Hashimoto's Thyroiditis

Overview

• Also known as Chronic Lymphocytic Thyroiditis, Hashimoto's Disease, Autoimmune Thyroiditis.
• An autoimmune disease where the thyroid gland is gradually destroyed.
• Most common cause of hypothyroidism in developed countries.

Specialty

• Endocrinology

Symptoms

• Early symptoms may not be noticed.
• Over time: thyroid enlargement (goiter), weight gain, fatigue, constipation, hair loss.
• Complications: Thyroid lymphoma, high cholesterol, heart disease, potential pregnancy issues.

Causes

• Combination of genetic and environmental factors.
• Risk factors: Family history, other autoimmune diseases.

Diagnosis

• Blood tests: TSH, T4, antithyroid autoantibodies.
• Ultrasound.
• Differential diagnosis includes Graves' Disease and Nontoxic Nodular Goiter.

Treatment

• Not treated unless hypothyroidism or goiter present.
• Levothyroxine is the standard treatment.
• Avoid large amounts of iodine.

Epidemiology

• Global prevalence of 7.5%, varies by region.
• More common in women, and low to middle income groups.

History

• First described by Hakaru Hashimoto in 1912.
• Recognized as an autoimmune disorder in 1956.

Pathophysiology

• T-lymphocyte mediated attack on the thyroid.
• Development of autoantibodies.

Complications

• Rare but serious: Thyroid lymphoma.

Pregnancy Considerations

• Hypothyroidism should be treated before conception.
• Screening recommended for high-risk pregnant women.

Other Topics

• Impact of iodine intake.
• Genetic and chromosomal disorder associations.

Future Directions

• No cure; focus on managing symptoms and hormone levels.
• Research ongoing in understanding genetic factors and potential new treatments.