What Is Hashimotos Disease
Hashimotos disease affects the thyroid gland. Its also called Hashimotos thyroiditis, chronic lymphocytic thyroiditis or autoimmune thyroiditis. The thyroid gland makes hormones that control virtually all of the bodys metabolic functions and keep it working normally. Hashimotos thyroiditis is a type of autoimmune disease your immune system doesnt recognize your thyroid as your own and attacks it.
Hashimotos disease is common and affects about five people in 100 in the United States.
What Are The Risk Factors For Thyroid Nodules
Risk factors for developing thyroid nodules include:
- Family history. Having parents or siblings who have had thyroid nodules or thyroid or other endocrine cancers increases your chance of developing nodules.
- Age: The chance of developing nodules increases as you get older.
- Gender: Women are more likely than men to develop thyroid nodules.
- Radiation exposure: A history of radiation exposure to the head and neck increases your risk of developing nodules.
Risk factors for developing cancerous thyroid nodules include:
- Family history of thyroid cancer
- A nodule that is hard or is stuck to a nearby structure
- Male gender
How Does Hypothyroidism Affect Your Body
Hypothyroidism can affect you in ways that can be hard emotionally and physically. For example:
- When your metabolism slows due to hypothyroidism, you eventually gain weight, feel tired more often and have little energy.
- You can experience fuzzy thinking and memory problems .
- Women can develop menstrual irregularity and change in flow, and find it harder to become pregnant.
- You may be increasingly constipated , have heartburn and other digestive problems.
- Hypothyroidism can also lead to sexual dysfunction in both men and women.
A slow metabolism can affect almost every part of your body, with effects mild to severe.
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How Can I Prevent Thyroid Cancer
Many people develop thyroid cancer for no known reason, so prevention isnt really possible. But if you know youre at risk for thyroid cancer, you may be able to take these steps:
- Preventive surgery: Genetic tests can determine if you carry an altered gene that increases your risk for medullary thyroid cancer or multiple endocrine neoplasia. If you have the faulty gene, you may opt to have preventive surgery to remove your thyroid gland before cancer develops.
- Potassium iodide: If you were exposed to radiation during a nuclear disaster, such as the 2011 incident at Fukushima, Japan, taking potassium iodide within 24 hours of exposure can lower your risk of eventually getting thyroid cancer. Potassium iodide blocks the thyroid gland from absorbing too much radioiodine. As a result, the gland stays healthy.
Who Is Most Likely To Develop Hashimotos Disease
- Is more common in women than men.
- Commonly appears between the ages of 30 and 50.
- Tends to run in families .
- Is more likely to develop in people who have other autoimmune diseases, like certain liver conditions, B12 deficiency, gluten sensitivity, rheumatoid arthritis, type 1 diabetes, lupus and Addisons disease .
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How Is Thyroid Cancer Treated
The main treatment for thyroid cancer is surgery to take out the whole thyroid gland or as much of it as can be safely removed. Surgery alone can cure thyroid cancer if the cancer is small and has not yet spread to lymph nodes.
Your doctor may also use radioiodine therapy after surgery. Radioiodine therapy destroys any thyroid cancer cells that were not removed during surgery or that have spread to other parts of the body.
Your doctor may also talk with you about other treatments for thyroid cancer. Learn more about thyroid cancer treatments at the National Cancer Institute.
How Are Thyroid Nodules Treated
Treatment depends on the type of thyroid nodule. Treatment options include:
- No treatment/”watchful waiting.” If the nodules are not cancerous, you and your doctor may decide that you dont need to be treated at this time. You will see your doctor on a regular basis so he or she can watch for any changes in the nodules.
- Radioactive iodine. Your doctor may use radioactive iodine to treat hyperfunctioning thyroid nodules and goiters with several nodules. The radioactive iodine is absorbed into the thyroid gland, causing the nodules to shrink. Pregnant women and women trying to become pregnant should not have this treatment.
- Surgery. Surgery to take out the nodules is the best treatment for nodules that are cancerous, cause “obstructive symptoms” , and are suspicious .
