The name Hashimoto’s disease may not be as commonly used as common the disease is. Hashimoto’s disease is the name given to the very common thyroid disease. Before getting into details of Hashimoto’s disease knowing about the thyroid gland and its function becomes very important for clear understanding. The thyroid gland is a small bow-tie-shaped organ that is placed just beneath the Adam’s apple in the throat. The thyroid gland secretes thyroid hormone that controls the metabolic rate by activating every cell to produce protein and by increasing the oxygen consumption of cells. Many vital functions of the body like heart rate, respiratory rate, nervous system function, the rate at which our body burns out calories, growth, body temperature, digestion, skin moisture levels, and fertility are maintained by thyroid hormone. Precisely, it takes care of the speed at which the body’s chemical function (metabolic rate) has to take place.
Understanding Hashimoto’s disease
Hashimoto’s disease, which is also called chronic thyroiditis or autoimmune thyroiditis refers to gradual inflammation and swelling of the thyroid gland that result in reduced thyroid function or hypothyroidism. Hypothyroidism refers to the condition where the thyroid gland produces very little thyroid hormone that is insufficient for the body’s metabolic activities. Please note that hypothyroidism is not Hashimoto’s disease, Hashimoto’s disease refers only to the inflammation of the thyroid gland that results in hypothyroidism.
Causes
Hashimoto’s disease is an autoimmune disease, where one’s own body produces antibodies against thyroid cells and damages them, also disrupting their normal function. Production of low thyroid hormone for a long time results in hypothyroidism. The exact reason why the immune system acts against the thyroid gland is not yet known. However, researchers believe that some bacteria or viral infection might trigger the autoimmune reaction and some say that it is because of genetic flaws that run through families. Hashimoto’s disease can affect anyone but it is more common in women than in men.
Risk factors
The risk of developing Hashimoto’s disease increases in women seven times more than in men; it is also found that people between the age group of 40-60 years are at higher risk. The condition runs in families where if one is affected, then the risk of the closest relative being affected increases. People suffering from other disease conditions like Grave’s disease (thyroid gland making too much of thyroid hormone), vitiligo ( a disease that destroys the cells responsible for skin colour), rheumatoid arthritis, Addison’s disease (disease of the adrenal gland), Diabetes type – 1, and pernicious anaemia (anaemia due to inadequate absorption of vitamin B12) are more prone to develop Hashimoto’s disease. In addition, consuming high amounts of iodine also results in Hashimoto’s disease.
Symptoms
Many people suffering from Hashimoto’s disease do not exhibit any symptoms. As the disease progresses over time they show few symptoms that are similar to the symptoms exhibited by hypothyroidism. A few symptoms of Hashimoto’s disease are
- Weight gain
- Fatigue
- Difficulty swallowing
- Slow heart rate
- Enlarged thyroid gland that is visible
- Constipation
- Depression
- Hair loss
- Ache, cramp, tenderness, or stiffness of the muscles
- Increase sensitivity to cold
- Skin turning pale and dry
- Pain, stiffness, and swelling of the joints
- Puffy face
- Hoarse voice
- Excess menstrual bleeding
- Difficulty conceiving
- High level of blood cholesterol
- Forgetfulness
Diagnosis
Diagnosis begins with a simple physical examination looking for the enlarged thyroid gland. In a person with no symptoms, the doctor may perform routine thyroid function tests. A simple blood test will be done to check the levels of TSH (Thyroid-stimulating hormone) and T4 (thyroid hormone). When the thyroid gland fails in its function the pituitary gland produces an excess amount of TSH, to stimulate the production of thyroid hormone (T4) by the thyroid gland. Therefore initially the level of TSH will be slightly increased and the level of T4 will be normal, a condition called clinical hypothyroidism. But over time, the thyroid gland can’t keep going any longer and the level of T4 drops below normal and the level of TSH remains high indicating hypothyroidism.
People who have Hashimoto’s hypothyroidism have a specific kind of autoantibodies in their blood, which is not found in other people who have hypothyroidism due to other causes. A blood test showing the presence of these antibodies confirms Hashimoto’s disease.
Treatment
There is no cure for Hashimoto’s disease. Treatment for Hashimoto’s disease depends on how damaged the thyroid gland is. If there is no hormone deficiency and your thyroid function is normal, then the doctor may go for the wait-and-watch approach or choose to treat for reducing the size of the gland in case of goitre. If the thyroid is not working properly and the TSH is too high, then treatment starts with thyroid replacement therapy, also known as levothyroxine. Taking a daily pill of levothyroxine can help restore thyroid function and get your T4 & TSH levels back to normal. The dosage of the medicine depends on the age, weight, and the severity of hypothyroidism. A routine blood test is done frequently to check the level of thyroid hormone and the dosage of the medicine is adjusted accordingly.
Conclusion
To avoid complications caused by Hashimoto’s disease, the disease must be diagnosed at the earliest and treated effectively. The basic rule to keep the hormone level close to normal is to take medicines properly and have regular check-ups with your doctor.
