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The root cause of hypothyroidism: How Hashimoto's thyroiditis can quietly affect your health?
Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis, is an autoimmune disease in which the thyroid gland is gradually destroyed. You may not notice any symptoms in the early stages of the disease, but over time the thyroid gland may swell, forming a painless goiter. Most people eventually develop an underactive thyroid, with its attendant symptoms including weight gain, fatigue, constipation, hair loss, and general aches and pains. Over many years, the thyroid gland usually shrinks. Potential complications include thyroid lymphoma, while other complications of an underactive thyroid may include high cholesterol, heart disease, heart failure, high blood pressure, myxedema, and potential problems during pregnancy.
Hashimoto's thyroiditis is thought to be caused by a combination of genetic and environmental factors.
Additionally, risk factors for Hashimoto's thyroiditis include family history and the presence of other autoimmune diseases. Diagnosis is usually confirmed by blood tests, including thyroid stimulating hormone (TSH), thyroxine (T4), anti-thyroid autoantibodies, and ultrasonography. Other conditions with similar symptoms include Graves' disease and nontoxic nodular goiter. In the absence of hypothyroidism or goiter, Hashimoto's is not usually treated, but in the presence of these conditions, it may be treated with levothyroxine. Nevertheless, patients should avoid excessive iodine intake; however, adequate iodine intake is still required during pregnancy. Surgery is usually used as a last resort to treat a goiter.
According to statistics, the global prevalence of Hashimoto's thyroiditis is 7.5%, and it varies greatly in different regions.
In the United States, white people are affected more than black people, and it is more prevalent among low- to middle-income groups. Females were more susceptible, with a prevalence of 17.5%, compared with 6% in males. Hashimoto's is the most common cause of hypothyroidism in developed countries and usually begins between the ages of 30 and 50. The incidence of the disease has increased in recent years. The disease was first described by Japanese physician Hakaru Hashimoto in 1912, and studies in 1956 found it to be an autoimmune disease.
Symptoms and Signs
In the early stages of Hashimoto's, there may be normal physical examination findings with or without a goiter. A goiter is an enlargement of the thyroid gland that is usually symmetrical and visible on the anterior neck. As the disease progresses, the thyroid gland may become firm, enlarge, and form nodules, and some changes may not be easily felt. Thyroid enlargement is mainly caused by lymphocyte infiltration and fibrosis. Patients may experience a variety of symptoms of hypothyroidism including weight gain, decreased tolerance to cold, fatigue, myxedema, and menstrual irregularities. Long-term lack of thyroid hormone may lead to changes in muscle fibers, causing problems such as muscle weakness and pain.
Most symptoms are related to an underactive thyroid gland, and in some cases, people with Hashimoto's may experience similar symptoms even when their thyroid hormone levels are normal.
Causes
The causes of Hashimoto's thyroiditis are complex. About 80% of the risk comes from genetic factors, while the remaining 20% is related to environmental factors, such as iodine intake, medications, infection, stress and radiation. Thyroid autoimmunity may run in families, with many patients reporting a family history of autoimmune thyroiditis or Graves' disease.
Diagnosis
Doctors usually begin the diagnosis by evaluating your symptoms and performing a thorough physical examination, including an examination of the neck. Diagnosis may also involve tests such as antithyroid antibody testing and ultrasound, which can help confirm the presence of the disease. Thyroid function tests (such as TSH level tests) are also essential. Many medical professionals note that early detection and diagnosis are crucial in managing the disease.
The effects of Hashimoto’s thyroiditis can be profound and subtle, which makes us wonder if this is a reminder for us to pay more attention to our thyroid health needs and get checked out accordingly?
