Referred hypothalamus. The hypothalamus signals the pituitary to create

Referred to as an
autoimmune thyroid disease, Hashimoto’s Diseases can also be called Chronic
Lymphocytic Thyroiditis or even Hashimoto’s Thyroiditis.  It often leads to an underactive thyroid or
hypothyroidism as we know it, which is especially the case in the US as it
tends to be hypothyroidism’s number one cause. Causing hypothyroidism is
typically due to the disease creating an environment where thyroid hormones are
not being produced from the thyroid gland. The buildup of lymphocytes in the
gland, attack the gland and can cause zero hormones to be produced. Many times,
when an endocrinologist is expecting possible hypothyroidism, they will often
check for Hashimoto’s Disease.  Hashimoto’s
Disease researchers are still trying to figure out why this disease that
affects one’s ability to make antibodies is occurring. However, there is a familial
tie that has been found.  There are still
many theories, though, of why someone’s immune system would fight the thyroid.  Such theories include a microbe that signals
the attack from the immune system like a virus. Another theory is the genetic theory;
women being more affected then men. Aging may also be a key contributor along
with the aforementioned hereditary factor, being exposed to radiation, and
having other autoimmune diseases like Lupus.  Besides causing the thyroid gland to not produce
the thyroid hormone, the disease can have other effects on the gland such as gradual
swelling that can cause a goiter or complete damage of the thyroid gland.  To really break this down, let’s look at what
happens with the hormone production. The thyroid normally makes thyroxine and
tri-iodothryonin. Their release from the gland is regulated by the pituitary gland
and hypothalamus. The hypothalamus signals the pituitary to create TSH (Thyroid
Stimulating Hormone). The pituitary looks at the blood’s thryoxine (T4) and
tri-iodothyronin (T3) levels and will release the TSH if levels need brought
up. The more TSH the thyroid receives, the more T4 and T3 the pituitary
releases. Hashimoto’s Disease stops the release of T4 and T3. Antibodies attack
the thyroid causing inflammation or thryoiditis and the thyroid will not be
able to make the T3 and T4. So, more TSH is released and a goiter is,
therefore, formed.  There are some
opposite effects in the young that have auto immune thyroid problems. Their
inflamed glands can over produce more hormones and briefly reach
Hashitoxicosis, but it tends to eventually flip to being under-active/hypothyroidism.
 

            Thyroid hormones manage many
functions in our body. Signs and symptoms tend to mirror this as we will see.
Such symptoms include chronic fatigue, cold sensitivity, the inability to
concentrate, hair loss, oedema, dry and course hair, brittle nails, froggy or
horse voice, body weakness, body aches/pains/cramps, feeling of pins and
needles on extremities, puffy face, slow movements/speech/thinking, memory
lapses, depression, slower heart beats and a little raise in blood pressure,
constipation and higher cholesterol readings. 
 A goiter in the throat is a good
signal of the disease but doesn’t always go hand in hand. Signs often match
those of hypothyroidism and tend not to be unique to Hashimoto’s Disease, hence
why we tend to check for both. Symptoms like hypothyrodism symptoms may include
the ones mentioned above but also a person may get an enlarged tongue, joint
pain, joint stiffness, weight gain, and menorrhagia or longer menstrual
bleeding.  Most of the time, those with
Hashimoto’s do not show any symptoms at first if any at all, and the disease is
only detected by blood work. Sometimes, doctors are looking for something
entirely different but come across the disease as the disease doesn’t always show
those signs and symptoms. Symptoms are usually brought on at a slower rate and build
as the disease progresses all the way to goiters and thyroid gland malfunction
as mentioned above.

