Autoimmune thyroiditis ( Hashimoto's thyroiditis ) - Causes, Symptoms and Treatment .MF .
Autoimmune thyroiditis - this is one of the most common diseases of the thyroid gland (6-10 every woman over age 60 suffer from this disease).Often the diagnosis is in patient anxiety, which leads them to the doctor-endocrinologist.I would like to reassure the right: a benign disease, and if you do the advice of your physician, you have nothing to fear.
This disease was first described by a Japanese scientist Hashimoto.Therefore, the second name of the disease - Hashimoto's thyroiditis.Although in reality, Hashimoto's thyroiditis - this is only one type of autoimmune thyroiditis.
What is Hashimoto's thyroiditis?Autoimmune thyroiditis - a chronic disease of the thyroid gland, which results in the destruction (destruction) of thyroid cells (follicles) due to the impact of antithyroid autoantibodies.
Causes autoimmune thyroiditis
What are the causes of the disease?Why does it occur?
1. Immediately it should be noted that your guilt in causing disease is not present.There is a genetic predispositi
2. In addition, the emergence of the disease often contributes transferred on the eve of stress.
3. Noticed dependence of the frequency of the disease by age and sex of the patient.For women it occurs much more frequently than men.According to different authors, women are 4-10 times more likely to put this diagnosis.Autoimmune thyroiditis most often occurs at middle age from 30-50 years.Now often this disease occurs at an earlier age: Hashimoto's thyroiditis is also found in adolescents and children of all ages.
4. Environmental pollution, poor environmental situation in the place of residence may contribute to the development of autoimmune thyroiditis.
5. Infectious agents (bacterial, viral diseases) may also be the triggering factor for the development of autoimmune thyroiditis.
important systems of our body's with you - it is the immune system.It is responsible for recognition of foreign agents, including microorganisms, and prevents their penetration and development in humans.As a result of stress, genetic predisposition when available, in a number of other reasons there is a failure in the immune system: it begins to confuse "their" and "foreign".And he starts to attack "their".Such diseases are called autoimmune.This is a large group of diseases.In the body, the immune system cells - lymphocytes produce so-called antibodies - proteins that are produced in the body and are directed against his own body.In the case of autoimmune thyroiditis, develop antibodies to the thyroid cells - antithyroid autoantibodies.They cause the destruction of thyroid cells and, therefore, can develop later hypothyroidism - low thyroid function.Given the mechanism of the disease, there is also another name for autoimmune thyroiditis - a chronic lymphocytic thyroiditis.
Symptoms of autoimmune thyroiditis
What kind of clinical picture of the disease?What are the symptoms of the disease should lead you to the doctor-endocrinologist?
Immediately it should be noted that autoimmune thyroiditis is often asymptomatic and is detected only during the examination of the thyroid gland.At the beginning of the disease, in some cases, throughout life, it can maintain the normal function of the thyroid gland, the so-called euthyroidism - a condition where the thyroid gland produces normal amount of hormones.This condition is not dangerous and is the norm, but requires further follow-up.
symptoms arise, if the result of the destruction of thyroid cells occurs decrease its function - hypothyroidism.Often in the beginning of an autoimmune thyroiditis amplification occurs thyroid function, it generates more than normal hormones.This condition is called hyperthyroidism.Hyperthyroidism can be stored, and can go into hypothyroidism.Symptoms of hypothyroidism and hyperthyroidism are different.
The symptoms of hypothyroidism are:
weakness, memory loss, apathy, depression, depressed mood, pale, dry and cold skin, rough skin on the palms and elbows, slowed speech, swelling of the face, eyelids, presence of overweight or obesity, chilliness,cold intolerance, decreased sweating, increased, swelling of the tongue, increased hair loss, brittle nails, swelling in the legs, hoarseness, nervousness, menstrual irregularities, constipation, pain in the joints.
Symptoms of hypothyroidism
Symptoms are often non-specific, there are a lot of people may not be associated with impaired thyroid function.However, if you have most of the following symptoms, it is necessary to investigate the thyroid hormones.
Symptoms of hyperthyroidism are:
Increased irritability, weight loss, mood swings, tearfulness, heart palpitations, a feeling of disruption of the heart, high blood pressure, diarrhea (loose stools), weakness, susceptibility to fractures (reduced bone strength), feelingheat, hot climate of intolerance, sweating, increased hair loss, menstrual disorders, decreased libido (sex drive).
Symptoms of hyperthyroidism
It also happens that the symptoms of autoimmune thyroiditis with thyrotoxicosis analyzes indicate reduced function of the thyroid gland, so a diagnosis solely on their appearance can not be even an experienced physician.If you notice these symptoms in yourself, you should immediately consult a doctor-endocrinologist for examination of thyroid function.
