An autoimmune disease that negatively affects the thyroid gland is called Hashimoto’s disease. An organ that is located at the base of the neck, below the Adam’s apple, is called the thyroid. It produces essential hormones that help the body to function properly.
This condition occurs due to an immune system response, in which antibodies attack healthy tissues instead of germs. In people with Hashimoto’s disease, the immunity destroys thyroid cells that make hormones. As a result, hypothyroidism may occur. This is a condition in which the thyroid gland produces fewer hormones than normal.
While anyone may develop this autoimmune condition, it mostly happens in middle-aged females. Usually, doctors recommend thyroid hormone replacement to treat this autoimmune condition. Sometimes, this condition is called Hashimoto’s thyroiditis, chronic lymphocytic thyroiditis, or chronic autoimmune thyroiditis.
Symptoms
Usually, the disease progresses gradually over time, and in early stages, it may not cause symptoms. However, when the condition advances and thyroid hormone levels drop, you may notice any of the following symptoms. For example:
- Fatigue (extreme tiredness)
- Sluggishness
- Dry skin
- Constipation
- Muscle weakness
- Increased sensitivity to cold
- Sleepiness
- Muscle aches, stiffness, or tenderness
- Joint stiffness or even pain
- Irregular or excessive menstrual bleeding
- Mental health problems (such as difficulty concentrating, depression, anxiety, and others)
- A puffy face
- Hair loss
- Tongue enlargement
- Goiter (thyroid gland swelling)
- Memory issues
- Brittle nails
The symptoms of this autoimmune condition vary among people and are not specific to this disease. Previous symptoms may occur due to multiple health conditions. Thus, you should visit a doctor if any of the previous symptoms occur for a diagnosis.
Causes
This is an autoimmune condition, and it happens when the immune system mistakenly attacks healthy thyroid cells instead of bacteria, viruses, and other germs. In other words, the immunity wrongly enlists disease-fighting agents that damage the cells, causing them to die. Experts do not fully understand what exactly causes Hashimoto’s disease. However, they think there is a combination of factors. For example:
- Genetic factors
- Environmental factors (including stress, radiation exposure, infections, and others)
- Interactions between the previous two factors
Risk Factors
While physicians do not know the exact cause of the disease, they have identified some factors that could increase your risk of developing it. Check below some examples:
- Sex – Females are more likely to develop this disease than males.
- Age – While it may happen at any age, it mostly occurs during middle age.
- Other autoimmune conditions – The risk of developing Hashimoto’s disease increases if you have another autoimmune disease. These include rheumatoid arthritis, type 1 diabetes, lupus, or another one.
- Genetics and family history – If you have a parent or sibling with Hashimoto’s disease, your risk of developing significantly increases.
- Pregnancy – Certain changes in the immune function during pregnancy may lead to Hashimoto’s disease, which usually occurs after pregnancy.
- Excessive iodine intake – If you take too much iodine from your diet, it may trigger this autoimmune disease among people at high risk.
- Radiation exposure – The risk of developing Hashimoto’s disease also increases if you are exposed to radiation (such as radiation therapy used to treat cancer).
What Are The Potential Complications of Hashimoto’s Disease?
The hormones produced by the thyroid gland are vital for multiple body systems. People with this autoimmune disease may experience some complications, especially if they leave it untreated. Examples include:
- Goiter – This is a condition in which the thyroid gland becomes enlarged. When the thyroid begins to make fewer hormones, it receives signals from the pituitary gland to produce more. As a result, it becomes enlarged due to extra strain on it. Generally, goiter does not cause serious health problems. However, in some cases, it may interfere with breathing or swallowing.
- Heart issues – People with hypothyroidism (an underactive thyroid gland) may experience some heart problems that often lead to heart muscle enlargement and irregular heartbeats.
- Mental disorders – Most people with Hashimoto’s disease develop depression in the early stages of the autoimmune disease. However, they may develop other mental conditions when the disease worsens.
- Reproductive and sexual dysfunction – Reduced thyroid hormone levels may cause low sex drive, inability to ovulate, and irregular menstrual bleeding. Males with hypothyroidism may develop erectile dysfunction (ED), decreased sperm count, and reduced libido.
