Hashimoto’s thyroiditis is an immune disorder that destroys the thyroid gland, causing hypothyroidism and hyperthyroidism. It affects about one in a thousand people, is more common in women, and can cause a wide range of symptoms. It is often misdiagnosed as depression or other psychological disorders. Treatment involves replacing thyroid hormone for life.
Hashimoto’s thyroiditis, also called chronic lymphocytic thyroiditis, is the first disease to be classified as an immune disorder, by Japanese physician Hakaru Hashimoto, in 1912 in Germany. It is characterized by the destruction of the thyroid gland by the body’s immune system. It results in hypothyroidism, or underproduction of thyroid hormones, with brief periods of hyperthyroidism, or overproduction of thyroid hormones.
The causes of Hashimoto’s thyroiditis aren’t well understood, but there is often a genetic component. It affects about one in a thousand people and is ten to 20 times more common in women. Most patients are between 45 and 65 years of age.
Hashimoto’s thyroiditis causes symptoms associated with other thyroid disorders, including weight gain, constipation, abdominal cramps, high cholesterol, low or low blood sugar, tingling sensation in the skin, sensitivity to heat and cold, muscle weakness, fatigue, speed or abnormally slow heartbeat, migraines, hair loss, infertility, memory loss, panic attacks, and mania. If left untreated, it can lead to muscle failure, including heart failure. Thyroid hormone controls the metabolism, or the rate of all processes in the body, so abnormal amounts of the hormone cause a wide variety of problems.
Due to the psychological symptoms, Hashimoto’s thyroiditis is often misdiagnosed as depression, premenstrual syndrome (PMS). It is also sometimes misdiagnosed as bipolar or an anxiety disorder. Identifying anti-thyroid antibodies can help diagnose Hashimoto’s thyroiditis correctly.
Hashimoto’s thyroiditis is treated by replacing thyroid hormone with orally given levothyroxine or dried thyroid extract. The patient must follow the treatment for life in most cases. It is important to maintain the body’s levels of thyroid stimulating hormone, which is secreted by the pituitary gland but controls the production of the thyroid gland. TSH should not exceed 3.0 µIU/mL in a patient with Hashimoto’s thyroiditis, otherwise the increased thyroid activity could cause an antithyroid immune reaction.
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