Do you sometimes feel tired, lethargic, or just a little sad? Are you gaining weight? Or do you feel like the front of your neck is a little swollen? These could be symptoms of a condition called Hashimoto's disease. Hearing this name may scare you a little. But don't be afraid. Today, we will talk about Hashimoto's Disease in detail and very simply.
What is Hashimoto's Disease?
Simply put, Hashimoto's disease is a condition caused by a small problem in our own immune system, the system that protects us from disease. What happens in this case is that our own defense cells attack our thyroid gland. When this happens over time, the thyroid gland cannot function properly, and the amount of hormones it produces decreases. We call this condition hypothyroidism . Hashimoto's disease is a lifelong, chronic condition.
What is the thyroid gland? How is it important for our body?
The thyroid gland is a small, butterfly-shaped gland located in the front of your neck, just under the skin. It is part of our endocrine system . It produces thyroid hormones and secretes them into the blood.
The main function of the thyroid gland is to control the rate of our body's metabolism . Metabolism is the process by which the food we eat is converted into energy. We usually think of this only in terms of weight gain or loss, but in fact this process affects every organ in our body, including our heart and brain.
What really happens in Hashimoto's disease?
In many people with Hashimoto's disease, the thyroid gland is unable to produce enough thyroid hormones for the body. As a result, the aforementioned metabolic process begins to slow down. That's when the symptoms begin to appear.
This disease was first discovered in 1912 by a Japanese doctor named Dr. Hakaru Hashimoto. That is why it is called Hashimoto's disease. It is also known by other names:
- Hashimoto thyroiditis
- Chronic autoimmune thyroiditis
- Lymphocytic thyroiditis
How common is Hashimoto's disease? Who is most likely to get it?
Hashimoto's disease is a very common disease . According to statistics in some countries, it can affect up to 5 out of 100 people.
In countries where iodine-added salt and other iodine-rich foods are common, Hashimoto's disease is the leading cause of hypothyroidism. In other countries, iodine deficiency is the leading cause.
Who gets it? Anyone can get Hashimoto's disease at any age. However, women are about 10 times more likely to develop the disease than men . It is most commonly diagnosed in women between the ages of 30 and 50.
What are the symptoms of Hashimoto's disease? How do you feel?
Some people may have Hashimoto's disease but not show any symptoms in the early stages.
As the disease progresses, the thyroid gland can sometimes become swollen. This is called a goiter . This is often the first sign of Hashimoto's disease. It is not painful, but it can feel like something is full in the lower part of the neck. The front of the neck may also appear swollen.
If thyroid hormones are reduced due to Hashimoto's disease (Hypothyroidism), over time, the following symptoms may appear:
- Drowsiness, excessive fatigue, and a constant need to sleep.
- A little weight gain.
- Constipation.
- Dry skin.
- Inability to bear the cold.
- A heart rate that is slower than normal (Bradycardia).
- Joint pain and muscle pain.
- Dry hair, hair breakage, reduced hair growth or hair loss.
- Decreased happiness, depressed mood.
- Swelling of the eyes and face.
- Decreased memory, difficulty concentrating.
- Irregular menstrual cycles or heavy bleeding in women.
- Decreased libido.
- Infertility in either male or female.
How does someone with Hashimoto's usually feel?
Even if you have Hashimoto's disease, if your thyroid hormones are low (hypothyroidism), you may not notice much difference.
However, if you have hypothyroidism, you may feel like "something is wrong." "Hypo-" means "less" or "under." So you can think of the symptoms of hypothyroidism as a "slowing down" of various processes in the body.
You may feel less energetic than you used to, and you may not be able to exercise as much as you used to. If you use a fitness tracker, your heart rate may seem lower than it used to. You may experience brain fog, and it may be hard to remember things. Hypothyroidism can also "slow down" your mood - you may feel sad and depressed. It can also reduce your sex drive and slow down your digestive system - meaning you may not have bowel movements as often as you used to.
