Hashimoto's disease, or chronic autoimmune thyroiditis, is an autoimmune disease that causes inflammation of the thyroid gland and a decrease in its function. This disease is one of the most common causes of hypothyroidism, affecting millions of people worldwide. In this article, we will look at the causes, symptoms, diagnosis and treatment options of Hashimoto's disease to help you better understand the disease and how to live with it.

What is Hashimoto's disease?

Hashimoto's disease is an autoimmune disease in which the immune system mistakenly attacks the thyroid gland, causing it to become inflamed and disrupt hormone production. The thyroid gland is responsible for producing the hormones thyroxine (T4) and triiodothyronine (T3), which regulate the body's metabolism and other important functions. In Hashimoto's disease, thyroid tissue is gradually destroyed, causing a lack of hormone production, which in turn causes hypothyroidism.

Hashimoto's disease is more common in women and can develop at any age, although it is most common in middle age. It is one of the most common autoimmune diseases and the most common cause of hypothyroidism.

Hashimoto's disease is named after the Japanese physician Hakaru Hashimoto (1881–1934), who first described the disease in 1912. He conducted research on the inflammatory process of the thyroid gland, which led to the discovery of chronic lymphocytic infiltration of the thyroid gland. Hashimoto's research and description have greatly contributed to the understanding of autoimmune diseases and thyroid disorders, so his name has been retained in the name of the disease in recognition of his contributions to medicine.

The role of the thyroid gland in the body

The thyroid gland is a butterfly-shaped gland located at the front of the neck. It produces two main hormones, thyroxine (T4) and triiodothyronine (T3), which regulate the body's metabolism, energy levels, body temperature, heartbeat and other body functions. Normal thyroid function is essential to maintain the body's energy balance and ensure normal cellular function.

Hashimoto's disease causes a decrease in the production of these hormones, which in turn causes a variety of symptoms and health problems related to a slow metabolism and a lack of energy in the body.

Causes and risk factors of Hashimoto's disease

The development of Hashimoto's disease is associated with several factors that can contribute to autoimmune reactions against thyroid cells:

• Genetic predisposition: Hashimoto's disease is often associated with a family history. If a parent or close relative has had this disease or other autoimmune diseases, the risk is increased.
• Sex and age: Women are about 8 times more likely to develop Hashimoto's disease than men, and the disease is more likely to develop between the ages of 30 and 50.
• Hormonal changes: Fluctuations in hormones, such as during pregnancy, childbirth or menopause, can increase the risk of developing Hashimoto's disease.
• Iodine intake: Excessive or insufficient iodine consumption can contribute to thyroid dysfunction and contribute to the development of Hashimoto's disease.
• Radiation exposure: Exposure to radiation may increase the risk of Hashimoto's disease.

What are the symptoms of Hashimoto's disease?

Symptoms of Hashimoto's disease usually develop gradually and can vary depending on the stage of the disease and the severity of the thyroid disorder. Some of the more common symptoms include:

• Fatigue and lack of energy: Chronic fatigue and loss of energy is one of the most common symptoms of Hashimoto's disease.
• Weight gain: despite normal diet and physical activity, patients may experience weight gain.
• Cold intolerance: patients often experience a constant feeling of coldness and inability to warm up.
• Dry skin and brittle hair: Dry and rough skin as well as brittle hair and nails are typical symptoms of Hashimoto's disease.
• Depression and mood swings: Hormone imbalances can affect mood, causing depression, irritability and anxiety.
• Constipation: A slow metabolism can cause indigestion, including constipation.
• Muscle weakness and pain: Muscle weakness, pain, and stiffness are common symptoms in patients with Hashimoto's disease.
• Swollen face and enlarged thyroid gland (goiter): inflammation of the thyroid gland can cause swelling of the face and the development of goiter.

It is important to consult an endocrinologist or family doctor if symptoms of Hashimoto's disease appear or if a thyroid disorder is suspected. The doctor will be able to examine the examinations performed by the patient, as well as help to choose the most appropriate treatment methods.

