Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis is the most common autoimmune disease affecting the thyroid. In Hashimoto’s, the body makes antibodies that attack the cells of the thyroid. The thyroid may swell and create a goiter, may become overactive, or may become underactive.
Risk factors for Hashimoto’s thyroiditis are:

  • Being female. Women are about 7 times more likely to have the disease.
  • Middle age. Most cases happen between 40 to 60 years of age. But it has been seen in younger people.
  • Heredity. The disease tends to run in families, although no gene has been found that carries it.
  • Autoimmune diseases. These health problems raise a person’s risk. Some examples are rheumatoid arthritis and type 1 diabetes. Having Hashimoto’s thyroiditis also puts you at higher risk for other autoimmune illnesses.

Symptoms of Hashimoto’s thyroiditis:

Goiter. This is a benign, non-nodular enlargement of the thyroid gland, causing a bulge in the front of the neck.

Overactive thyroid

This phase of Hashimoto’s thyroiditis is not always seen. It can cause these symptoms:

  • Rapid heart rate
  • Sweating
  • Weight loss
  • Tremors
  • Anxiety
  • Tiredness
  • Muscle weakness
  • Weight gain
  • Being hot bothers you

Underactive thyroid

Symptoms of hypothyroidism differ, are often subtle and usually start slowly. They include:

  • Coarse, dry, and thickened skin is the commonest symptom
  • Tiredness (fatigue)
  • Being troubled by cold
  • Altered menses; these may be increased, irregular or even absent.
  • Infertility in either sex
  • Loss of libido, sexual impotence
  • Slow speech
  • Droopy eyelids
  • Puffy and swollen face
  • Weight gain
  • Constipation
  • Sparse, coarse, and dry hair
  • Hand tingling or pain (carpal tunnel syndrome)
  • Slow pulse
  • Muscle cramps
  • Thinning or loss of eyebrows hair
  • Confusion
  • Anemia
  • Hashimoto’s, like any other disease, is diagnosed by history taking, physical exam and lab testing. Blood tests to measure levels of thyroid hormone and anti-thyroid antibodies are essential to correct diagnosis.

    If thyroid hormone levels are normal, therapy may be moot, although such patients benefit from regular testing. When Hashimoto’s thyroiditis creates hyperthyroidism or hypothyroidism, these should be treated. Therapy should stop symptoms and resolve a goiter. A goiter can cause pain in the neck or trouble swallowing, breathing, or speaking. If these symptoms don’t get better, we may suggest surgery to remove the goiter.

    Robert Howe, MD

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