Autoimmune thyroiditis in adults
The term “thyroiditis” is translated as inflammation of the thyroid gland. There are many possible variants of the disease, but autoimmune thyroiditis in adults is the most common cause of hypothyroidism in our country.

Thyroiditis is a general term for “inflammation of the thyroid gland”. Thyroiditis includes a group of separate diseases that cause inflammation of the organ, but manifest themselves in different ways. For example, Hashimoto’s thyroiditis is the most common cause of hypothyroidism. Postpartum thyroiditis, which causes temporary thyrotoxicosis (high levels of thyroid hormones in the blood) followed by temporary hypothyroidism, is a common cause of thyroid problems in postpartum women. Subacute thyroiditis is the main cause of thyroid pain. Thyroiditis can also occur in patients taking interferon or amiodarone preparations. But not all of these diseases are classified as autoimmune thyroiditis in adults, some have an infectious or other cause.

The most common form of autoimmune thyroiditis is the so-called Hashimoto’s disease. It can lead to hypothyroidism, when the thyroid gland is severely damaged and gradually stops producing enough hormones to keep the body functioning normally. This pathology is more common in middle-aged women than in men and can cause constant fatigue and weight gain.

What is autoimmune thyroiditis

The thyroid gland is a butterfly-shaped organ in the front of the neck. The thyroid gland produces two hormones, T3 and T4, which control metabolism (how the body converts food into energy) and keep the body working properly.

In thyroiditis, the thyroid gland is damaged, inflammation and damage to the thyroid cells develops. Antibodies that attack the thyroid gland cause most of the known types of thyroiditis. Thus, thyroiditis is often an autoimmune disease such as juvenile diabetes (type 1) and rheumatoid arthritis.

Causes of autoimmune thyroiditis in adults

Scientists don’t know exactly why some people develop antibodies to their own thyroid. However, it has been observed that this disease usually runs in families. Thyroiditis can also be caused by an infection, such as a virus or bacteria, which can also cause the gland to become inflamed. After an infection, the immune system mistakes its own tissues for foreign ones. Finally, drugs such as interferon and amiodarone can also damage thyroid cells and cause thyroiditis. But it is of a different nature.

The most common is Hashimoto’s disease. It is also called Hashimoto’s thyroiditis, chronic lymphocytic thyroiditis, or autoimmune thyroiditis. The disease is common and affects about five people out of 100.

What causes Hashimoto’s disease? This is a classic autoimmune disease: the body’s immune system attacks its own cells and organs. Normally, the immune system protects the body from infections caused by bacteria, viruses, and other harmful substances. In Hashimoto’s disease, the immune system produces antibodies that attack and damage thyroid tissue. As a result, the thyroid gland becomes inflamed and the ability to produce thyroid hormones is impaired, eventually leading to hypothyroidism.

Hashimoto’s thyroiditis is most common in middle-aged women, but can occur at any age and can also affect men and children.

People with other autoimmune diseases are more likely to develop the problem, such as certain liver diseases, B12 deficiency, gluten sensitivity, rheumatoid arthritis, type 1 diabetes, lupus, and Addison’s disease (adrenal gland disease).

Symptoms of autoimmune thyroiditis in adults

Some people may not show symptoms at first. As the disease slowly progresses, the thyroid gland enlarges (a condition called a goiter occurs). A goiter is a common first sign of Hashimoto’s disease. It is painless, but can cause a feeling of fullness in the throat and lead to swelling of the front of the neck.

There are no signs or symptoms unique to Hashimoto’s thyroiditis. Because the condition usually progresses very slowly over many years, people with thyroiditis may not show any early symptoms, even if blood tests show the characteristic anti-thyroid peroxidase (TPO) antibodies. TPO is an enzyme that plays a role in the production of thyroid hormones. If Hashimoto’s thyroiditis causes cellular damage resulting in low thyroid hormone levels, patients will develop symptoms of hypothyroidism over time.

Other symptoms of Hashimoto’s disease and hypothyroidism that develop over time include:

  • fatigue, severe and excessive fatigue;
  • weight gain without any changes in the usual diet;
  • feeling of cold;
  • joint stiffness and muscle pain;
  • constipation (difficulty emptying the bowels);
  • depression;
  • swelling in the eyes and face;
  • dry skin;
  • thinning hair or even hair loss;
  • heavy or irregular periods;
  • problems with pregnancy;
  • memory problems, difficulty thinking or concentrating;
  • slow heartbeat.

