Hashimoto's thyroiditis | |
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Other names | Chronic lymphocytic thyroiditis, autoimmune thyroiditis, struma lymphomatosa, Hashimoto's disease |
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The thyroid of someone with Hashimoto's thyroiditis as seen with a microscope at low magnification | |
Specialty | Endocrinology |
Symptoms | Painless goiter, weight gain, feeling tired, constipation, depression, dry skin, hair loss[1] |
Complications | Thyroid lymphoma.[2] |
Usual onset | 30–50 years old[1][3] |
Causes | Genetic and environmental factors.[4] |
Risk factors | Family history, another autoimmune disease[1] |
Diagnostic method | TSH, T4, anti-thyroid autoantibodies[1] |
Differential diagnosis | Graves' disease, nontoxic nodular goiter[5] |
Treatment | Levothyroxine, surgery[1][5] |
Frequency | 2% at some point[4] |
Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis and Hashimoto's disease, is an autoimmune disease in which the thyroid gland is gradually destroyed.[1][6] A slightly broader term is autoimmune thyroiditis, identical other than that it is also used to describe a similar condition without a goiter.[7][8]
Early on, symptoms may not be noticed.[1] Over time, the thyroid may enlarge, forming a painless goiter.[1] Some people eventually develop hypothyroidism with accompanying weight gain, fatigue, constipation, depression, hair loss, and general pains.[1] After many years the thyroid typically shrinks in size.[1] Potential complications include thyroid lymphoma.[2] Furthermore, because it is common for untreated patients of Hashimoto's to develop hypothyroidism, further complications can include, but are not limited to, high cholesterol, heart disease, heart failure, high blood pressure, myxedema, and potential pregnancy problems.[9]
Hashimoto's thyroiditis is thought to be due to a combination of genetic and environmental factors.[4] Risk factors include a family history of the condition and having another autoimmune disease.[1] Diagnosis is confirmed with blood tests for TSH, T4, and antithyroid autoantibodies.[1] Other conditions that can produce similar symptoms include Graves' disease and nontoxic nodular goiter.[5]
Hashimoto's thyroiditis is typically treated with levothyroxine.[1][10] If hypothyroidism is not present, some may recommend no treatment, while others may treat to try to reduce the size of the goiter.[1][11] Those affected should avoid eating large amounts of iodine; however, sufficient iodine is required especially during pregnancy.[1] Surgery is rarely required to treat the goiter.[5]
Hashimoto's thyroiditis affects about 5% of Caucasians at some point in their lives.[4] It is the most common cause of hypothyroidism in iodine-sufficient areas of the world.[12] It typically begins between the ages of 30 and 50 and is much more common in women than men.[1][3] Rates of the disease appear to be increasing.[5] It was first described by the Japanese physician Hakaru Hashimoto in 1912.[13] In 1957, it was recognized as an autoimmune disorder.[14]
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