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Hashimoto’s Disease (Hashimoto’s Thyroiditis)

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OVERVIEW

What is Hashimoto’s disease?

Hashimoto’s disease (also called Hashimoto’s Thyroiditis) is an autoimmune disease that affects your thyroid gland. The thyroid gland is located in the front of your neck, just below your Adam’s apple. It makes hormones that control metabolism. This includes things like your heart rate and how quickly you burn calories. When you have Hashimoto’s disease, your immune system begins to attack your thyroid gland. This causes it to become swollen and irritated. When this happens, your thyroid can’t make hormones as it normally does.

SYMPTOMS

Many people who have Hashimoto’s disease have no symptoms at all. If the disease does enough damage to the thyroid, it can cause hypothyroidism (underactive thyroid disease). This is because the attack on the thyroid causes the gland to produce fewer hormones. Symptoms of Hashimoto’s disease include:

  • Fatigue
  • Weight gain
  • Increased sensitivity to cold
  • Joint and muscle pain or stiffness.
  • Pale, dry skin
  • Puffy face
  • Hoarse voice
  • Constipation
  • Heavier than normal periods
  • Elevated cholesterol
  • Depression
  • Visibly enlarged thyroid
  • Forgetfulness or memory problems

CAUSES & RISK FACTORS

What causes Hashimoto’s disease?

Hashimoto’s disease is an autoimmune disease. Normally, the immune system produces antibodies. These help protect the body against viruses, bacteria, and other foreign substances. Sometimes your immune system produces antibodies that attack your body’s tissues and/or organs. This is an autoimmune disease. When you have Hashimoto’s disease, these antibodies attack your thyroid. Healthcare providers are not sure why people get this disease.

Who gets Hashimoto’s disease?

Although Hashimoto’s disease can affect people of all ages, it’s most common in women who are between 30 and 50 years of age. If someone in your family has had thyroid disease, you may have an increased risk for Hashimoto’s disease.

DIAGNOSIS & TESTS

Your healthcare provider may do a physical exam. They may ask about your symptoms and your medical history. They will order blood tests that can tell if your thyroid gland is working properly. The tests can measure hormone levels to check for Hashimoto’s disease.

Your healthcare provider may also order imaging tests. These could include an ultrasound or CT scan. These tests allow your healthcare provider to see images of your thyroid gland to look for problems. Imaging tests are usually not needed to diagnose Hashimoto’s disease.

PREVENTION

Can Hashimoto’s disease be prevented or avoided?

There is no known way to prevent or avoid Hashimoto’s disease.

TREATMENT

Hashimoto’s disease has no cure. But it can be treated with medicine. This will minimize any long-term effects. It is treated with a synthetic thyroid hormone.  This hormone replaces the hormones your thyroid gland usually makes. The medicine is taken daily in pill form. It regulates hormone levels and shifts your metabolism back to normal. It will also lower your low-density lipoprotein (LDL) cholesterol and may help reverse weight gain. The thyroid medicine can replace the hormones your thyroid gland usually makes.  For most people, taking thyroid hormone medicine causes no problems.

To help prevent symptoms, always take your thyroid medicine. Also get regular blood tests to see how your thyroid gland is working. Some medicines, supplements, and foods may affect your body’s ability to absorb the synthetic thyroid hormone. Tell your healthcare provider if you:

  • Eat large amounts of soy products,
  • Are on a high fibre diet,
  • Take other medicines such as iron supplements, calcium supplements, cholestyramine, or aluminum hydroxide (found in some antacids).

Living with Hashimoto’s disease

Hashimoto’s disease often stays stable for many years. If it does progress to hypothyroidism, it is easily treated.

If you are diagnosed with Hashimoto’s disease and plan to become pregnant, you should talk to your healthcare provider. Hypothyroidism can affect both you and your baby if left untreated. You’ll need to be careful and watch for symptoms of hypothyroidism throughout your pregnancy. Thyroid medicines are generally safe to take during pregnancy.

This information provides a general overview and may not apply to everyone. Talk to your healthcare provider to find out if this information applies to you and to get more information on this subject.

Contributed by familydoctor.org editorial staff.

Copyright (c) by the American Academy of Family Physicians

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, April 2024

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