Chronic thyroiditis (Hashimoto disease)
Chronic thyroiditis is caused by a reaction of the immune system against the thyroid gland. It often results in reduced thyroid function (hypothyroidism).
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....
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Do you feel tired and weak? Well, there could be many reasons for that, but a slow, underactive thyroid may be your problem. Let's talk about hypothyroidism - also known as Slow Thyroid. Here's the thyroid. It's this butterfly shaped gland in your neck - just below the voice box. The thyroid gland is known as the master gland of the body. It regulates our metabolism, so we don't act slow, like turtles, or fast, like jackrabbits. This gland releases hormones that control many important things, like helping your heart pump blood, stimulating your brain and muscles, and helping you keep your body at a healthy temperature. When you have hypothyroidism, your thyroid gland does not make enough hormone, so you end up feeling a bit slow, and perhaps cold, like the turtle. So, what causes a slow thyroid? For at least 9 out of 10 folks, the cause is something called Hashimoto's thyroiditis -- It's what we call an autoimmune condition, where, for reasons that we don't quite understand, our own body attacks perfectly good thyroid tissue as though it were a foreign invader. This attack damages the thyroid gland, so much, that it can't put out enough hormone. This attack happens much more often in women than in men, 10 and 20 times more often. Also, some women develop this condition soon after pregnancy, Why that happens? Nobody knows for sure! So, how do you feel if you have a slow thyroid? If it's just mildly slow, you might not feel anything at all, that's called subclinical hypothyroidism. On the other hand, you might be experiencing symptoms of a slow thyroid RIGHT NOW, but you just haven't connected the dots. You might have mild fatigue, memory or concentration problems. You may have a decreased sex drive, or have trouble losing weight. If you have hypothyroidism, the main treatment is to use a synthetic form of T4 hormone, called Levothyroxine, that simply replaces what your body isn't producing. After starting hormone replacement, your hormone levels should be checked about every 6 weeks, to make sure you are maintaining normal levels. It's important to remember that treating hypothyroidism does not cure the problem, it only controls it. And once you're on Thyroid hormone replacement, you're probably on it for life. The good news is that once your thyroid situation is properly regulated, you'll probably feel a whole lot better.
The disorder is also called Hashimoto disease.
The thyroid gland is located in the neck, just above where your collarbones meet in the middle.
Causes
Hashimoto disease is a common thyroid gland disorder. It can occur at any age, but is most often seen in middle-aged women. It is caused by a reaction of the immune system against the thyroid gland.
Reaction of the immune system
An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...
Read Article Now Book Mark ArticleThe disease begins slowly. It may take months or even years for the condition to be detected and for thyroid hormone levels to become lower than normal. Hashimoto disease is most common in people with a family history of thyroid disease.
In rare cases, the disease may be related to other hormone problems caused by the immune system. It can occur with poor adrenal function and type 1 diabetes. In these cases, the condition is called type 2 polyglandular autoimmune syndrome (PGA II).
Rarely (usually in children), Hashimoto disease occurs as part of a condition called type 1 polyglandular autoimmune syndrome (PGA I), along with:
- Poor function of the adrenal glands
- Fungal infections of the mouth and nails
- Underactive parathyroid gland
Symptoms
Symptoms of Hashimoto disease may include any of the following:
- Constipation
- Difficulty concentrating or thinking
- Dry skin
- Enlarged neck or presence of a goiter, which may be the only early symptom
Goiter
A simple goiter is an enlargement of the thyroid gland. It is usually not a tumor or cancer.
Read Article Now Book Mark Article - Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Hair loss
- Heavy or irregular menstrual periods
- Intolerance to cold
Intolerance to cold
Cold intolerance is an abnormal sensitivity to a cold environment or cold temperatures.
Read Article Now Book Mark Article - Mild weight gain
- Mood changes
- Small or shrunken thyroid gland (late in the disease)
Exams and Tests
Laboratory tests to determine thyroid function include:
- Free T4 test
Free T4 test
T4 (thyroxine) is the main hormone produced by the thyroid gland. A laboratory test can be done to measure the amount of free T4 in your blood. Fre...
Read Article Now Book Mark Article - Serum TSH
Serum TSH
A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It prompts the thyroid g...
Read Article Now Book Mark Article - Thyroid autoantibodies
Thyroid autoantibodies
Thyroid peroxidase is a type of protein (called an enzyme) that cells in the thyroid gland use to make thyroid hormone. If these enzymes leak out in...
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Imaging studies and fine needle biopsy are generally not needed to diagnose Hashimoto thyroiditis.
This disease may also change the results of the following tests:
- Complete blood count
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark Article - Serum prolactin
Serum prolactin
Prolactin is a hormone released by the pituitary gland. The prolactin test measures the amount of prolactin in the blood.
Read Article Now Book Mark Article - Serum sodium
Serum sodium
The sodium blood test measures the concentration of sodium in the blood. Sodium can also be measured using a urine test.
Read Article Now Book Mark Article - Total cholesterol
Untreated hypothyroidism can change how your body uses medicines that you may take for other conditions, such as epilepsy. You'll likely need to have regular blood tests to check the levels of the medicines in your body.
Treatment
If you have findings of an underactive thyroid, you may receive thyroid replacement medicine.
Not everyone with thyroiditis or goiter has low levels of thyroid hormone. You may just need regular follow-up by a health care provider.
Outlook (Prognosis)
The disease stays stable for years. If it does slowly progress to thyroid hormone deficiency (hypothyroidism), it can be treated with hormone replacement therapy.
Possible Complications
This condition can occur with other autoimmune disorders. In rare cases, thyroid cancer or thyroid lymphoma may develop.
Severe untreated hypothyroidism can lead to a change in consciousness, coma, and death. This usually occurs if people get an infection, are injured, or take medicines, such as opioids.
When to Contact a Medical Professional
Contact your provider if you develop symptoms of chronic thyroiditis or hypothyroidism.
Prevention
There is no known way to prevent this disorder. Being aware of risk factors may allow earlier diagnosis and treatment.
Reviewed By
Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Jonklaas J. Hypothyroidism. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 74.
Pearce EN, Hollenberg AN. Thyroid. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 207.
Wassner AJ, Smith JR. Hypothyroidism. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 581.