Complications autoimmune thyroiditis
Autoimmune thyroiditis is relatively harmless disease only if the maintenance of the normal amount of hormones in the blood - the state euthyrosis.Hypothyroidism and hyperthyroidism - threatening condition that requires treatment.Untreated hyperthyroidism can cause serious arrhythmias lead to severe heart failure and provoke vozniknovanie myocardial infarction.Severe untreated hypothyroidism can lead to dementia (dementia), widespread atherosclerosis and other complications.
diagnosis of autoimmune thyroiditis
In order to detect the presence of autoimmune thyroiditis, you must pass an examination that includes inspection endocrinologist, hormonal examination, ultrasound examination of the thyroid gland.
main research are:
1. Hormonal study: determination of TSH, free fractions T3, T4,
T3, T4 increased, TSH decreased - indicates the presence of tireotoksikozae
T3, T4 decreased, TSH increased - a sign of hypothyroidism.If St.
T3, T4 St., TTG in norm - euthyroidism - normal function of the thyroid gland.
more detail your hormonal investigation can comment on the endocrinologist.
2. Determining the level of anti-thyroid autoantibodies: antibodies against thyroid peroxidase (TPO or antibodies to microsomes), antibodies to thyroglobulin (AT-TG).
90-95% of patients with autoimmune thyroiditis oprdelyaetsya increase in TPO, in 70-80% of patients determined by the increase in the AT-TG.
3. thyroid gland is necessary to perform an ultrasound.
for autoimmune thyroiditis is characterized by a diffuse decrease in echogenicity of thyroid tissue, may be to increase or decrease the size of the thyroid gland.
In order to accurately diagnose autoimmune thyroiditis must be 3 main components: the decline of tissue echogenicity of the thyroid gland and other signs of autoimmune thyroiditis on thyroid ultrasound, the presence of hypothyroidism, the presence of autoantibodies.In other cases the absence of at least one of the components is a likely diagnosis.
treatment of autoimmune thyroiditis
main goal of treatment - maintaining stable euthyrosis, that is the normal amount of thyroid hormones in the blood.
euthyrosis If there is no treatment.Displaying a regular inspection: hormonal examination St. T3, T4 St., control TTG 1 time in 6 months.
In hypothyroidism stage appointed levothyroxine (L-thyroxine, Eutiroks) - a thyroid hormone.This drug is given in order to make up the number of the missing body of thyroid hormones for hypothyroidism is characterized by reduction of own products gland hormones.The dosage is adjusted individually endocrinologist.Starting treatment with a small dose and gradually increase it happens under the constant control of thyroid hormones.Pick up a maintenance dose of the drug, on the background of which the normalization of hormone levels is achieved.This levothyroxine therapy in a maintenance dose is usually taken for life.
Under thyrotoxicosis decision about the treatment the doctor chooses.Drugs that reduce the synthesis of hormones (tireostatiki) in this disease usually are not assigned.Instead of them being symptomatic therapy, ie appointed medications that reduce symptoms of the disease (reduced sense of palpitations, irregular heart work).Treatment is adjusted individually.
Treatment folk remedies
should warn against self-medication.Proper treatment can you appoint a doctor and only under the supervision of a systematic analysis on hormones.In autoimmune thyroiditis
not recommended to use immunomodulators and immunostimulants, including natural origin.It is important to observe the principles of a healthy diet: eat more fruits and vegetables.If necessary, in a period of stress, physical and emotional stress, during illness, you can take multivitamin preparations, for example, Vitrum, Centrum, Supradin and others. And even better, and do to avoid stress and infections.They contain the body needs vitamins and minerals.
Long-term use of excessive amounts of iodine (including the adoption baths with iodine salt) increases the frequency of autoimmune thyroiditis, as it increases the number of antibodies to thyroid cells.
forecast generally favorable.In the case of persistent hypothyroidism - a life of levothyroxine treatment with drugs.
Dynamic control of hormonal parameters should be performed regularly 1 time in 6-12 months.
If thyroid ultrasound revealed nodules, you should always consult with a physician-endocrinologist.If
nodes greater than 1 cm in diameter, or they grow over time, compared to the previous ultrasound, it is recommended to perform needle biopsy of the thyroid gland, to exclude malignancy.Ultrasound of the thyroid gland 1 time in 6 months.If
nodes less than 1 cm in diameter, it is necessary to perform the control of thyroid ultrasound 1 time in 6-12 months to avoid knots growth.
Medical consultation for autoimmune thyroiditis:
question: a significant increase in antibodies against the thyroid cells is determined in the analysis.How dangerous autoimmune thyroiditis if thyroid hormones are normal?
Answer: The high level of anti-thyroid antibodies can occur even in healthy people.If thyroid hormones are normal, there is no cause for concern.It does not require treatment.It is only necessary to perform the control of thyroid hormones 1 once a year, if necessary - ultrasound of the thyroid gland.
Question: How to make sure that during treatment gland function returned to normal?
Answer: It is necessary to assess the level of T4 St., St. T3 - their normalization indicates the elimination of violations of the hormonal function of the gland.TSH should be assessed no earlier than a month from the beginning of the treatment, as its normalization is slower than that of the hormones T4 and T3.
endocrinologist MS Artemyev