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What Are The Complications Of Hashimotos Disease
Many people with Hashimotos disease develop hypothyroidism. Untreated, hypothyroidism can lead to several health problems, including5
- dry skin or dry, thinning hair
- heavy or irregular menstrual periods or fertility problems
- slowed heart rate
Hashimotos disease causes your thyroid to become damaged. Most people with Hashimotos disease develop hypothyroidism. Rarely, early in the course of the disease, thyroid damage may lead to the release of too much thyroid hormone into your blood, causing symptoms of hyperthyroidism.3
Your thyroid may get larger and cause the front of the neck to look swollen. The enlarged thyroid, called a goiter, may create a feeling of fullness in your throat, though it is usually not painful. After many years, or even decades, damage to the thyroid may cause the gland to shrink and the goiter to disappear.
Symptoms Of Thyroid Disease
Signs and symptoms of hypothyroid and hyperthyroid conditions include:
- Slowed mental processes and poor memory
More on Hyperthyroidism
Each persons experience of thyroid illness differs depending on a number of factors a patient will not necessarily have all of the above symptoms and some patients have the symptoms in the absence of thyroid disease, perhaps due to other causes. A physician should be consulted if thyroid illness is suspected.
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Is There A Higher Risk Of Developing Thyroid Disease If I Have Diabetes
If you have diabetes, youre at a higher risk of developing a thyroid disease than people without diabetes. Type 1 diabetes is an autoimmune disorder. If you already have one autoimmune disorder, you are more likely to develop another one.
For people with type 2 diabetes, the risk is lower, but still there. If you have type 2 diabetes, youre more likely to develop a thyroid disease later in life.
Regular testing is recommended to check for thyroid issues. Those with type 1 diabetes may be tested more often immediately after diagnosis and then every year or so than people with type 2 diabetes. There isnt a regular schedule for testing if you have type 2 diabetes, however your healthcare provider may suggest a schedule for testing over time.
If you have diabetes and get a positive thyroid test, there are a few things to you can do to help feel the best possible. These tips include:
- Getting enough sleep.
- Taking all of your medications as directed.
- Getting tested regularly as directed by your healthcare provider.
Can I Live A Normal Life With A Thyroid Disease
A thyroid disease is often a life-long medical condition that you will need to manage constantly. This often involves a daily medication. Your healthcare provider will monitor your treatments and make adjustments over time. However, you can usually live a normal life with a thyroid disease. It may take some time to find the right treatment option for you and control your hormone levels, but then people with these types of conditions can usually live life without many restrictions.
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When To Get Tested
If you notice any of the above symptoms, in tandem with the classic symptoms either of thyroid dysfunction, as mentioned above, you should speak with your primary care doctor about being tested. If you are generally healthy and are aged 60 or older, it is still a good idea to discuss testing with your doctor if it is deemed you are at risk of developing a thyroid condition.
How Does Thyroid Disease Affect Pregnancy
Pregnancy-related hormones raise the level of thyroid hormones in the blood. Thyroid hormones are necessary for the baby’s brain development while in the womb.
It can be harder to diagnose thyroid problems during pregnancy because of the change in hormone levels that normally happen during pregnancy. But it is especially important to check for problems before getting pregnant and during pregnancy. Uncontrolled hyperthyroidism and hypothyroidism can cause problems for both mother and baby.
Hyperthyroidism that is not treated with medicine during pregnancy can cause:
- Premature birth
- a serious condition starting after 20 weeks of pregnancy. Preeclampsia causes high blood pressure and problems with the kidneys and other organs. The only cure for preeclampsia is childbirth.
- Thyroid storm
- Fast heart rate in the newborn, which can lead to heart failure, poor weight gain, or an enlarged thyroid that can make it hard to breathe
- Low birth weight
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How Is Thyroiditis Treated
How thyroiditis is treated depends on the type, symptoms, and phase of thyroiditis.
