What is Hashimoto's Thyroiditis: Questions and Answers

Hashimoto's thyroiditis is an autoimmune thyroid disease

What is Hashimoto's thyroiditis?

Hashimoto's thyroiditis is an autoimmune disease of the thyroid gland. In autoimmune diseases, your immune system turns on your own organs, cells or tissues that it is supposed to protect. The causes of many autoimmune diseases are not well understood. While around 75 percent of autoimmune diseases occur in women, it remains unclear why these conditions -- including Hashimoto's thyroiditis -- are predominant in women.

In Hashimoto's, the immune system becomes misdirected, and attacks your thyroid gland with antibodies that can cause the gland to enlarge, atrophy, and/or become less able to produce thyroid hormone over time.  

What are the symptoms of Hashimoto's thyroiditis?

Some patients with Hashimoto's thyroiditis may have no symptoms, especially in the earliest stage, when thyroid antibodies become elevated, but other thyroid levels remain within the reference range. Even during this early stage, some patients, however, experience symptoms typical of hypothyroidism that may include fatigue, depression, sensitivity to cold, weight gain, muscle weakness, dry skin, hair loss and breakage, constipation, muscle cramps, menstrual problems, infertility, miscarriage, muscle and joint aches and pains, and an enlarged thyroid gland, known as goiter

What is the difference between Hashimoto's thyroiditis and hypothyroidism?

Hashimoto's thyroiditis is an autoimmune disease of the thyroid gland.

Hypothyroidism refers to a condition where the thyroid is unable to produce enough thyroid hormone. Hashimoto's thyroiditis is the most common cause of hypothyroidism in the United States and many developed countries. 

Is Hashimoto's thyroiditis hereditary?

While autoimmune diseases are themselves not directly inherited, there is evidence that the propensity to develop an autoimmune condition has a genetic component.

This means that research shows that first-degree relatives -- such as parents, children, and siblings -- of those with an autoimmune disease have a somewhat increased risk of themselves developing autoimmune diseases. 

Is Hashimoto's thyroiditis preventable? 

For the most part, there are no known factors that can definitively prevent Hashimoto's thyroiditis. There are factors, however, such as cigarette smoking, unmanaged stress, exposure to radiation, and other thyroid risk factors that you may be able to address to minimize the risk of Hashimoto's disease, or progression of Hashimoto's to hypothyroidism.

How do I know if I have Hashimoto's thyroiditis? 

In addition to a clinical exam, your doctor will run a blood test for thyroid antibodies -- specifically, Thyroid Peroxidase Antibodies (TPO) -- that can help diagnose autoimmune Hashimoto's disease. This will usually be done in conjunction with blood tests to tell if your body has the correct amount of thyroid hormones, typically the blood TSH (Thyroid Stimulating Hormone) to determine if your thyroid hormone levels are in the normal range.

What is the treatment for Hashimoto's thyroiditis? 

The conventional medical view does not offer any specific treatments for Hashimoto's thyroiditis, unless it is accompanied by abnormalities in other thyroid blood levels, such as TSH. The exception is that some endocrinologists do believe that treating thyroid antibodies, even when other levels are normal, may help prevent increases in antibody levels or progression to overt hypothyroidism. Most conventional physicians will, however, only offer treatment if you have hypothyroidism confirmed by blood tests, and not just evidence of Hashimoto's thyroiditis.

The integrative and functional view of Hashimoto's thyroiditis looks at some of the triggers for immune dysfunction, nutritional deficiencies, and other factors that may be causing or driving the Hashimoto's disease. These include:

Some of the integrative and functional medicine treatments for Hashimomto's thyroiditis include a gluten-free diet, iodine testing and supplementation, dietary changes, low dose naltrexone (LDN), and autologous stem cell transplants

The hypothyroidism resulting from Hashimoto's thyroiditis is treated with thyroid hormone replacement drugs, including levothyroxine (Synthroid, Levoxyl, Tirosint, Unithroid), and natural desiccated thyroid (NDT) drugs, such as Armour and Nature-throid. These medications will, in most cases, need to be taken for the rest of the your life. You may have to work with your physician over time to determine the best thyroid medication for you, and the most effective dosage. 

What would happen without treatment for Hashimoto's thyroiditis? 

If left untreated, Hashimoto's thyroiditis can cause further complications, including changes in menstrual cycles, prevention of ovulation, an increased risk of miscarriage, progression to overt hypothyroidism, and is associated with a slightly increased risk of thyroid cancer.

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