If your body and mind feel like they're stuck in a slow-motion movie, definitely talk to your doctor.
Why does Hashimoto's disease occur? What are the risk factors?
Cause: A malfunction in our own defense system (Autoimmune Disease)
Hashimoto's is an autoimmune disease . That means your body's own immune system attacks your own cells and organs. Imagine it, like the army that is supposed to protect our country is attacking our country.
Normally, our immune system protects us from harmful things like bacteria and viruses. But in Hashimoto's disease, this is what happens:
- Your immune system, for some unknown reason, produces antibodies that attack your thyroid tissue.
- A large number of white blood cells, especially lymphocytes , accumulate inside the thyroid gland.
- This accumulation causes inflammation of the thyroid gland, or thyroiditis , and damages the gland.
- Over time, this damage causes the thyroid gland to be unable to produce enough thyroid hormones for the body. This is what causes `Hypothyroidism`.
- However, not everyone with Hashimoto's disease develops hypothyroidism.
Things that increase risk
There are several factors that increase the risk of developing Hashimoto's disease:
- Family history: Research has shown that about 80% of your risk of developing Hashimoto's disease is due to genetics. If your blood relatives have Hashimoto's disease or other thyroid diseases, you are more likely to develop it too.
- Gender: Women are about 10 times more likely to develop this condition than men. The influence of sex hormones may also be a factor.
- Age: The risk of developing this disease (and other thyroid diseases) increases with age.
Also, you are at higher risk of developing Hashimoto's if you have other autoimmune diseases, such as:
- Addison's disease
- Celiac disease
- Lupus
- Pernicious anemia
- Rheumatoid arthritis
- Sjögren's syndrome
- Type 1 diabetes
How is Hashimoto's disease diagnosed?
Your doctor will first do these things:
- I'm asking about your symptoms.
- Ask about your medical history (like whether anyone in your family has thyroid problems).
- A physical examination will be performed, during which your thyroid gland will be manually examined.
After this assessment, they will order several blood tests to confirm the diagnosis:
- Thyroid Stimulating Hormone Test (TSH test): A high TSH level usually means that your thyroid gland is not producing enough thyroxine (T4) hormone. This result indicates that you have either hypothyroidism or subclinical hypothyroidism (a condition where there are no symptoms, but there are changes in hormone levels).
- Free Thyroxine (Free T4) test: Low T4 levels are another indication that you have hypothyroidism.
- Antithyroid antibody test: If you have certain autoantibodies in your blood, it indicates that the cause of your hypothyroidism is not something else like iodine deficiency, but Hashimoto's disease.
In some cases, your doctor may also recommend a thyroid ultrasound to check the size of the thyroid gland and to check for thyroid nodules (small lumps that form on the gland).
What are the treatments for Hashimoto's disease?
Does everyone need medicine?
Not everyone with Hashimoto's disease develops hypothyroidism. If your blood antibody levels are high but you don't have clinical signs of hypothyroidism, your doctor will monitor your thyroid levels regularly instead of starting treatment.
Main treatment: Levothyroxine
If you have hypothyroidism due to Hashimoto's disease, the main treatment is a medication called levothyroxine . This is a synthetic form of the T4 hormone produced by your thyroid gland.
Levothyroxine is available under different brand names. Your doctor will prescribe the right one for you.
This medicine helps restore the thyroid hormone levels in your body. You will need to take it every day for the rest of your life . Over time, the dose of medicine you need to take may change. Your doctor will know how to adjust the dose to best manage your hypothyroidism.
Does Levothyroxine have side effects?
If you are experiencing side effects from levothyroxine, it is likely that you are taking too much. This can lead to a condition called thyrotoxicosis – an increase in thyroid hormones.
The symptoms of thyrotoxicosis are:
- Rapid heartbeat (Tachycardia) – usually more than 100 beats per minute.
- Irregular heartbeat (Arrhythmia).
- Unexplained weight loss.
- Feeling like your body is shaking.