Diagnosis of Hashimoto's disease

The diagnosis of Hashimoto's disease includes several examinations that help determine the functioning of the thyroid gland and the presence of autoimmune reactions:

• Blood tests: Thyroid hormone (T3 and T4) levels are checked, as well as thyroid-stimulating hormone (TSH) levels. In Hashimoto's disease, TSH levels are usually elevated (above 4.0 mIU/L), while T3 and T4 levels are decreased (T3 < 80 ng/dL, T4 < 4.5 µg/dL). Antibodies such as anti-TPO (thyroid peroxidase antibodies) are also detected, the elevated level of which (above 35 IU/mL) indicates an autoimmune process.
• Ultrasound examination: A thyroid ultrasound helps to assess the size and structure of the gland and to determine if inflammation or nodules are present.
• Evaluation of health history and symptoms: The doctor considers the patient's health history and symptoms to determine whether Hashimoto's disease is suspected.

It is definitely recommended to discuss the results of blood tests and examinations with an endocrinologist, family doctor, to ensure a quality approach to treatment.

What are the complications of Hashimoto's disease?

Untreated Hashimoto's disease can cause several serious complications that significantly affect the patient's quality of life:

• Hypothyroidism: If Hashimoto's disease is not treated, it can cause severe hypothyroidism, as a result of which the body is unable to produce sufficient amounts of hormones necessary for the body to function normally.
• Goiter: inflammation of the thyroid gland can cause it to enlarge, forming a goiter, which can put pressure on the throat and make it difficult to breathe or swallow.
• Heart problems: Untreated hypothyroidism can lead to high cholesterol, which increases the risk of cardiovascular diseases such as atherosclerosis and heart attack.
• Mental health disorders: Hashimoto's disease can cause depression, reduced concentration, and other mental health problems.

Treatment and control of Hashimoto's disease

Treatment for Hashimoto's disease is aimed at normalizing thyroid hormone levels and reducing symptoms. Treatment options include:

• Hormone replacement therapy: Levothyroxine is a synthetic thyroid hormone used to replace missing hormones. It helps to normalize T4 and T3 levels in the body and reduce the symptoms of hypothyroidism.
• Regular medical monitoring: Patients with Hashimoto's disease require regular check-ups to monitor thyroid hormone levels and adjust the dose according to individual needs. The goal of treatment is to keep hormone levels in the normal range to ensure you feel good and prevent complications.
• Nutritional recommendations: It is important to pay attention to nutrition in patients with Hashimoto's disease. It is recommended to include foods that contain enough iodine, selenium and zinc in the diet. Iodine can be found in seafood and dairy products, selenium is found in Brazil nuts, and zinc is abundant in meat and whole grains. Avoid excessive consumption of soy and cruciferous vegetables, as they can interfere with thyroid function.
• Physical activity: regular physical activity helps to improve metabolism, reduce fatigue and improve general well-being. It is recommended to engage in moderate-intensity physical activities such as walking, cycling or swimming.
• Stress management: Stress can worsen the symptoms of Hashimoto's disease, so it is important to learn stress management techniques such as meditation, yoga or breathing exercises. Reducing stress levels can help stabilize the immune system and reduce disease symptoms.

It is important to consult an endocrinologist or family doctor if symptoms of Hashimoto's disease appear or if a thyroid disorder is suspected. The doctor will be able to examine the examinations performed by the patient, as well as help to choose the most appropriate treatment methods.

Living with Hashimoto's disease

Hashimoto's disease is chronic, but with the right treatment and lifestyle adjustments, it is possible to successfully control symptoms and maintain a good quality of life. It is important to be aware of your health, visit your doctor regularly and follow the prescribed treatment plan. Support groups and family support can also be essential for patients to feel understood and motivated to adhere to treatment.

Additional materials

• Gita Erta: Thyroid underfunction or hypothyroidism(Source: arsts.lv)
• Una Gailiša: The thyroid gland and its diseases (Source: arsts.lv)
• Thyroid dysfunction in psychiatric practice (Source: Doctus)
• Diagnostic mazes of thyroid diseases (Source: Doctus)