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Hashimotos Thyroiditis

Alternate Names

  • chronic lymphocytic thyroiditis

Definition

Hashimoto thyroiditis is a chronic inflammation of the thyroid gland. The thyroid gland is in the front of the neck just below the Adam's apple. It secretes thyroid hormone, which is important in metabolism throughout the body.

What is going on in the body?

Hashimoto thyroiditis is considered an autoimmune disease. This means that a person's immune system attacks his or her own body. No one knows why this happens. With this disease, the immune system attacks the thyroid gland. This can cause thyroid hormone imbalances.
Hashimoto's thyroiditis is one of the most common causes of a low thyroid hormone level, called hypothyroidism.

Risks

What are the causes and risks of the disease?

The exact cause of Hashimoto thyroiditis is not known. As with all autoimmune disorders, the immune system abnormally attacks the body. Hashimoto thyroiditis also occurs more often in people who have other autoimmune disorders and diabetes.

Prevention

What can be done to prevent the disease?

Nothing can be done to prevent the disease because the exact cause is not understood.

Diagnosed

How is the disease diagnosed?

The healthcare professional will take a medical history and complete a physical examination. He or she will usually order blood tests, including:
  • thyroid function tests
  • a complete blood count, also known as CBC
Additional blood tests or special X-ray tests can usually confirm the diagnosis of Hashimoto thyroiditis.
Sometimes a thyroid fine needle biopsy may be needed. To do a biopsy, the healthcare professional will take a small sample of the thyroid gland with a special needle that he or she inserts through the skin. A healthcare professional (such as a pathologist) can look at this sample under a microscope to make the diagnosis.

Long Term Effects

What are the long-term effects of the disease?

Hashimoto thyroiditis often causes low thyroid hormone levels, called hypothyroidism. This condition may be permanent. This means that the person may need to take thyroid hormone replacement medicine for the rest of his or her life.

Other Risks

What are the risks to others?

There are no risks to others, as this disease is not contagious.

Treatments

What are the treatments for the disease?

Treatment generally focuses on managing the level of thyroid hormone.
If the level is low, as it is in most cases, the healthcare professional will prescribe thyroid hormone pills.
If the thyroid level is high, the healthcare professional will prescribe medicines that block thyroid hormone from working in the body.
Rarely, surgery may be needed if the thyroid gland gets too big.

Side Effects

What are the side effects of the treatments?

All medicines have side effects. If too much thyroid medicine is given, the levels can become toxic.
Medicines used to treat abnormal thyroid levels may cause:
  • allergic reactions
  • stomach upset
  • other side effects
Surgery carries the following risks:
  • bleeding
  • infection
  • a reaction to the anesthesia

After Treatment

What happens after treatment for the disease?

A person with Hashimoto thyroiditis often requires monitoring and treatment for life.

Monitor

How is the disease monitored?

Periodic thyroid function tests and visits to the healthcare professional are recommended to monitor the course of the disease. Any new or worsening symptoms should be reported to the healthcare professional as well.

Sources

Cecil's Textbook of Medicine, 1996, Bennett et al.

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