An Overview of Hashimoto’s Disease

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Hashimoto’s disease is the most common type of thyroid disease in the United States and worldwide. Researchers believe incidence is at 3.5 per 1,000 in women per year and 0.8 per 1,000 in men per year. Twin studies have shown Hashimoto’s is quite common in twins, as genetics play a central role in the development of this condition.

Symptoms

Hashimoto’s comes in two different types—goiter and hypothyroidism.  

With a goiter, the thyroid becomes inflamed and enlarged to the point that a person develops a goiter, appearing as a visible bulge in the front of the neck. The goiter may be painful over time and without treatment, it may interfere with swallowing and breathing.

Hypothyroidism impairs the thyroid’s ability to produce enough thyroid hormone. And without enough thyroid hormone, the body cannot function correctly.

It quite possible for someone to have Hashimoto’s for a number of years and not know because they are not experiencing symptoms. But the disease does eventually bring about symptoms and it is important to recognize these in order to get effective treatment for this condition.

Common Symptoms

Hashimoto’s may cause the following symptoms: 

  • Weight gain
  • Fatigue
  • Cold sensitivity
  • Concentration troubles
  • Dry skin, hair and nails and thinning hair
  • Stomach troubles, especially constipation
  • Drowsiness
  • Joint and muscle pain and stiffness
  • Heavy menstrual flow
  • Depression
  • Puffiness in face and eyes
  • Slow heartbeat
  • Problems with getting pregnant

Anyone who is experiencing one or more of these symptoms for many weeks should talk to their doctor about getting their thyroid levels checked and/or determine a cause for symptoms.

Causes and Risk Factors

Because Hashimoto’s disease is an autoimmune disease, it causes white blood cells and certain antibodies to attack the thyroid. Scientists don’t know why this happens but believe genetics play a role.

Common Risk Factors

  • Autoimmune diseases: Having at least one autoimmune disease, such as Graves’ disease, lupus, or type 1 diabetes.
  • Age: The risk for Hashimoto’s increases with age and the highest risk is after age 50.
  • Ethnicity: Caucasians have the highest risk for developing Hashimoto’s over other races.
  • Gender: Women have a much higher risk for Hashimoto’s than do males. Pregnancy and menopause might be to blame.
  • Medications: Certain medications, especially those containing iodine, may increase a person’s risk for Hashimoto’s disease.
  • Smoking: Smoking increases the risk for thyroid diseases, especially Hashimoto’s. Certain chemicals in cigarette smoking are harmful to the thyroid.

Diagnosis

A doctor may suspect Hashimoto’s if a person experiences some of the symptoms associated with the condition. Blood work can check a person’s thyroid-stimulating hormone (TSH) levels. TSH levels are highest when thyroid hormone activity is low because the body is working harder to produce more thyroid hormone.

Additional blood work may help to confirm a diagnosis, including testing for antibodies and other thyroid hormones. If a person does not have antibodies in their blood, an ultrasound can show the size of the thyroid and look for thyroid nodules—small lumps in the thyroid gland.

Treatment

Most people with Hashimoto’s will need medication. However, if a person’s thyroid is still functioning normally, a "watch-and-wait" approach is taken.   

One of the most common medications prescribed for people whose thyroid isn’t producing enough hormone is Levothyroxine. This medication is a synthetic hormone that mimics thyroxine, the missing hormone. Levothyroxine medication has few side effects and most people who take it will need to for their entire lives.

Any side effects of Levothyroxine tend to be mild and usually go away within a few days or a couple of weeks. If side effects are severe or don’t go away, it is a good idea to talk to a doctor.

The goal of treatment is to return thyroid hormone levels back to normal, so symptoms disappear. Hormone levels will be monitored with blood work and medications will be adjusted as needed. 

It is important to tell your doctor about all the medications and supplements you are taking, as some medications and supplements affect the body’s ability to absorb the drug. Moreover, certain foods may affect absorption, so it is important to discuss with a doctor the best ways to incorporate thyroid medications into your diet.

Complications

Hashimoto’s increases a person’s risk for a number of autoimmune diseases. And because of this increased risk, it is a good idea to talk to a doctor about managing risks. Management may include periodic testing to assist with early treatment. 

Hashimoto’s disease may increase the risk for a type of thyroid cancer called thyroid lymphoma. If found early, it is treatable and curable. Therefore, it is important to pay attention to any thyroid nodules that may develop and have them examined by a doctor.

A Word From Verywell

Hashimoto’s disease is a lifelong condition with no cure. And while there is no way to prevent the condition, it is very treatable and the sooner a person is diagnosed, the sooner they can start treatment. 

The prognosis for someone with Hashimoto’s is usually good with the right treatment. Getting thyroid hormone levels back to normal will reverse symptoms. But without proper treatment, Hashimoto’s can worsen and lead to severe illness and organ and tissue damage.

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Article Sources
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