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Hashimotos Disease - Medical Malpractice
Hashimoto's disease is called autoimmune thyroiditis or, alternatively, chronic lymphocytic thyroiditis. The thyroid gland becomes inflamed and is damaged, leading to a low thyroid condition known as hypothyroidism. This is when the thyroid gland fails to make enough thyroid hormone so there are symptoms of low thyroid disease. It is believed that Hashimoto's disease is the most common cause of a low thyroid condition in the US and Canada.
The thyroid gland is located in the neck and is in the shape of a butterfly. It is located beneath the larynx or the voice box of the neck. It makes two forms of hormones: thyroxine or T4 and triiodothyronine or T3. These hormones circulate in the bloodstream and go into the cells, increasing the metabolism of all cells of the body. They affect breathing, heart rate, nerve system functions, body temperature and brain development. The menstrual cycles are affected by the thyroid hormones as are the moisture level of the skin, weight, cholesterol level, and muscle strength. The entire body is affected by the thyroid hormones and without them, there are a lot of symptoms.
The thyroid hormone production is under the control of the thyroid stimulating hormone or TSH, which is made by the pituitary gland. In Hashimoto's thyroiditis, the TSH level is elevated because the pituitary gland is pushing t to try and make the thyroid hormone levels higher. Once the thyroid hormone levels are high enough, the TSH level drops way down.
Hashimoto's disease is considered an autoimmune disorder because antibodies are made by the body that attacks its own tissue, in this case, the thyroid gland. The thyroid gland cannot produce enough T4 or T3 and symptoms of hypothyroidism ensue. In microscopic slides, there are large numbers of lymphocytes within the damaged thyroid tissue.
The symptoms of Hashimoto's thyroiditis are few in the beginning. You may feel tired or lack energy. You begin to get an enlarged thyroid gland and the front of the neck appears swollen. This is called a "goiter". Eventually the thyroid gland is damaged enough to actually shrink and go away.
Interestingly, not everyone with Hashimoto's disease goes on to develop hypothyroidism. They have no symptoms or only very mild symptoms. If you develop hypothyroidism, you can develop tiredness, cold intolerance, weight gain, constipation, joint pain, muscle pain, heavy menstrual periods, impaired fertility, dry hair that is thinning, depression and a lower than normal heart rate.
Risk factors for hypothyroidism from Hashimoto's disease include being female. In fact, the disease occurs seven times more likely in women than in men. It is a disease that sometimes begins in adolescence or in a woman's 20's but usually begins in women between the ages of 40 and 60. It is often a hereditary disease and is passed from one woman to her daughter. It may also be related to excessive iodine consumption. It is possible that certain viral infections or the use of certain medications may trigger the onset of Hashimoto's thyroiditis. People with Hashimoto's disease are also more likely to develop other types of autoimmune diseases. You are more likely to get rheumatoid arthritis, for example, or vitiligo, type I diabetes, pernicious anemia or other autoimmune diseases.
Hashimoto's disease is typically diagnosed via a thorough history and physical exam. The thyroid gland may be enlarged or may be shrunken. Blood tests showing an elevated TSH, a low T4 and a low T3 level help with the diagnosis. Anti-thyroid antibodies are usually positive in Hashimoto's thyroiditis. Perhaps the best test is the TSH test, which is very sensitive to a low thyroid condition. It is only when the condition is serious that the T4 and T3 become low. Anti-thyroid peroxidase or anti-TPO antibodies are positive in Hashimoto's thyroiditis.
The treatment of Hashimoto's disease is to replace the thyroid hormone so that the levels are normal again. Early in the disease, no treatment may be necessary but the thyroid hormones and TSH are followed carefully. As the TSH rises above normal, the T4 is replaced in the form of synthetic thyroid hormone. The dose of synthetic thyroid hormone depends on how bad the disease is and how much a person weighs. Age plays a role in the thyroid hormone dosage. These replacement hormones bring the blood T4 and T3 back to normal and normalize the TSH level.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here