Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis, is an autoimmune disease characterized by the destruction of the thyroid gland by cell and antibody-mediated immune responses. Its symptoms initially indicate the features of hyperthyroidism and gradually changes to hypothyroidism.

Factors which may contribute to the risk of developing Hashimoto's disease are:

• Gender: Women are more likely to get affected than men
• Age: It can occur at any age, more commonly occurs during middle age
• Heredity: There is an increase in risk if others in the family have thyroid or other autoimmune diseases
• Other autoimmune diseases: Having another autoimmune disease, such as rheumatoid arthritis, type 1 diabetes or lupus, increases the risk

The common symptoms of Hashimoto’s thyroiditis are:

• Weight gain
• Fatigue
• Paleness or puffiness of the face
• Joint and muscle pain
• Constipation
• Inability to get warm
• Difficulty getting pregnant
• Joint and muscle pain
• Hair loss or thinning, brittle hair
• Irregular or heavy menstrual periods
• Depression
• Slow heart rate

The usual investigations asked by the doctor are:

1. Thyroid profile: It consists of TSH (Thyroid stimulating hormone), T3 and T4 tests. The test results would be similar to hypothyroidism if the TSH levels are raised and hyperthyroidism if decreased or in the lower normal range.
2. Thyroid autoantibodies: Anti-thyroid peroxidase and anti-microsomal antibodies would be raised in this condition
3. Ultrasonography of the gland
4. Fine needle aspiration cytology
5. Iodine uptake (RAIU) test and thyroid scan

The treatment for Hashimoto thyroiditis is thyroid hormone replacement. The drug of choice is orally administering levothyroxine sodium, usually for life, and regular monitoring of the TSH levels.