- Thyrotoxic phase: Usually temporary, it will eventually either recover and go to the euthyroid phase, or go to the hypothyroid phase. This hypothyroid phase could be temporary or permanent. It may not be necessary to treat symptoms in subacute, painless, or post-partum thyroiditis. During the thyrotoxic phase, treatment is symptomatic. Antithyroid medications are rarely needed.
- Palpitations/anxiety/tremors/heat intolerance/increased sweating: These symptoms are treated with beta blockers.
- Thyroidal pain: The pain can usually be managed with anti-inflammatory medications such as aspirin or ibuprofen. If the pain is severe enough, steroid therapy may be required .
- In other forms, treating the infection will be necessary to eliminate acute thyroiditis. Drug-induced thyroiditis generally lasts as long as the drugs are taken.
- Hypothyroid phase: If necessary, thyroid hormone replacement therapy is used to treat hypothyroidism. This type of therapy usually continues for 6 to 12 months. Hashimoto’s thyroiditis usually causes permanent hypothyroidism and requires continued treatment.
How Is Postpartum Thyroiditis Treated
Treatment for postpartum thyroiditis depends on the phase of the disease and what symptoms you have. For example, if you get symptoms of hyperthyroidism in the first phase, your treatment may include medicines to slow down the heart rate.
In most women who have postpartum thyroiditis, the thyroid returns to normal within 12 to 18 months after symptoms start. But if you have a history of postpartum thyroiditis, your risk is higher for developing permanent hypothyroidism within 5 to 10 years.
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How Is Hashimotos Disease Treated
If Hashimotos disease does progress to hypothyroidism, usual treatment is a synthetic form of thyroid hormone called levothyroxine .
This drug restores the normal function of the thyroid. Youll need to take it every day for the rest of your life. Your providers and you will figure out how to adjust your dose to make sure that your hypothyroidism is kept under control.
How Is Hashimotos Disease Diagnosed
First, your healthcare provider will take your medical history and perform a physical exam. He or she will feel your thyroid gland to determine if it is enlarged. Blood tests are also ordered. These include:
- Thyroid stimulating hormone test: A high TSH level most commonly means the thyroid gland is not producing enough T4 hormone. This lab is usually most consistent with a diagnosis of hypothyroidism or subclinical hypothyroidism.
- Free T4 test: A low T4 level suggests that the person has hypothyroidism.
- Antithyroid antibody test: Presence of antibodies indicates a higher risk of developing Hashimotos hypothyroidism.
The most common imaging test that may be ordered is an ultrasound of your thyroid gland. The ultrasound shows the size and appearance of the thyroid and if there are any nodules or growths in your neck area.
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Thyroid Disease: What You Need To Know
The thyroid is not a part of the human anatomy most of us think about unless something goes wrong. Thyroid conditions can cause a range of seemingly unrelated problems, including drastic changes in weight, energy, digestion, or mood. The good news is that most thyroid disorders can be managed or even cured with medication, radioactive iodine therapy, or surgery, depending on the type of thyroid condition being treated.
The thyroid is a small, butterfly-shaped gland at the base of the neck that produces thyroid hormone. This hormone controls many of the bodys functions, such as heart rate and how fast calories are burned. Diseases of the thyroid cause it to make either too much or too little of the hormone, causing symptoms such as weight fluctuations, fatigue, and restlessness.
Common types of thyroid disease include thyroid nodules, hypothyroidism and hyperthyroidism, Graves disease, goiters, thyroiditis, and thyroid cancer. Women are more likely than men to have thyroid diseases, especially after pregnancy or menopause.
Nearly one in 20 Americans age 12 and older has an underactive thyroid, or hypothyroidism. If the thyroid gland doesnt produce enough hormones, many body functions will slow down. A smaller number of people about one in 100 have an overactive thyroid, called hyperthyroidism. Their thyroids release too much hormone.
What Are Thyroid Disorders
Thyroid disorders refer to a group of syndromes which arise due to dysfunctions of the thyroid gland that may cause increased or decreased secretion of thyroid hormones.
Reduced secretion of thyroid hormones leads to Hypothyroidism and increased secretion of thyroid hormones leads to Hyperthyroidism.
