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Hashimoto’s Disease: Symptoms, Diagnosis, and Treatment

Hashimoto's, Hashimoto's Disease, Thyroid Gland, Thyroid Hormones

Hashimoto’s Disease, also known as Hashimoto’s Thyroiditis, Autoimmune Hypothyroiditis, and Chronic Lymphocytic Thyroiditis, is a chronic autoimmune illness wherein the body’s immune system mistakenly attacks the thyroid gland. This attack upon the thyroid gland causes the body to be deficient in thyroid hormones, a condition called “hypothyroidism.” Hypothyroidism causes a variety of troubling symptoms, and if left untreated can damage the body. Hashimoto’s Disease is the leading cause of hypothyroidism in North America today.

The thyroid gland is a part of the endocrine system. It produces two important hormones, thyroxine (called T-4) and triiodothyronine (called T-3). T-4 and T-3 together regulate many of the body’s functions, including temperature and metabolism. When the immune system attacks the thyroid gland, it cannot produce enough of these important hormones, leading to hypothyroidism. Doctors don’t know for sure what causes the immune system to attack the thyroid gland. Some think that the immune system reacts incorrectly to a bacterial or viral infection; some think that Hashimoto’s Disease is genetic. Most agree that it is caused by a combination of factors.

Hashimoto’s Disease is a progressive illness. In the first years of the disease, sufferers may not notice many symptoms. They may feel more tired than usual, feel strange pains, or gain a little bit of weight. Often people dismiss these initial symptoms as products of aging or stress. As Hashimoto’s Disease progresses, however, symptoms can become more numerous and severe. The symptoms of Hashimoto’s Disease include fatigue, muscle and joint pain, weight gain, sensitivity to cold, dry skin and hair, low body temperature, constipation, a puffy face, muscle weakness, excessive or prolonged menstrual periods, and depression. Sufferers may experience “brain fog” and forgetfulness. Without treatment, symptoms will become more severe and the thyroid gland may even become visibly enlarged, causing a swelling in the throat, called “goiter.” If you have several of these symptoms, you may have Hashimoto’s Disease.

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To find out if you have Hashimoto’s Disease, visit an endocrinologist. The guidelines for diagnosis and treatment are constantly revised, and an ordinary internist or general practitioner may not be aware of the new guidelines, or have much experience with the disease. Hashimoto’s Disease is diagnosed using blood tests. The doctor will test for T-3, T-4, and for another hormone called “Thyroid Stimulating Hormone”, or TSH. TSH is produced by the pituitary gland; it tells the thyroid to produce thyroid hormones. The more deficient the thyroid, the more TSH the pituitary will produce. The TSH test gives a doctor an idea of how long the thyroid has been deficient, and the T-4 and T-3 tests give the doctor an idea of how severe the disease has become. The initial tests also give the doctor a baseline against which to compare future tests, to chart the patient’s improvement. The doctor will also test for anti-thyroid antibodies, which are the immune system’s way of attacking the thyroid. A person can have hypothyroidism without having Hashimoto’s Disease.

Hashimoto’s Disease, like other forms of hypothyroidism, is treated by replacing the missing thyroid hormones. Some doctors and patients choose to replace only T-4, while others choose to replace T-4 and T-3. They can be replaced with synthetic medications, or by taking medications made from purified, standardized pig thyroid. The immune attack on the thyroid cannot be treated, so the disease will continue to progress, and the patient will need to take replacement hormones for the rest of his or her life. Without treatment, Hashimoto’s Disease can be debilitating, eventually leading to severe fatigue, severe obesity, chronic digestive problems, miscarriage or even heart failure, so it is important to stay on medication and to see a doctor regularly to monitor the disease.

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