Hashimoto thyroiditis is a problem with the immune system that leads to inflammation and damage to the thyroid gland. The thyroid gland is shaped like a butterfly and located in the front of the neck. It makes hormones that control metabolism.
The body makes antibodies to fight germs. In Hashimoto thyroiditis, the body makes antibodies that attack the thyroid. This leads to inflammation and damage of the thyroid. It is not clear why the body begins to make this type of antibody.
Hashimoto thyroiditis is more common in women. It often appears between 30 and 50 years of age.
Factors that may increase the risk of Hashimoto thyroiditis are:
- Having other immune system problems, such as Addison disease, rheumatoid arthritis, and celiac disease
- Having family members with Hashimoto thyroiditis
- Genetic problems, such as Turner syndrome, Down syndrome, Klinefelter syndrome, and Noonan syndrome
- Workplace exposure to ionizing radiation
- Recent childbirth
- High iodine intake
- Selenium deficiency
Symptoms may not be present during early stages of Hashimoto thyroiditis. When symptoms are present, they begin with enlargement of the thyroid gland. The front of the neck may look swollen. This enlargement of the gland is called a goiter.
Other symptoms may include:
- Underactive thyroid (hypothyroidism) symptoms:
- Weight gain
- Difficulty tolerating cold temperatures
- Facial puffiness
- Dry skin
- Hair loss
- A hoarse throat
- Overactive thyroid (hyperthyroidism) symptoms:
- Rapid heart beat
- Weight loss
- Difficulty sleeping
The doctor will ask about symptoms and past health. A physical exam will be done.
Blood tests will be done to check for anti-thyroid antibodies and thyroid function.
Pictures of the thyroid gland may be taken. This can be done with an ultrasound.
Not everybody with Hashimoto thyroiditis will need treatment. Regular blood tests and exams will be done to look for any changes.
In others, the goal of treatment is to replace the missing hormone that the thyroid gland cannot make. This can be done with medicine. It may take time to find the dose that works best.
In some people, thyroid tissue may grow to try to meet hormone needs. This can lead to a goiter. Surgery may be needed to remove the extra tissue or the entire thyroid.
There is no known way to prevent Hashimoto thyroiditis. It is caused by a problem with the immune system.
- Hashimoto thyroiditis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hashimoto-thyroiditis.
- Hashimoto’s disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease.
- Hashimoto’s thyroiditis (lymphocytic thyroiditis). American Thyroid Association website. Available at: https://www.thyroid.org/hashimotos-thyroiditis/.
- Hashimoto’s thyroiditis overview. EndocrineWeb website. Available at: https://www.endocrineweb.com/conditions/hashimotos-thyroiditis/hashimotos-thyroiditis-overview.
- Elizabeth Margaret Prusak, MD
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