Other pathological conditions also arise due to dysfunctions of the thyroid gland namely- Thyroid nodules, Graves disease, Goitre, Hashimotos Thyroiditis and Thyroid cancer.
In the following sections, each of these diseases will be discussed separately.
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What Is The Thyroid
The thyroid gland is a small organ thats located in the front of the neck, wrapped around the windpipe . Its shaped like a butterfly, smaller in the middle with two wide wings that extend around the side of your throat. The thyroid is a gland. You have glands throughout your body, where they create and release substances that help your body do a specific thing. Your thyroid makes hormones that help control many vital functions of your body.
When your thyroid doesnt work properly, it can impact your entire body. If your body makes too much thyroid hormone, you can develop a condition called hyperthyroidism. If your body makes too little thyroid hormone, its called hypothyroidism. Both conditions are serious and need to be treated by your healthcare provider.
What Questions Should I Ask My Doctor
If you have thyroid cancer, you may want to ask your healthcare provider:
- Why did I get thyroid cancer?
- What type of thyroid cancer do I have?
- Has the cancer spread outside of the thyroid gland?
- What is the best treatment for this type of thyroid cancer?
- What are the treatment risks and side effects?
- Will I need thyroid replacement hormone therapy?
- Is my family at risk for developing this type of thyroid cancer? If so, should we get genetic tests?
- Can I get thyroid cancer again?
- Am I at risk for other types of cancer?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Receiving a cancer diagnosis is unsettling, regardless of the type. Fortunately, most thyroid cancers respond extremely well to treatment. Your healthcare provider can discuss the best treatment option for the type of thyroid cancer you have. After treatment, you may need to take synthetic thyroid hormones for life. These hormones support vital body functions. They usually dont cause any significant side effects, but youll have regular checkups to monitor your health.
Last reviewed by a Cleveland Clinic medical professional on 08/13/2020.
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Thyroid Nodules And Thyroid Cancer
Thyroid nodules are common and often require no treatment but should be investigated since a small proportion of them are cancerous. The majority of thyroid cancers have a favourable prognosis and require a multidisciplinary approach. The team may include endocrinologists, radiologists, surgeons, pathologists, nuclear medicine specialists and sometimes oncologists. In the past years there has been a rise in the number of thyroid cancers being identified, largely due to the incidental discovery of small low risk cancers related to the increased use of neck imaging for other unrelated conditions. There has been no change however, in the mortality rate.
Is There A Special Diet For People With Hashimotos Disease
There is no special diet for Hashimotos disease, but some foods, medicines or supplements may affect your ability to absorb levothyroxine, your thyroid medication. These include iron and calcium supplements, the ulcer medicine sucralfate, cholestyramine and aluminum hydroxide . Taking these four hours before or after the levothyroxine may solve this problem.
Talk to your doctor about any dietary questions you have.
Eating well and a healthy lifestyle exercising, sleeping well and controlling stress can help your immune system. No matter what, youll need to keep taking your medications if you are diagnosed with hypothyroidism.
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What Are The Complications Of Thyroid Cancer
Most thyroid cancers respond well to treatment and arent life-threatening.
After thyroid surgery or treatments, your body still needs thyroid hormones to function. Youll need thyroid replacement hormone therapy for life. Synthetic thyroid hormones, such as levothyroxine , take over for the thyroid hormones that your body no longer naturally produces.
Who Is More Likely To Have Hashimotos Disease
Hashimotos disease is 4 to 10 times more common in women than men.2 Although the disease may occur in teens or young women, it more often develops in women ages 30 to 50.3 Your chance of developing Hashimotos disease increases if other family members have the disease.
You are more likely to develop Hashimotos disease if you have other autoimmune disorders, including4
- celiac disease, a digestive disorder that damages the small intestine
- lupus, a chronic, or long-term, disorder that can affect many parts of the body
- rheumatoid arthritis, a disorder that affects the joints
- Sjögrens syndrome, a disease that causes dry eyes and mouth
- type 1 diabetes, a disease that occurs when your blood glucose, also called blood sugar, is too high
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