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Hashimoto's Thyroditis

What is Hashimoto’s Thyroiditis?

In Hashimoto’s, the thyroid is attacked which can cause inflammation of the gland and nodules.  This can also lead to an underproduction of thyroid hormones with additional symptoms.  The symptoms could take years to develop but include:  fatigue, difficulty losing or maintaining weight, brain fog, mood changes, cold hands and feet.  Laboratory tests will usually show high TSH levels in hypothyroidism.  Other conditions with high levels of TSH include:  tumors that produce thyrotropin (lung and breast cancer), Pituitary tumor, hypothyroid patients receiving insufficient thyroid replacement hormone or thyroid hormone resistance. 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.  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.

The most common cause of hypothyroidism is Hashimoto’s thyroiditis, an autoimmune disorder in which the thyroid gland may be destroyed by an immunologic process.  It is the major cause of goiter and hypothyroidism in children and adults.  Hashimoto’s thyroiditis is predominantly a disease of women, with a female to male ratio of 5:1.  The course of the disease varies.  At the onset, only a goiter may be present.  In time, hypothyroidism usually becomes evident.  Although the disorder usually causes hypothyroidism, a hyperthyroid state may develop midcourse in the disease.  The transient hyperthyroid state is caused by leakage of preformed thyroid hormone from damaged cells of the gland. 

 Understanding Hashimoto’s Thyroiditis:

Everything You Need to Know








Who gets this disease?

Hashimoto's disease is about 7 times more common in women than in men. It can occur in teens and young women, but more commonly shows up in middle age. People who get Hashimoto's disease often have family members who have thyroid or other autoimmune diseases. People who get Hashimoto's disease sometimes have other autoimmune diseases, such as:

  • Vitiligo — a disease that destroys the cells that give your skin its color

  • Rheumatoid arthritis — a disease that affects the lining of the joints throughout the body

  • Addison's disease — a disease that affects the adrenal glands, which make hormones that help your body respond to stress and regulate your blood pressure and water and salt balance

  • Type 1 diabetes — a disease that causes blood sugar levels to be too high

  • Graves' disease — a disease that causes the thyroid to make too much thyroid hormone

  • Pernicious anemia — a disease that keeps your body from absorbing vitamin B12 and making enough healthy red blood cells

  • Lupus — a disease that can damage many parts of the body, such as the joints, skin, blood vessels, and other organs


What causes Hashimoto’s Thyroiditis?

Many factors are thought to play a role in getting Hashimoto's disease. These include:

  • 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).

  • Mutations in the PDS gene (Pendred’s syndrome gene)



What is the difference between Hashimoto's thyroiditis and hypothyroidism?

This common question can be confusing to even veteran thyroid patients. Let's clear up the main difference: Hashimoto's thyroiditis is a disease; hypothyroidism is a condition. In the United States, hypothyroidism is most commonly caused by Hashimoto's thyroiditis, but the two terms are not interchangeable. Here is more information to help understand the difference. 




Hashimoto's disease is typically diagnosed by clinical examination that demonstrates one or more of the following findings:

  • Enlargement of your thyroid, known as a goiter

  • High levels of antibodies against thyroglobulin (TG) and thyroid peroxidase (TPO), detected via blood test

  • Fine needle aspiration of your thyroid (also known as a needle biopsy), which shows lymphocytes and macrophages

  • A radioactive uptake scan, which would show diffuse uptake in your enlarged thyroid gland

  • Ultrasound, which would show an enlarged thyroid gland

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