Hashimoto’s Disease: Things You Should Know

February 8, 2017

Hashimoto’s disease is a condition caused by chronic inflammation of the thyroid gland. The resulting inflammation often leads to hypothyroidism, an underactive thyroid gland. The condition is also known as chronic lymphocytic thyroiditis or autoimmune thyroiditis. The most common cause of hypothyroidism is Hashimoto’s disease.

The thyroid gland, located in front of your neck just below the voice box (larynx) produces two hormones namely thyroxine (T4) and triiodothyronine (T3) that regulate body metabolism.

The thyroid is a small, butterfly-shaped gland located in the front of the neck that produces hormones, notably thyroxine (T4) and triiodothyronine (T3), which stimulate vital processes in every part of the body. These thyroid hormones have a major impact on the following functions –

  • Growth
  • Use of energy and oxygen
  • Heat production
  • Fertility
  • The use of vitamins, proteins, carbohydrates, fats, electrolytes, and water
  • Immune regulation in the intestine

These hormones can also alter the actions of other hormones and drugs.

With Hashimoto’s disease, the immune system makes antibodies that damage thyroid cells and interfere with their ability to make thyroid hormone. Over time, thyroid damage can cause thyroid hormone levels to be too low. This is called an underactive thyroid or hypothyroidism (heye-poh-THEYE-royd-ism). An underactive thyroid causes every function of the body to slow down, such as heart rate, brain function, and the rate your body turns food into energy. Hashimoto’s disease is the most common cause of an underactive thyroid. It is closely related to Graves’ disease, another autoimmune disease affecting the thyroid.

Who’s at Risk?

Genes – Some people are prone to Hashimoto’s disease because of their genes. Researchers are working to find the gene or genes involved.

Gender – Sex hormones also might play a role. This may help to explain why Hashimoto’s disease affects more women than men.

Pregnancy – Pregnancy affects the thyroid. Some women have thyroid problems after having a baby, which usually go away. But about 20 percent of these women develop Hashimoto’s disease in later years. This suggests that pregnancy might trigger thyroid disease in some women.

Too much iodine and some drugs may trigger the onset of thyroid disease in people prone to getting it.

Radiation exposure has been shown to bring on autoimmune thyroid disease. This includes radiation from the atomic bomb in Japan, the nuclear accident at Chernobyl, and radiation treatment of Hodgkin’s disease (a type of blood cancer).

Causes

Hashimoto’s thyroiditis is an autoimmune disease. The patient’s own immune system creates antibodies that attack and damage the thyroid gland.

Our immune system is designed to protect us against harmful invaders, such as viruses, bacteria, parasites and fungi. In patents with Hashimoto’s thyroiditis, their immune system mistakenly recognizes normal thyroid gland cells as harmful, foreign tissue and attacks them.

Experts are not sure why the immune system becomes activated in such a way. Some suggest that perhaps a virus or bacterium may play or role, maybe a genetic fault, or possibly a combination. So far, none of these environmental or genetic factors have been compellingly proven to be the cause of Hashimoto’s thyroiditis.

Symptoms

Many people with Hashimoto’s disease have no symptoms for years. An enlarged thyroid, called a goiter, is often the first sign of disease. The goiter may cause the front of the neck to look swollen. You or your doctor may notice the goiter. If large, it may cause a feeling of fullness in the throat or make it hard to swallow. It rarely causes pain.

Many people with Hashimoto’s disease develop an underactive thyroid. They may have mild or no symptoms at first. But symptoms tend to worsen over time. Symptoms of an underactive thyroid include –

  • Fatigue
  • Weight gain
  • Pale, puffy face
  • Feeling cold
  • Joint and muscle pain
  • Constipation
  • Dry, thinning hair
  • Heavy menstrual flow or irregular periods
  • Depression
  • A slowed heart rate
  • Problems getting pregnant

Treatment

Medication – Some medications and supplements may interfere with levothyroxine absorption. Some foods may affect absorption as well, including soy products or very high fiber foods.

The following medications and supplements may interfere with proper levothyroxine absorption –

  • Blood thinners, such as warfarin
  • Estrogen-containing medications, such as birth control pills
  • Sodium polystyrene sulfonate
  • Antacids that contain aluminum hydroxide
  • Calcium supplements
  • Iron supplements (many multivitamins contain iron)
  • Some cholesterol-lowering drugs, such as cholestyramine

Synthetic hormone treatment – For patients with goiter or hypothyroidism, thyroid hormone therapy is required. The patient needs to take one tablet of levothyroxine each day. People with an underlying heart disease or severe hypothyroidism start off on a low dose which is gradually increased.

The treatment may take a few months before any improvements in symptoms are noticed. There may be some hair loss during the first few months of treatment. This effect is temporary.

Alternative Treatment

Lithium – Prescription lithium carbonate is well known to cause hypothyroidism. Small studies have shown that lithium carbonate is also effective at controlling symptoms of hyperthyroidism. There are also case reports where patients who were prescribed lithium for other reasons and went on to develop Hashimoto’s disease remained asymptomatic while on lithium

Selenium – A dose of slenium may show effective in reducing symptoms of Hashimoto’s disease, including ophthalmopathy.

Carnitine – L-carnitine helps to improve symptoms of hyperthyroidism.

Probiotics like acidophilus – These can help the immune system as well.

Omega-3 Fatty Acids – Omega-3s such as those that are found in fish oil decrease inflammation and improve immunity.

Iodine – Iodine is a vital nutrient in the body and essential to thyroid function; thyroid hormones are comprised of iodine. While autoimmune disease is the primary cause of thyroid dysfunction in the United States, iodine deficiency is the main cause worldwide.

Vitamin D – Hyperthyroidism, particularly Graves’ disease and Hashimoto’s disease, is known to cause bone loss, which is compounded by the vitamin D deficiency commonly found in people with hyperthyroidism. This bone mass can be regained with treatment for hyperthyroidism, and experts suggest that adequate bone-building nutrients, such as vitamin D, are particularly important during and after treatment.

  • Goitrogens – Cruciferous vegetables such as broccoli, cauliflower, and cabbage naturally release a compound called goitrin when they’re hydrolyzed, or broken down. Goitrin can interfere with the synthesis of thyroid hormones. Soy is another potential goitrogen

 

Reference –

http://www.medicalnewstoday.com/articles/266780.php

http://womenshealth.gov/publications/our-publications/fact-sheet/hashimoto-disease.html

http://www.thyroidawareness.com/hashimotos

http://www.healthline.com/health/chronic-thyroiditis-hashimotos-disease#Overview1

http://www.nytimes.com/health/guides/disease/chronic-thyroiditis-hashimotos-disease/print.html

http://emedicine.medscape.com/article/120937-overview

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/thyroid-hashimotos-disease

https://www.aace.com/files/hashimotos.pdf