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            Many
times, a doctor or specialist will test a patient for Hashimoto’s if they are
displaying any signs or symptoms listed previously or if there already is a
thyroid or goiter problem.  Blood tests
are a number one go to as they can test the levels of the Thyroid Hormone and
the Thyroid Stimulating Hormone.  This
can be done as early as birth with the heel prick or Guthrie Test.  Other tests include the thyroid hormone, TSH,
and antibody test. The hormone test looks at levels of hormones in the
pituitary and thyroid gland and can see if the thyroid is underactive and producing
lower amounts of the Thyroid Hormone. The TSH test can spot if the pituitary
and thyroid are working overtime by seeing if there are higher amounts of TSH. It
is a great helper in earlier detection due to its super sensitivity.  The antibody blood test looks at what the disease
is; an autoimmune disease that creates antibodies that are atypical.  It tests for antibodies against TPO (Thyroid
Peroxidase).  TPO does have a supportive function
in hormone production. Blood tests have an additional purpose for doctors in
which there results assist doctors in determining medication dosage amounts for
treatment purposes. Usually more than one test is completed because tests, such
as the antibody test, show antibodies in people with a normal thyroid. Doctors
looking for Hashimoto’s Disease can also look at medical history, family
history, and they complete a regular physical exam.  During a physical exam, a doctor will often
check the neck/throat area for a goiter. Ultrasounds of the thyroid may also be
completed for a closer look to verify that it is in fact a goiter and not
something else like thyroid nodules.

            Doctors
can treat Hashimoto’s Disease in a variety of ways. Frequently, they will
arrange monthly or every month and a half follow-up appointments for
observation. This is usually combined with several medications such as the
common Levothyroxine.  Its purpose is to
replace the thyroxine that our body needs. 
Adjustments are often made due to results in blood tests showing
different levels. This is why they prescribe reoccurring blood work at the
follow up exams or with outside laboratories. Once the level is maintained, the
doctors may back off on the amount of appointments needed.  At this time, the patient is usually pushed
to see a general practitioner for that point on with possible yearly follow ups
with them or the specialist. If symptoms return, they cycle may have to restart.
Medications, however, tend to continue for the rest of a patient’s life so the
correct level of hormones is attained. If medication is ceased, symptoms will
return.  When Levothryoxine is not doing
the trick, doctors may also combine the drug with Cytomel for the T3 or
Thyrolar for needed T4.  Synthetic hormones
are being prescribed more regularly as of late. They are medications such as
Synthroid,and Levoxyl and can also aid with balancing the correct hormone
levels while relieving symptoms.  An all
natural form of medication, called Nature Throid is also being ordered. There
are other alternative forms of treatments that may be recommended as a more
holistic approach such as yoga, hypnosis and meditation. Patients may also take
a variety of vitamins, herbs, and look at changing their diets. Often, it is
recommended to look at ones intake of iodine and salt with iodine in that one may
need to consume less of it and/ or avoid iodine supplements as well.  Working out the body also shows benefits and
it may be recommended to try Tai Chi, reiki, massage, and chiropractic care.  Others look at healing wellness and include
in their health regimen Chinese medicine, naturopathy,   homeopathy,
expiritism, and Ayurvedic medicine.

            The prognosis of someone with
Hashimoto’s Disease that ignores signs and symptoms can mean many health
problems down the road. Such problems can include a goiter that may get so
large that it protrudes from the throat and can even cause swallowing and breathing
problems.  Underactive thyroid glands can
also cause an increase in levels of the bad cholesterol or LDLs. This can
create an enlarged heart, high cholesterol, heart disease or even heart failure.  The male and female libido may also be
decreased along with the possibility of slower mental functioning. Myxedema or
a myxedema coma may occur from severe hypothyroidism as well and would require
immediate medical treatment.  There may
also be a link to birth defects such as a cleft palate or even
brain/heart/kidney malformations with the babies from those that are pregnant
with the disease. With women, the disease can cause troubles getting pregnant,
problems during pregnancy and issues with the menstrual cycle such as the
period being heavier or irregular.

            Again, Hashimoto’s Disease is the
most common autoimmune disease and the most common cause of
hypothyroidism.  It affects 46 in every
1000 cases when looking at thyroid antibodies and 5 out of every 100 people. We
see 1.5 cases per 1000 per year across the world. The disease affects men,
women, and children of any age but is the most prevalent in middle aged women
within the ages of thirty to sixty.  In
fact, it affects 8 times to upwards of 20 times more women than it does men. On
top of that, if you have familial ties, the chances of you getting Hashimoto’s
Disease increases further. We are seeing an overall increase of the disease as
the year’s progress.

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