Treatment of autoimmune thyroiditis in adults

The diagnosis of Hashimoto’s thyroiditis can be made when patients present with symptoms of hypothyroidism, which is often accompanied by a goiter (enlarged thyroid gland). Diagnosis is made by physical examination along with laboratory tests.

Diagnostics

First, your doctor will review your medical history and perform a physical examination. He will carefully feel the thyroid gland to determine if it is enlarged. Blood tests are also ordered.

Thyroid-stimulating hormone (TSH) test: A high TSH level most often means that the thyroid gland is not producing enough T4 hormone. A decrease in this indicator corresponds to the diagnosis of hypothyroidism or subclinical hypothyroidism.

Definition of free T4: low T4 levels are indicative of hypothyroidism.

Antibodies to thyroperoxidase: anti-TPO antibodies are usually elevated when measured.

Test for antithyroid antibodies to globulin: the presence of antibodies indicates a higher risk of developing Hashimoto’s hypothyroidism.

The most common imaging test that can be performed at any clinic is a thyroid ultrasound. An ultrasound shows the size and appearance of the thyroid gland, as well as the presence of nodules or growths in the neck.

In some patients, the disease can be diagnosed at an early stage, especially in people with a poor family history of thyroid disease. Anti-TPO antibodies may be positive, but thyroid hormone levels may be normal or there may be only a slight increase in serum TSH. There may be no symptoms of hypothyroidism.

Modern treatments

Not everyone with Hashimoto’s disease develops hypothyroidism. Because antibody levels consistent with Hashimoto’s disease are associated with a higher risk of developing hypothyroidism, doctors generally prefer to monitor the condition and monitor for any changes in thyroid health.

If Hashimoto’s disease progresses to hypothyroidism, the standard treatment is a synthetic (artificial) form of a thyroid hormone called levothyroxine. This drug restores normal thyroid function. A person will need to take it every day for the rest of their lives. Yours will explain how to adjust the dose to keep hypothyroidism under control.

Prevention of autoimmune thyroiditis in adults at home

Proper nutrition and a healthy lifestyle, regular exercise, good sleep and stress control can help the immune system. No matter what, if the diagnosis is already made, you will need to continue taking medications to prevent hypothyroidism.

Popular questions and answers

Issues related to hypothyroidism and thyroiditis, we discussed with general practitioner, endoscopist, head of the organizational and methodological office Lidia Golubenko.

Why is autoimmune thyroiditis dangerous?
The most dangerous is hypothyroidism. It occurs when the thyroid gland does not produce enough thyroid hormone to meet the body’s needs because the immune system has damaged it. Thyroid hormones regulate metabolism, that is, the conversion of food into energy. Without enough energy, the body cannot function properly and its functions begin to slow down.
How does hypothyroidism affect the body?
Hypothyroidism can affect emotionally and physically. For example:

● when your metabolism slows down due to hypothyroidism, you end up gaining weight, feeling more tired and losing energy – you may experience blurry thinking and memory problems (hypothyroidism is often mistaken for depression);

● women may develop irregular menstrual cycles and scanty periods, making it harder for them to get pregnant;

● constipation (problems with bowel movement), heartburn and other digestive problems may increase, hypothyroidism can also lead to sexual dysfunction in both men and women;

● slow metabolism can affect almost all parts of the body, worsening other diseases.

What are the complications of autoimmune thyroiditis?
If left untreated, hypothyroidism can lead to serious complications and, in rare cases, death. This includes:

● heart problems, such as an enlarged heart or heart failure;

● mental health problems, including depression;

● Emergency myxedema coma: Myxedema is a rare, life-threatening condition that can lead to heart failure, seizures, coma, and death.

When to call a doctor at home for autoimmune thyroiditis of the thyroid gland?
There is usually no need to call a doctor at home. But if the general condition suffers, it is worth consulting with an endocrinologist to adjust the dose of hormones in order to control the general condition.
Do I need to remove the thyroid gland due to Hashimoto’s disease and hypothyroidism?
No. Since hypothyroidism and Hashimoto’s disease are treated with medication, surgery is not required.
Is there a special diet for people with Hashimoto’s disease?
There is no specific diet for Hashimoto’s, but certain foods, medications, or supplements can affect your ability to absorb levothyroxine, a thyroid medication. These include iron and calcium supplements, sucralfate for ulcers, cholestyramine, and aluminum hydroxide (found in some antacids). Taking these drugs within four hours before or after levothyroxine may solve this problem.

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