Hashimoto's thyroiditis

"Hashimoto's disease" redirects here. For the encephalopathy, see Hashimoto's encephalopathy.

Hashimoto's thyroiditis
Other namesChronic lymphocytic thyroiditis, autoimmune thyroiditis, struma lymphomatosa, Hashimoto's disease
The thyroid of someone with Hashimoto's thyroiditis as seen with a microscope at low magnification
SpecialtyEndocrinology
SymptomsPainless goiter, weight gain, feeling tired, constipation, depression, dry skin, hair loss[1]
ComplicationsThyroid lymphoma.[2]
Usual onset30–50 years old[1][3]
CausesGenetic and environmental factors.[4]
Risk factorsFamily history, another autoimmune disease[1]
Diagnostic methodTSH, T4, anti-thyroid autoantibodies[1]
Differential diagnosisGraves' disease, nontoxic nodular goiter[5]
TreatmentLevothyroxine, surgery[1][5]
Frequency2% 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 white people of Western European descent 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]

  1. ^ a b c d e f g h i j k l m n o p "Hashimoto's Disease". NIDDK. May 2014. Archived from the original on 22 August 2016. Retrieved 9 August 2016.
  2. ^ a b Noureldine SI, Tufano RP (January 2015). "Association of Hashimoto's thyroiditis and thyroid cancer". Current Opinion in Oncology. 27 (1): 21–25. doi:10.1097/cco.0000000000000150. PMID 25390557. S2CID 32109200.
  3. ^ a b Hiromatsu Y, Satoh H, Amino N (January 2013). "Hashimoto's thyroiditis: history and future outlook". Hormones. 12 (1): 12–18. doi:10.1007/BF03401282. PMID 23624127. S2CID 38996783.
  4. ^ a b c d Pyzik A, Grywalska E, Matyjaszek-Matuszek B, Roliński J (2015). "Immune disorders in Hashimoto's thyroiditis: what do we know so far?". Journal of Immunology Research. 2015: 979167. doi:10.1155/2015/979167. PMC 4426893. PMID 26000316.
  5. ^ a b c d e Akamizu T, Amino N, Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K, Grossman A, Hershman JM, Hofland J, Kaltsas G, Koch C, Kopp P, Korbonits M, McLachlan R, Morley JE, New M, Purnell J, Singer F, Stratakis CA, Trence DL, Wilson DP (2000). "Hashimoto's Thyroiditis". In Akamizu T, Amino N (eds.). Endotext. MDText. PMID 25905412. Archived from the original on 24 September 2020. Retrieved 31 January 2021.
  6. ^ "Hashimoto's disease". Office on Women's Health, U.S. Department of Health and Human Services. 12 June 2017. Archived from the original on 28 July 2017. Retrieved 17 July 2017.Public Domain This article incorporates text from this source, which is in the public domain.
  7. ^ Dayan Dayan, Colin M, Dayan, Colin M., Gilbert H. Daniels (1996). "Chronic Autoimmune Thyroiditis". The New England Journal of Medicine. 335 (2): 99–107. doi:10.1056/nejm199607113350206. PMID 8649497.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. ^ "Autoimmune thyroiditis". Autoimmune Registry Inc. Archived from the original on 25 February 2020. Retrieved 15 June 2022.
  9. ^ "Hashimoto's Disease | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Archived from the original on 8 December 2021. Retrieved 28 November 2021.
  10. ^ "Hashimoto Thyroiditis – Endocrine and Metabolic Disorders". Merck Manuals Professional Edition. July 2016. Archived from the original on 31 December 2017. Retrieved 30 December 2017.
  11. ^ "Hashimoto Thyroiditis – Hormonal and Metabolic Disorders". Merck Manuals Consumer Version. Archived from the original on 30 December 2017. Retrieved 30 December 2017.
  12. ^ Cite error: The named reference :6a was invoked but never defined (see the help page).
  13. ^ Shoenfeld Y, Cervera R, Gershwin ME, eds. (2010). Diagnostic Criteria in Autoimmune Diseases. Springer Science & Business Media. p. 216. ISBN 978-1-60327-285-8.
  14. ^ Moore EA, Wilkinson S (2009). The Promise of Low Dose Naltrexone Therapy: Potential Benefits in Cancer, Autoimmune, Neurological and Infectious Disorders. McFarland. p. 30. ISBN 978-0-7864-5258-3.