Doctor's Notes on Hashimoto's Thyroiditis
Hashimoto’s thyroiditis (also termed chronic autoimmune thyroiditis and/or chronic lymphocytic thyroiditis) is disorder that causes the thyroid gland to underproduce thyroid hormones (hypothyroidism). The symptoms and signs are slowly progressive and may develop over years. Some of the signs and symptoms of hyperthyroidism are numerous and may more or less increase in severity as the disease worsens. Signs and symptoms include at least one or more of the following: fatigue, feeling cold, constipation, mental fogginess, dry skin, retention, stiffness and aches in muscles and joints, prolonged menstrual bleeding, depression, weight gain, face puffiness, infertility, thinning and brittle hair and/or hair loss, slow heart rate, irregular menstrual periods, decreased sweating, nails are thick and/or brittle, decreased reflexes, swollen hands and feet, cold skin, sleepiness and enlargement of the thyroid gland (goiter).
The cause of Hashimoto’s thyroiditis is thought by researchers to be a combination of genetic predisposition along with an environmental trigger that starts the autoimmune destruction of the thyroid. The triggers are unknown. Researchers also theorize that heredity, gender and age play a role in developing this disease. In addition, there are risk factors that are closely associated with the development of Hashimoto’s thyroiditis such as female gender (about 10 to 15 times more likely to develop the disease than men), family history, excessive iodine intake and radiation exposure to the thyroid gland.
Hashimoto's Thyroiditis Symptoms
The signs and symptoms of Hashimoto's thyroiditis are the same as those of hypothyroidism. The disease is slow to progress, and the onset of symptoms is gradual. It may take years for true hypothyroidism to develop.
The signs and symptoms of hypothyroidism vary widely, depending on the severity of hormone deficiency. Some of the complaints experienced by those with hypothyroidism include:
- Mental fogginess and forgetfulness
- Feeling excessively cold
- Dry skin
- Fluid retention
- Non-specific aches and stiffness in muscles and joints
- Excessive or prolonged menstrual bleeding (menorrhagia)
- Weight gain
- Puffiness in the face
- Infertility (difficulty getting pregnant)
- Thinning, brittle hair
- hair loss
- Slow heart rate
- Irregular menstrual periods
- Decreased sweating (perspiration)
- Thick or brittle nails
- Decreased reflexes
- Swollen hands and feet
- Cold skin
These signs and symptoms can increase in severity as the condition worsens.
Hashimoto's Thyroiditis Causes
The cause of Hashimoto's is thought to be a combination of a genetic predisposition along with an environmental trigger that starts the process of autoimmune destruction. What actually triggers the immune response against the thyroid gland remains unknown. Additional factors, including heredity, gender, and age, also play a role in developing this disorder.
Normally, the immune system acts to protect against viruses, bacteria, and foreign substances (antigens) that invade the body. In conditions of autoimmune disease, the immune system mistakenly attacks parts of the body itself. In the case of Hashimoto's thyroiditis, the immune system attacks the thyroid gland. The autoimmune process causes inflammation of the thyroid gland (thyroiditis) resulting in an impaired ability of the thyroid gland to produce hormones, leading to hypothyroidism. The pituitary gland responds by increasing TSH and attempting to stimulate the thyroid gland to produce more thyroid hormones. This can cause growth of the gland, or a goiter.
It's hard to tell if you have thyroid abnormalities. You might feel run down and tired, or have what is known as "brain fog." You may be gaining weight, pregnant, or experiencing hair loss. Others may feel "hyper," anxious, or sweat a lot more than usual. All of these are common symptoms of thyroid disorders. The thyroid gland regulates many processes within the body, and women are particularly likely to have disorders that affect the function of this essential gland. Recognizing and treating these conditions is critical for optimum health and preventing long-term health problems.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.