Hashimoto’s disease is a condition in which the immune system attacks the thyroid. If you do not know what the thyroid is, it is a small gland at the base of your neck below your Adam’s apple. The thyroid gland is an important part of your endocrine system. It is responsible for producing hormones that coordinate many of your body’s functions.
Inflammation from Hashimoto’s disease often leads to an underactive thyroid gland also known as hypothyroidism. Hashimoto’s disease primarily affects middle-aged women but also can occur in men and women of any age and also in children.
Causes of Hashimoto’s Thyroiditis
There are still not clear evidence showing the exact cause of Hashimoto disease. However, there are many factors believed to play a role and they can include:
- Genes. In many cases, it is believed that when people have family members who have thyroid disease or other autoimmune diseases, then it is more likely that they will develop Hashimoto disease. This suggests a genetic component to the disease.
- Hormones. Hashimoto’s affects about seven times as many women as men, suggesting that sex hormones may play a role. Furthermore, for pregnant women, many of the thyroid problems start to appear. Although the problem usually goes away, as many as 20% of these women develop Hashimoto’s years later.
- Excessive iodine. Some research studies have shown that certain drugs and too much iodine, a trace element required by your body to make thyroid hormones, may trigger thyroid disease in susceptible people.
- Exposure to radiation. Increased cases of thyroid disease have been reported in people exposed to radiation, including the atomic bombs in Japan, the Chernobyl nuclear accident, and radiation treatment for a form of blood cancer called Hodgkin’s disease.
Signs and Symptoms
Usually, the signs and symptoms of Hashimoto’s thyroiditis are very similar to hypothyroidism. As they are not specific, people often time attribute it to aging. Moreover, it may be that the patients with mild hypothyroidism may not have any 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 and signs of Hashimoto’s thyroiditis include:
- Modest weight gain
- Cold intolerance
- Excessive sleepiness
- Dry, coarse hair
- Dry skin
- Muscle cramps
- Increased cholesterol levels
- Decreased concentration
- Vague aches and pains
- Swelling of the legs
When hypothyroidism becomes more severe, there are other symptoms that can appear. For instance, patients can experience puffiness around the eyes, a slowing of the heart rate, a drop in body temperature, and heart failure. In cases when hypothyroidism becomes more severe, it may lead to a life-threatening coma (myxedema coma). This condition requires hospitalization and immediate treatment with thyroid hormone.
Other symptoms and signs include:
- Swelling of the thyroid gland (due to the inflammation), which can cause a feeling of tightness or fullness in the throat
- A lump in the front of the neck from the enlarged thyroid gland called a goiter
- Difficulty swallowing solids and/or liquids due to the enlargement of the thyroid gland with compression of the esophagus.
If you ignore Hashimoto’s thyroid, it can lead to a number of serious health problems:
- Goiter. Constant stimulation of your thyroid to release more hormones may cause the gland to become enlarged, a condition known as goiter. Hypothyroidism is one of the most common causes of goiters. Although generally not uncomfortable, a large goiter can affect your appearance and may interfere with swallowing or breathing.
- Heart problems. Hashimoto’s disease also may be associated with an increased risk of heart disease, primarily because high levels of low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol — can occur in people with an underactive thyroid gland (hypothyroidism). If left untreated, hypothyroidism can lead to an enlarged heart and, possibly, heart failure.
- Mental health issues. Depression may occur early in Hashimoto’s disease and may become more severe over time. Hashimoto’s disease can also cause sexual desire (libido) to decrease in both men and women and can lead to slowed mental functioning.
- Myxedema. Its signs and symptoms include drowsiness followed by profound lethargy and unconsciousness. A myxedema coma may be triggered by exposure to cold, sedatives, infection or other stress on your body. Myxedema requires immediate emergency medical treatment.
- Birth defects. Babies born to women with untreated hypothyroidism due to Hashimoto’s disease may have a higher risk of birth defects than do babies born to healthy mothers. A connection also exists between hypothyroid pregnancies and heart, brain and kidney problems in infants. If you’re planning to get pregnant or if you’re in early pregnancy, be sure to have your thyroid level checked.
How Is This Condition Treated?
There has not been identified yet a permanent cure for Hashimoto’s. However, replacing hormones with medication can help a lot in regulating hormone levels and restore the normal metabolism. Your doctor will monitor your evolution and will prescribe you the pills depending on a number of factors:
- severity of hypothyroidism
- other health problems
- other medicines that may interact with synthetic thyroid hormones
As soon as you start the treatment recommended by your doctor, he will monitor your thyroid function with a lab test called thyroid-stimulating hormone (TST). This test will help your doctor check if you get the right dose. Because thyroid hormones act very slowly in the body, it may take a few months for symptoms to go away and your goiter to shrink. However, large goiters that do not improve may make it necessary to remove the thyroid gland.