyroiditis, is a common autoimmune disorder that affects the thyroid gland 2, 3.
- It is characterized by the immune system attacking the thyroid gland, leading to inflammation and damage to the thyroid tissue 2, 3.
- This damage can result in a decrease in the production of thyroid hormones, leading to hypothyroidism 4, 2, 3.
Causes and Risk Factors
- The exact cause of Hashimoto's disease is not fully understood, but it is thought to be a combination of genetic and environmental factors 2, 3.
- Women are 7-10 times more likely to develop Hashimoto's disease than men 2.
- Other risk factors include a family history of autoimmune disorders, radiation exposure, and certain medical conditions such as type 1 diabetes and rheumatoid arthritis 2, 3.
Symptoms and Clinical Presentation
- The symptoms of Hashimoto's disease can vary, but common symptoms include fatigue, weight gain, dry skin, and hair loss 2, 3.
- Some people may experience thyrotoxicosis, which is a condition where the thyroid gland releases stored thyroid hormones into the bloodstream, leading to symptoms such as anxiety, irritability, and rapid heartbeat 2.
- Others may experience euthyroidism, where the thyroid gland is able to produce enough thyroid hormones to meet the body's needs, but the thyroid tissue is still damaged 2.
- In some cases, Hashimoto's disease can lead to hypothyroidism, which is a condition where the thyroid gland is not able to produce enough thyroid hormones 4, 2, 3.
Treatment and Management
- The treatment for Hashimoto's disease typically involves thyroid hormone replacement therapy, which involves taking synthetic thyroid hormones to replace the hormones that the thyroid gland is not able to produce 4, 2, 3.
- The goal of treatment is to restore normal thyroid function and alleviate symptoms 4, 2, 3.
- In some cases, treatment may also involve managing related conditions, such as gastroparesis and small intestinal bacterial overgrowth (SIBO) 4.