Hashimoto: What is it, Causes, Symptoms and Treatment

Hashimoto’s disease is a disorder that affects the thyroid gland. This disease, also called Hashimoto’s thyroiditis, causes the thyroid gland to underfunction.

What is Hashimoto’s Disease?

Hashimoto’s disease; It is an autoimmune disease that causes underactive thyroid glands, that is, hypothyroidism. It is the most common disease that causes hypothyroidism.

The thyroid is a butterfly-shaped organ located in the front of the neck. Thyroid glands are responsible for the synthesis of thyroid hormones and these glands are part of the endocrine system.

Thyroid hormones affect metabolism in the body. Failure to produce enough of these hormones causes problems in many areas, from heart rhythm to calorie burning.

What are the symptoms of Hashimoto?

Hashimoto patients may not have any signs or symptoms in the early stages, but they may also experience an enlargement of the thyroid gland. This growth occurs in the front part of the neck, just below the Adam’s apple.

Hashimoto’s disease develops slowly over years and causes chronic damage to the thyroid tissue. The main reason is that the body recognizes the thyroid gland as a foreign tissue and tries to destroy it. It does this through substances called antibodies that it produces against the thyroid gland. Damaged thyroid tissue cannot synthesize enough hormones. As a result, thyroid hormone levels in the blood decrease. This condition, called hypothyroidism, causes many symptoms in different parts of the body.

Symptoms of hypothyroidism

• Fatigue, drowsiness
• Becoming intolerant to cold, feeling very cold
• Constipation
• Pale, dry skin
• Swollen, edematous face
• brittle nails
• Hair loss
• language growth
• unintentional weight gain
• Muscle pain, muscle tenderness and stiffness
• Joint pain and stiffness
• muscle weakness
• Heavy or prolonged menstrual periods
• Depression
• It can be considered as forgetfulness.

What Causes Hashimoto’s?

Hashimoto’s disease is an autoimmune disease. In Hashimoto’s disease, the patient’s immune system produces antibodies against the thyroid gland, which it should normally produce against foreign tissues in the body. It is not yet fully understood why the immune system sees the thyroid gland as foreign and produces antibodies against it. However, it is thought that genetic and environmental factors play a role together in the development of the disease.

There are some factors that pose a risk for Hashimoto’s disease. These factors:

• Gender: Hashimoto’s disease is more common in women than in men.
• Age: Hashimoto’s thyroiditis can affect people of all ages, but this disease is especially common in people in the middle age group.
• Genetics: People with a family history of Hashimoto’s or another autoimmune disease have an increased risk of developing Hashimoto’s thyroiditis.
• Radiation Exposure: People who are exposed to a lot of environmental radiation are more likely to develop Hashimoto’s.

How to Diagnose Hashimoto?

People who consult a doctor with complaints such as dry skin, constipation, extreme fatigue, deepening or hoarseness in the voice are usually evaluated for Hashimoto’s disease.

The patient’s signs and symptoms are very important in diagnosing Hashimoto’s disease. If the patient’s symptoms suggest Hashimoto’s thyroiditis, a blood test is performed. In the blood test, the patient’s thyroid hormone levels are checked. In addition to these hormones, the levels of the hormone called TSH, which is secreted from the pituitary gland and stimulates the thyroid gland, are also checked with a blood test. Tests that can be used in the diagnosis of Hashimoto:

• Hormone Test: In this test, the concentration of both thyroid hormones and TSH is measured in the blood. If the thyroid gland is underactive, thyroid hormone levels will be low. TSH aims to increase hormone production by further stimulating the thyroid gland. In this case, the TSH value increases to stimulate the underactive thyroid gland.
• Antibody Test: Hashimoto’s is an autoimmune disease, which results in the formation of abnormal antibodies in the body. Thyroid peroxidase (TPO) is an enzyme normally found in the thyroid gland and involved in hormone production. In Hashimoto’s disease, TPO antibodies are formed against this enzyme. Anti-Tg antibodies may also be positive. The presence of these antibodies in Hashimoto patients can be demonstrated by blood tests. However, it should be kept in mind that this antibody test is not positive in every Hashimoto patient or that not everyone who tests positive shows symptoms of Hashimoto’s.

