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Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis and Hashimoto's disease, is an autoimmune disease in which the thyroid gland is gradually destroyed. Early on there may be no symptoms. Over time the thyroid may enlarge forming a painless goiter. Some people eventually develop hypothyroidism with its accompanying weight gain, feeling tired, constipation, depression, and general pains. Hashimoto's thyroiditis is thought to be due to a combination of genetic and environmental factors. Risk factors include a family history of the condition and having another autoimmune disease. Diagnosis is confirmed with blood tests for thyroid-stimulating hormone (TSH) and antibodies against the enzyme thyroid peroxidase (TPO).

Signs and Symptoms

Individuals with Hashimoto's thyroiditis may not have any symptoms at first. As the disease slowly progresses, the thyroid may become enlarged, a condition known as a goiter. Symptoms of hypothyroidism, a condition resulting from an underactive thyroid, may then appear, including:

• Fatigue
• Weight gain
• Cold intolerance
• Joint and muscle pain
• Constipation
• Dry skin
• Hair loss
• Depression
• Memory lapses or forgetfulness

Causes

Hashimoto's thyroiditis is an autoimmune condition, which means it is caused by the immune system attacking the thyroid gland. The exact cause of this autoimmune reaction is unknown, but it is believed to involve a combination of genetic and environmental factors. A family history of Hashimoto's or other autoimmune diseases can increase the risk, as can certain environmental factors, such as exposure to radiation.

Diagnosis

Diagnosis of Hashimoto's thyroiditis is based on symptoms, physical examination, and blood tests. Blood tests will check levels of thyroid-stimulating hormone (TSH) and the presence of antibodies against thyroid peroxidase (TPO). High levels of TSH and TPO antibodies are indicative of Hashimoto's thyroiditis.

Treatment

There is no cure for Hashimoto's thyroiditis, but the condition can be managed with thyroid hormone replacement therapy. This involves taking a synthetic thyroid hormone, such as levothyroxine, to restore normal hormone levels. Treatment is typically lifelong. Regular monitoring of thyroid function tests is necessary to ensure proper dosing of the medication.

Epidemiology

Hashimoto's thyroiditis is the most common cause of hypothyroidism in areas of the world where iodine levels are sufficient. It is much more common in women than in men and can occur at any age, but it is most common in middle-aged women.

See Also

• Autoimmune thyroiditis
• Hypothyroidism
• Goiter
• Thyroid
• Autoimmune disease

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