ภาวะต่อมไทรอยด์อักเสบเรื้อรัง (Hashimoto’s Disease) อาการ สาเหตุ การตรวจวินิจฉัยและการรักษาภาวะต่อมไทรอยด์อักเสบเรื้อรัง - Hashimotos disease

Hashimoto’s Disease

Hashimoto’s disease or chronic lymphocytic thyroiditis occurs when thyroid, a small gland located at the base of the throat, is attacked by the immune system and gets inflamed.

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Hashimoto’s Disease

Hashimoto’s disease or chronic lymphocytic thyroiditis occurs when the thyroid, a small gland located at the base of the throat, is attacked by the immune system and gets inflamed. The thyroid gland is a part of the endocrine system providing hormones that are consistent with many of the body’s functions.

The inflammation of the thyroid often causes hypothyroidism, an underactive thyroid gland. Middle-aged women are most commonly affected by the disease. However, Hashimoto’s disease can occur in either women or men of any age. To detect the disease, the doctor may examine your thyroid function. Hormone replacement is a common treatment for Hashimoto’s disease.

Symptoms

The signs and symptoms of Hashimoto’s disease may not be noticed at the beginning. However, people with the disease may notice a swelling at the front of the throat or goiter. This inflammatory disease generally develops slowly over time and causes chronic damage to the thyroid. This leads to a decrease in hormone levels in the blood. The other signs and symptoms of Hashimoto’s disease may also include:

  • Joint pain and stiffness
  • Muscle aches, tenderness, and stiffness
  • Muscle weakness
  • Pale and dry skin
  • Fatigue and sluggishness
  • Gaining sensitivity to cold
  • Constipation
  • A puffy face
  • Brittle nails
  • Hair loss
  • Enlargement of the tongue
  • Unexplained weight gain
  • Excessive or prolonged menstrual bleeding
  • Memory lapses
  • Depression

When to see the doctor

Consult the doctor if you notice some changes such as a pale and puffy face, dry skin, constipation, or unexplained tiredness. You may also raise your awareness of the disease if you:

  • have had thyroid surgery.
  • have had treatment with antithyroid medications and radioactive iodine.
  • have had radiation therapy to the head, neck, or upper chest.
  • have high blood pressure.
  • are currently receiving hormone therapy for hypothyroidism.

Causes

Hashimoto’s disease is a kind of autoimmune system disorder. Antibodies that are created by the immune system damage the thyroid gland. The reason for this activity is still unknown but a virus and bacteria are considered impossible triggers as well as a genetic flaw. Moreover, gender, age, and heredity tend to promote the development of the disorder.

Risk factors

The risk factors of Hashimoto’s disease may include:

  • Age. Women have a higher risk of being involved with the disease.
  • Gender. Hashimoto’s disease tends to occur in people in middle age more than other ages. However, the disease can occur at any age.
  • Heredity. People whose family members have been involved with thyroid or other autoimmune diseases tend to tend to Hashimoto’s disease.
  • Other immune disease. The risk of Hashimoto’s disease increases in people who have other autoimmune diseases such as rheumatoid arthritis, lupus, or type 1 diabetes.
  • Radiation exposure. People who have had radiation exposure are inclined to have Hashimoto’s disease.

Complications

Hashimoto’s disease may cause other health problems including:

  • Goiter. The inflamed thyroid gland is enlarged and commonly causes an enlarged goiter which may affect swallowing or breathing.
  • Hear problem. The risk of heart disease is increased due to high levels of low-density lipoprotein (LDL) cholesterol. This may cause an enlarged heart and heart failure.
  • Mental health issues. People with Hashimoto’s disease may have depression that might become severe over time. Other mental issues such as an increased sexual desire (libido) may occur in some cases.
  • Myxedema. Untreated hypothyroid might lead to myxedema, a rare condition causing drowsiness which may be followed by profound lethargy and unconsciousness. People with myxedema may experience exposure to colds, sedatives, infection, or other problems as signs of the condition. At this stage, immediate emergency medical treatment is required.
  • Birth defects. Babies born to women with untreated hypothyroidism tend to have more health problems than those born with a healthy mother. The health problems may include heart, brain, and kidney problems in infants. Women with the disease who are planning to get pregnant are highly recommended to consult the doctor for more details.

Diagnosis

After reviewing the signs and symptoms, the doctor may conduct some tests aiming to measure the levels of thyroid hormone and thyroid-stimulating hormone (TSH). The tests may include a hormone test and an antibody test.

Treatment

The treatment for Hashimoto’s disease may include observation and use of long-term medications. Other treatments may include:

  • Synthetic hormones. Hormone replacement therapy may also take place if the disease causes thyroid hormone deficiency.
  • Monitoring the dosage of medications. Receiving the correct dosage of medication is very important. The doctor will monitor the dosage of medication to determine the effectiveness of the medications. The dosage may be changed according to the condition of the patient.

Preparing for the appointment

Before your appointment, you may:

  • Be aware of the restrictions before the appointment.
  • Make a list of the signs and symptoms you have experienced.
  • Make a list of your personal information including changes in the menstrual cycle, libido, and sex life.
  • Make a list of all medications and supplements you are consuming.
  • Make a list of the questions that you want to ask the doctor.

During the consulting, the doctor may ask some questions including information such as:

  • currently changes in your body
  • the symptoms that you are experiencing
  • the beginning of the symptoms
  • changes of your habits including sex life
  • your recent mental health
  • treatments that you may have tried
  • the history of your family member who may be involved with thyroid disease

Published: 25 Oct 2020

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