The most commonly used method for diagnosing Hashimoto’s disease is hormone testing. This test, which measures thyroid hormones and TSH values, can also be used in drug dose adjustment and treatment follow-up.

What are the symptoms that occur with Hashimoto?

Hashimoto’s disease can cause some health problems if left untreated. Complications that may occur due to Hashimoto:

• Goiter: The thyroid gland, which cannot fully function, is exposed to constant stimulation to work harder. This condition causes the thyroid gland to enlarge, known as goiter. Goiter usually does not cause a major problem. However, some people may be disturbed by the appearance of goiter. Goiters that reach excessive sizes can make swallowing and breathing difficult.
• Heart Diseases: It may cause an increase in LDL levels, defined as “bad” cholesterol, in people with hypothyroidism. High LDL levels increase the risk of heart disease. Additionally, untreated Hashimoto’s disease can lead to heart enlargement and heart failure.
• Mental Problems: Depression, which can be seen in Hashimoto’s disease, can progress and become more severe over time. Hashimoto’s can also cause a slowdown in mental functions. In addition, Hashimoto’s can reduce sexual desire (libido) in both men and women.
• Myxedema: Untreated Hashimoto’s can lead to myxedema, a serious condition that can be life-threatening in the long term. Mental status changes that begin with drowsiness and progress to loss of consciousness may be a symptom of myxedema. Myxedema coma; It can be triggered by exposure to extreme cold, use of sedative medications, infection, and other situations that can stress the body. Myxedema is a health problem that requires urgent medical attention. It is usually observed in elderly individuals with serious respiratory and cardiovascular system diseases.
• Birth Defects: Babies born to mothers with hypothyroidism due to untreated Hashimoto’s disease are more likely to have birth defects than babies born to healthy mothers. These babies are more prone to mental and developmental delays. In pregnancies with hypothyroidism, anomalies such as cleft palate are more common in the baby. These babies may also have problems with the brain, heart and kidneys. For this reason, it would be beneficial for women who plan to become pregnant to have their thyroid hormone levels checked.

How is Hashimoto Treatment?

In Hashimoto’s disease, treatments are applied to increase thyroid hormone levels to normal levels. Hashimoto’s patients are called for check-ups at regular intervals and their hormone levels are monitored.

Hashimoto’s treatment usually continues for life.

Synthetic (artificial) thyroid hormone derivatives are given to patients suffering from hormone deficiency due to Hashimoto’s disease. In this case, levothyroxine is usually used, which must be taken daily. Levothyroxine is the chemical equivalent of the hormone thyroxine, which is normally produced in the thyroid. Symptoms of hypothyroidism can be eliminated with regular use of this medicine.

In order to adjust the levothyroxine dose correctly, the patient’s TSH levels are checked 6-8 weeks after the start of treatment. This process is repeated after each dose change. After adjusting the dose of medication that brings thyroid hormones to normal levels, it is sufficient for the patient to go for a check-up once a year. Excessive use of levothyroxine may cause health problems such as osteoporosis and arrhythmia. Therefore, it is very important to use the drug in the correct dose.

Starting hormone therapy at high doses in patients with coronary heart disease and severe hypothyroidism may cause the body to have difficulty meeting the increasing needs of metabolism. Therefore, it is necessary to start treatment with small doses in these patient groups.

Levothyroxine generally does not cause side effects when used at the correct dose. In order for levothyroxine to have the required effect, it must be used regularly, without skipping doses.

Hashimoto’s disease causes a multitude of signs and symptoms. When the disease is not treated properly, health problems that can have serious consequences occur. For this reason, people who suspect hypothyroidism should contact the nearest health institution and have the necessary check-ups.