- Poor pregnancy results – Furthermore, pregnant women with hypothyroidism are at increased risk of miscarriage or preterm birth. Babies born to women with an untreated underactive thyroid gland are at elevated risk of speech delays, autism, intellectual disability, and other developmental problems.
- Myxedema – This is a rare and life-threatening complication caused by prolonged and severe untreated underactive thyroid gland. The most common symptoms include lethargy, drowsiness, and unconsciousness. Moreover, this complication often is triggered by exposure to colds, sedatives, infections, or other stressful situations. Myxedema is considered a medical emergency that requires immediate treatment.
Diagnosis
There are multiple health conditions that cause similar symptoms to Hashimoto’s disease. That’s why you should visit a doctor for a diagnosis and proper treatment if any of the symptoms associated with this disease occur. Doctors usually begin the diagnosis with a physical examination and questions about your symptoms and medical history.
Thyroid Function Tests
The following tests are used to identify the underactive thyroid gland. These include:
- TSH test – TSH (thyroid stimulating hormone) is produced by the pituitary gland. TSH is released when the pituitary gland detects low thyroid hormones in the blood. Thus, it sends TSH to the thyroid to increase the hormone production. If blood tests show increased TSH levels, it may indicate hypothyroidism.
- T-4 test – Thyroxine (T-4) is the main thyroid hormone. If a blood test shows reduced T-4 levels in the blood, it indicates thyroid gland problems.
Antibody Tests
There are multiple health problems that may cause hypothyroidism. One way to determine whether Hashimoto’s disease causes an underactive thyroid gland or not is through an antibody test. In most cases, people with this autoimmune disorder have thyroid peroxidase (TPO) antibodies in their blood.
Treatment
In most cases, doctors recommend hormone replacement medicines for people with Hashimoto’s disease. Those who have a mild form of hypothyroidism may not need treatment, but should get regular TSH tests to monitor levels of thyroid hormones.
T-4 Hormone Replacement Therapy
Commonly, an underactive thyroid gland caused by Hashimoto’s disease is treated with Levothyroxine (a synthetic hormone). It works like the hormone produced naturally by the thyroid (T-4).
The goal of the treatment is to keep healthy T-4 levels and improve the symptoms. Usually, people take these medicines for the rest of their lives.
Follow carefully the doctor’s recommendations because high T-4 levels may lead to some health problems, including osteoporosis (brittle bones), arrhythmia (irregular heart rhythm), and others.
Effects Caused by Other Substances
There are some foods, supplements, and medicines that may impact the body’s ability to absorb Levothyroxine. Therefore, you should administer the synthetic form of T-4 at least 4 hours before the following substances. For example:
- Soy products
- High-fiber foods
- Iron supplements
- Cholestyramine (a medicine used to treat high cholesterol)
- Aluminum hydroxide
- Sucralfate
- Calcium supplements
T-3 Hormone Replacement Therapy
In normal circumstances, natural T-4 is converted into another hormone called T-3 (triiodothyronine). However, a synthetic form of T-4 is also converted into T-3. When the synthetic form of T-4 is not effective, doctors may prescribe a synthetic form of T-3 or both of them at the same time. It usually helps control the symptoms (including sleeping disturbances, fast heartbeat, anxiety, and others).
Frequently Asked Questions
What is the life expectancy of someone with Hashimoto’s disease?
Those who get treatment for this autoimmune disorder have a normal life expectancy. Without treatment, people with Hashimoto’s disease are at higher risk of heart disease.
What is the best treatment for Hashimoto’s disease?
The main treatment for people with Hashimoto’s disease is thyroid hormone replacement therapy with Levothyroxine (a man-made form of T-4). In severe cases, people may need additional treatments and lifestyle changes, including supplements, dietary changes, other medications, and surgery.
What worsens Hashimoto’s?
Check below some foods that may worsen this autoimmune disorder:
- Soy
- High-glycemic fruits
- Gluten-containing foods
- Processed foods and meats
- Refined grains
- Fast food
- Added sugars and sweets (including energy drinks, cakes, cookies, ice cream, candies, soda, table sugar, and others)
This article does not contain all the factors that may worsen the disease. Ask your healthcare provider if you have additional questions.