- Restlessness, anxiety, irritability.
- Increased sensitivity to heat and sweating more than usual.
- Changes in the menstrual cycle.
If you experience symptoms like these, you should tell your doctor immediately.
Do people with Hashimoto's disease need a special diet?
There is no specific diet for Hashimoto's disease. However, some foods, medications, or supplements may affect the absorption of levothyroxine you take. For example:
- Iron and calcium supplements.
- Sucralfate (a medicine for stomach ulcers).
- Cholestyramine and aluminum hydroxide (found in some antacids).
This problem can be avoided if you take these four hours before or after taking levothyroxine.
If you have any questions about food, talk to your doctor or a Registered Dietitian.
Eating well and living a healthy lifestyle (exercising, getting enough sleep, managing stress) will help your immune system. However, if you have hypothyroidism, it is essential to take your medication properly no matter what.
Can Hashimoto's disease be completely cured? Can it be prevented?
Unfortunately, there is no cure or way to reverse Hashimoto's disease. However, lifelong medication can help manage hypothyroidism and thyroid hormone levels.
Unfortunately, there is nothing we can do to prevent Hashimoto's disease because we cannot change the risk factors that affect it - things like genes and age.
What are the possible complications of living with Hashimoto's disease?
With proper monitoring and treatment throughout life, people with Hashimoto's disease can maintain a very good health.
However, if hypothyroidism caused by Hashimoto's disease is left untreated, the following health problems can occur:
- High cholesterol.
- Heart disease and heart failure.
- High blood pressure.
- Depression.
- Myxedema coma . This is a rare, life-threatening complication of severe hypothyroidism. The body's functions slow down so much that it can even lead to death.
Hashimoto's disease during pregnancy
If hypothyroidism is left untreated during pregnancy, the following risks may increase:
- Miscarriage.
- Premature birth.
- Stillbirth.
Or, you may develop a condition called preeclampsia, which is a dangerously high blood pressure late in pregnancy. Untreated hypothyroidism can affect the growth and brain development of your unborn baby. Therefore, your doctors will help you manage your hypothyroidism well during pregnancy.
Hypothyroidism is not uncommon during pregnancy. However, its symptoms (such as fatigue and weight gain) are similar to those seen during normal pregnancy, so it can sometimes be missed. If you feel like you have symptoms of hypothyroidism, or if you think you may be developing a goiter, tell your doctor right away.
When should I see a doctor? What is an emergency?
Regular medical appointments
If you have Hashimoto's disease, you will need to see your doctor regularly . He or she will do blood tests to check that your thyroid hormone levels are normal and that the dosage of medication you are taking is right for you.
Additionally, see your doctor if you develop new symptoms, if your existing symptoms get worse, or if you notice any changes in your thyroid gland (e.g., swelling).
Cases requiring immediate hospitalization (Myxedema Coma)
If you experience symptoms of myxedema coma , call 911 or go to an emergency room as soon as possible. This severe complication of hypothyroidism is life-threatening!
Those characteristics are:
- Hypothermia is a drop in body temperature below 35 degrees Celsius (95 degrees Fahrenheit).
- Swelling (edema) in the body, especially in the face, tongue, and lower legs.
- Very slow heart rate and weak pulse.
- Slow breathing (Bradypnea) and difficulty breathing (Dyspnea).
- Confusion or loss of consciousness.
Finally, a few things to keep in mind (Take-Home Message)
It's normal to feel a little stressed and scared when you receive a new diagnosis. But the good news is that Hashimoto's is a well-managed and treatable disease .
If you think you may have symptoms of Hashimoto's, or if you have risk factors, such as a family history of thyroid disease, be sure to see your doctor. They can run some simple tests to see if your thyroid is producing enough hormones. Remember, the sooner it's detected, the sooner treatment can begin. Then you can live a healthy, comfortable life.
` Hashimoto's disease, thyroid, hypothyroidism, autoimmune diseases, thyroid hormones, levothyroxine, goiter
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