The autoimmune disease Hashimoto’s thyroiditis is the most common form of thyroiditis – accounting for about 80 percent of all cases of thyroiditis. Women are nine times more likely to have Hashimoto’s thyroiditis than men. In most cases, the disease occurs between the ages of 40 and 50 years. Read more about causes, diagnosis and treatment of Hashimoto’s thyroiditis here!
Two courses
Hashimoto’s thyroiditis is also called chronic lymphocytic thyroiditis, chronic thyroiditis Hashimoto or (more rarely) Hashimoto’s disease. Sometimes you also come across the terms autoimmune thyroiditis, Hashimoto syndrome, Hashimoto’s disease or the short name Hashimoto.
There are two forms of Hashimoto’s thyroiditis:
- The classical form enlarges the thyroid gland (goitre formation), but loses its function.
- In the atrophic form thyroid tissue is destroyed and the organ stunted.
In Germany, the atrophic form of Hashimoto’s thyroiditis is more frequently observed than the classical form.
Hashimoto’s thyroiditis: cause
The thyroid disease Hashimoto’s thyroiditis is autoimmune conditioned, that is: The body begins here for unknown reasons antibodies against proteins of the thyroid gland to form. This leads to a chronic inflammation of the thyroid gland. In the long term, the constantly inflamed thyroid tissue can be destroyed, resulting in hyperthyroidism (hypothyroidism). In fact, Hashimoto’s thyroiditis is the leading cause of hypothyroidism.
Since Hashimoto’s thyroiditis can occur in families, experts suspect that there is a genetic predisposition to the disease.
Also a role in the disease development apparently plays the liver inflammation of type C (hepatitis C).
Sometimes patients with Hashimoto’s thyroiditis additionally suffer from other autoimmune diseases such as Addison’s disease, type 1 diabetes, celiac disease or a severe form of anemia (pernicious anemia).
Hashimoto’s thyroiditis: symptoms
Hashimoto’s thyroiditis is painless. Even otherwise, hardly any symptoms occur, which is why the disease is often discovered only at an advanced stage – then, if it has led to hypothyroidism (hypothyroidism). There are then clearer complaints such as:
- constant fatigue, weakness and fatigue,
- Disinterest and displeasure,
- Concentration problems and memory weakness,
- Hoarseness,
- Cold hypersensitivity,
- Constipation,
- Weight gain despite unchanged dietary habits,
- dry skin and brittle nails,
- brittle hair and increased hair loss,
- Cycle disorders and decreased fertility as well
- elevated blood lipid levels.
Hashimoto’s encephalopathy
Hashimoto’s thyroiditis can cause brain disease. This Hashimoto’s encephalopathy leads to a variety of neurological and psychiatric symptoms, such as cognitive deficits, confusion, psychosis, transient drowsiness, coma, epileptic seizures, and movement disorder (ataxia).
Hashimoto’s thyroiditis: diagnosis
In the beginning, the doctor will raise his medical history in a detailed conversation with the patient (anamnesis). Subsequent blood tests may confirm the suspicion of thyroid dysfunction due to Hashimoto’s thyroiditis. The concentration of thyroid hormones T3 and T4 as well as those of TSH are measured. TSH is a pituitary hormone that stimulates the thyroid to produce hormones. In addition, the blood sample is tested for antibodies against proteins of the thyroid gland.
An ultrasound examination of the thyroid gland supports the Hashimoto diagnosis as an imaging procedure. This is the typical finding in Hashimoto: thyroid smaller than normal and with a uniformly dark structure in the ultrasound.
Using fine needle biopsy, the doctor can extract a tissue sample from the thyroid gland in order to examine it more closely: In Hashimoto’s thyroiditis, significantly more white blood cells can be found in the tissue than normally.
To investigate Hashimoto’s encephalopathy, further investigations may be necessary, such as the analysis of a sample of cerebrospinal fluid (CSF) and a measurement of electrical brain activity (EEG).
Hashimoto’s thyroiditis: therapy
There is no cure for the cause of Hashimoto. However, symptoms that result from hypothyroidism can be treated by replacing the missing thyroid hormone. Patients are usually given life-long tablets containing the artificial hormone levothyroxine. For optimal absorption in the body, the drug must be taken in the morning on an empty stomach.
If the disease has led to enlargement of the thyroid gland (goiter), Hashimoto’s therapy may consist of surgical removal of the organ.
Hashimoto’s encephalopathy can usually be treated well with high-dose cortisone (prednisolone).
Living with Hashimoto: Diet
Increased iodine intake may play a role in the development of Hashimoto’s thyroiditis and may also negatively affect the course of the disease. Therefore, patients with Hashimoto should avoid too high a dose of iodine, which means: Do not take iodine tablets and monitor iodine intake through the diet. For example, sea fish (such as mackerel, herring, saithe) and seafood are very rich in iodine.
Hashimoto in children and adolescents
If children and adolescents with Hashimoto’s thyroiditis have a goitre (goiter) or hypothyroidism, the doctor will prescribe the use of thyroid hormones.
Hashimoto’s thyroiditis: prognosis
The disease course in Hashimoto’s thyroiditis can not be predicted. Only rarely does the disease spontaneously develop.
The destruction of thyroid tissue caused by the chronic inflammation can not be undone. Hypothyroidism, which develops in the course of Hashimoto’s thyroiditis developed, usually requires a lifelong intake of thyroid hormones.