Hashimoto Thyroiditis: Causes, Symptoms, Diagnosis, Treatment, and Prevention
A common autoimmune disorder, Hashimoto thyroiditis affects the thyroid gland, a gland located at the base of the neck that produces hormones that control many of our bodies' functions. During Hashimoto thyroiditis, the immune system attacks the thyroid cells, causing inflammation and reduced hormone production. In addition to fatigue, weight gain, depression, goiter, and heart problems, these conditions can lead to a variety of symptoms and complications. In women and people with a family history of thyroid or autoimmune diseases, Hashimoto thyroiditis is more prevalent. Medication and lifestyle changes can help manage the disease.
Causes and Risk Factors
The exact cause of Hashimoto thyroiditis is unknown, but it is likely influenced by a combination of genetic and environmental factors. Some possible triggers or risk factors include:
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Family history of thyroid or autoimmune diseases
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Exposure to radiation, such as from nuclear accidents or medical treatments
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Exposure to certain chemicals, such as pesticides or solvents
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Hormonal changes, such as during pregnancy, menopause, or puberty
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Viral or bacterial infections, such as hepatitis C or Helicobacter pylori
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Stress, trauma, or emotional distress
Symptoms and Complications
Hashimoto thyroiditis usually develops slowly and may not cause any noticeable symptoms in the early stages. However, as the thyroid function declines, the following symptoms may appear:
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Fatigue and sluggishness
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Increased sensitivity to cold
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Weight gain or difficulty losing weight
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Dry skin and hair
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Hair loss or thinning
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Brittle nails
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Puffy face or eyes
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Enlarged thyroid gland (goiter)
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Muscle weakness, aches, or stiffness
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Joint pain or swelling
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Constipation or bloating
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Heavy or irregular menstrual periods
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Fertility problems or miscarriage
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Depression, anxiety, or mood swings
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Memory loss or difficulty concentrating
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Slow heart rate or low blood pressure
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High cholesterol or triglycerides
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Anemia or low blood count
If left untreated, Hashimoto thyroiditis can lead to serious complications, such as:
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Myxedema, a life-threatening condition characterized by extreme hypothyroidism, low body temperature, slow breathing, and coma
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Heart problems, such as enlarged heart, heart failure, or abnormal heart rhythm
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Birth defects, such as mental retardation, physical abnormalities, or developmental delays, in babies born to mothers with untreated or poorly controlled Hashimoto thyroiditis
Diagnosis and Treatment
Medical history, physical examination, and blood tests are used to diagnose Hashimoto thyroiditis. TSH is produced by the pituitary gland to regulate thyroid function, while thyroid hormones, such as thyroxine (T4) and triiodothyronine (T3), are produced by the thyroid gland, and are measured by blood tests. When a person has Hashimoto thyroiditis, the TSH level is usually high, while the T4 and T3 levels are usually low. Blood tests can also detect thyroid antibodies, which are produced by the immune system to attack thyroid cells.
The main treatment for Hashimoto thyroiditis is thyroid hormone replacement therapy, which involves taking synthetic thyroid hormones, such as levothyroxine, to restore the normal thyroid function and relieve the symptoms. It is usually prescribed for life, and regular check-ups are necessary to monitor the thyroid function and possible side effects. The dosage is adjusted based on the blood tests and the individual response.
If the goiter is very large, causes breathing or swallowing difficulties, or is suspected to be cancerous, surgery may be required to remove part or all of the thyroid gland. In order to maintain normal thyroid function after surgery, thyroid hormone replacement therapy is necessary.
Prevention and Lifestyle Changes
There is no known way to prevent Hashimoto thyroiditis, but some lifestyle changes may help reduce the risk or severity of the condition, such as:
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Eating a balanced and nutritious diet, rich in iodine, selenium, zinc, vitamin D, and antioxidants, which are essential for the thyroid health and the immune system
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Avoiding foods that may interfere with the thyroid function, such as gluten, soy, cruciferous vegetables, and processed or refined foods
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Taking supplements or medications as prescribed by the doctor, especially if there is a deficiency of iodine, selenium, or other nutrients
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Avoiding exposure to radiation, chemicals, or toxins that may harm the thyroid or the immune system
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Managing stress, anxiety, or depression, which may worsen the symptoms or trigger the autoimmune response
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Getting enough sleep, rest, and relaxation, which are vital for the physical and mental well-being
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Exercising regularly, but moderately, to improve the metabolism, circulation, mood, and energy levels
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Quitting smoking, drinking, or using illicit drugs, which may damage the thyroid or the immune system
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Seeking support from family, friends, or professionals, who can provide emotional, practical, or medical assistance
Despite the fact that Hashimoto thyroiditis is chronic and progressive, most people with Hashimoto thyroiditis can live a normal, healthy life with the proper diagnosis, treatment, and lifestyle changes.
