Hashimoto's thyroiditis is an autoimmune disease that affects the thyroid tissue. In autoimmune diseases, the immune system targets healthy parts of the body instead of just harmful cells.
The cause of the disease lies in the body's own defense system. This mistakenly fights the thyroid tissue, causing it damage. This leads to chronic inflammation of the thyroid gland, which in turn leads to hypothyroidism.
At the same time, Hashimoto's is the most common form of thyroid inflammation. Women suffer from Hashimoto's thyroiditis around nine times more often than men. In most cases, the disease occurs between the ages of 40 and 50. Incidentally, the disease owes its exotic name to its discoverer - the Japanese doctor Hakaru Hashimoto.
The location of the thyroid gland in the neck © SciePro | AdobeStock
The gradual destruction of thyroid tissue leads to hypothyroidism. Those affected experience the associated symptoms very differently. Some patients experience various symptoms even with mild hypothyroidism. Others are symptom-free even with pronounced changes in the thyroid hormone TSH.
The disease usually begins gradually and initially manifests itself through non-specific symptoms. They can affect various areas:
- Metabolism and digestion: general feeling of coldness, rapid weight gain (even with little food), constipation
- Drive and psyche: tiredness, lack of energy, depressive moods
- Cardiovascular system: high blood pressure and slow heartbeat
- Fertility: impotence in men, cycle disorders, reduced fertility, a higher risk of miscarriage in women.
Only very rarely do all the symptoms listed occur in combination in one patient. Often only a few symptoms are in the foreground.
Autoimmune diseases are caused by errors in the body's own defenses. The immune system normally only fights harmful viruses or bacteria. The immune system then forms antibodies against the invaders in order to render them harmless. The body's own defense system also becomes active when individual body cells are severely damaged or infected and need to be eliminated for this reason.
In the case of an autoimmune disease, however, the organism reacts against the body's own healthy tissue. In the case of Hashimoto's disease, this is the thyroid gland.
It is not yet known exactly why this immune system error occurs. Research assumes that a viral or bacterial infection could possibly be the trigger for the autoimmune reaction.
What is certain, however, is that the tendency to develop Hashimoto's thyroiditis is already genetically determined. Relatives of Hashimoto's patients are affected more frequently than the average population.
Other triggers for Hashimoto's can also be
- Environmental influences,
- emotional stress situations and
- an imbalance in the iodine metabolism
metabolism.
Blood tests and imaging procedures are the best means of diagnosing Hashimoto's thyroiditis.
Ultrasound examination
Examination of the thyroid gland by ultrasound(sonography) is painless and quick to perform. It can provide initial indications of the disease.
In the early stages, only minor changes in the tissue structure of the thyroid gland can be seen. These changes become more pronounced over time due to the increasing accumulation of inflammatory cells.
An ultrasound examination of the thyroid gland can provide initial indications of Hashimoto's © Kalim | AdobeStock
Antibodies in the blood
As a rule, elevated thyroid antibody levels in the blood (TPO-AK, Tg-AK, TRAK) can be observed even before changes in thyroid function.
The immune system mistakenly produces so-called TPO antibodies. In addition, antibodies against thyroglobulin, a special protein found in the thyroid gland, can often be found in the blood.
Hormones
The first sign of an underactive thyroid is an increase in the TSH value in the blood.
There are certain threshold values for classifying the TSH value. A TSH value in the range of 2.0 to 3.0 is considered normal, depending on the condition and symptoms. In the case of Hashimoto's and hypothyroidism, the TSH value is usually significantly higher if untreated.
However, a slightly higher or lower TSH value can be the individual "feel-good range". If you want to have children, however, the TSH value should be lower and level off around 1.
The TSH determination is therefore the most important test for detecting an underactive thyroid.
Hashimoto's is treated with the help of medication. Tablets replace the thyroid hormones.
With good medication, many patients can achieve freedom from symptoms. However, the more pronounced the hypothyroidism is and the longer it lasts, the longer it takes to achieve stable medication.
As a rule, Hashimoto's is treated with thyroxine (T4). This is similar to the hormone that is released into the blood by the thyroid gland itself. Thyroxine has hardly any effect on the metabolism. It serves as a depot and is slowly broken down by the body.
Various organs can produce the required amount of the thyroid hormone triiodothyronine (T3) from thyroxine. This is necessary for the metabolism.
In many cases, Hashimoto's progresses without symptoms. The body is then able to maintain the hormone level for a while.
If the inflammation attacks the hormone stores in the thyroid gland, larger quantities of thyroid hormones can enter the bloodstream. This triggers hyperthyroidism.
The tissue of the thyroid gland suffers more and more damage as a result, which further impairs its ability to function. This results in a drop in thyroid hormone levels, which in turn triggers symptoms of hypothyroidism.
Hashimoto's thyroiditis is one of the most common causes of hypothyroidism in adults. To date, this disease cannot be cured. However, with the help of good medication, many patients can achieve freedom from symptoms and the life expectancy of a healthy person.
