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What Does Atrophic Thyroid Gland Mean

Causes Of Hashimotos Syndrome


While the exact cause of Hashimotos Syndrome is not known, it is thought that several factors may play a role in the development of this disease, including:

  • It often affects people who have family members with thyroid disorders or autoimmune diseases. This suggests that there may be a genetic component to Hashimotos syndrome.
  • Autoimmune Disorder.;Individuals who have other autoimmune disorders such as Addisons disease, autoimmune hepatitis, celiac disease, lupus, type 1 diabetes, pernicious anemia, rheumatoid arthritis, Sjögrens syndrome, and vitiligo have been linked to Hashimotos syndrome.
  • Hashimotos syndrome affects as many as 7-8X more women than men, which suggests that sex hormones may play a role in its occurrence.
  • While the syndrome can occur even in teenage years or early adulthood, it more commonly occurs in middle-aged patients.
  • Radiation Exposure.;Individuals who have been exposed to excessive levels of radiation may be at increased risk of Hashimotos syndrome.

Signs Of End Stage Hashimoto’s

The good news is that it takes a long time for end stage Hashimoto’s to really set in.;

And I mean a long time.;

We are talking probably somewhere around the order of 20-30 years .;

In order to reach this late stage of this disease you really need to have not treated or attempted to treat/manage your Hashimoto’s for several decades.;

So, if you are reading this there is a good chance that there is still time for you to do something about your condition to try and prevent this issue from occurring!

But there is also bad news.;

The bad news is that MOST people with hypothyroidism have Hashimoto’s and a great many people have no idea that they do.;

It’s not common for doctors to test thyroid antibodies routinely so many people with hypothyroidism have Hashimoto’s without realizing it.;

And I’ve lost count of the number of patients that I’ve treated who have no idea why they take thyroid medication but who have been on it for 20+ years.;

These patients are often surprised when I check their thyroid antibodies and notify them that they have Hashimoto’s thyroiditis.;

Some of these patients may have had it all along and others may have only developed it recently but it’s impossible to tell for sure.;

So it may be the case that you already have late stage Hashimoto’s even if you never knew you had the disease in the first place.;

It’s a big bummer if this happens but it does occur from time to time.;

#1. Thyroid Gland Atrophy.;

In the case of your thyroid gland, atrophy is never a good sign.;

Living With Hashimotos Syndrome

While Hashimotos syndrome cannot be cured, with the right;hormone replacement therapy;and lifestyle changes, individuals can experience relief from many symptoms from this condition.

If you suspect you may have Hashimotos syndrome or are experiencing symptoms related to hypothyroidism such as fatigue, dry skin, depression, or constipation, or if you have an unexplained goiter, reach out to the experts at;CentreSprings MD. Our integrative, functional, holistic approach can help you get to the underlying issue behind your symptoms and create a holistic approach to treatment.

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Diets Free From Grains Dairy & Highly Processed Foods

While inflammatory foods such as grains, dairy, and highly processed foods arent the cause of Hashimotos syndrome, they can trigger an autoimmune response. This can exacerbate inflammation and tissue destruction. In these cases, a diet free from grains, dairy, and highly processed foods can be beneficial to individuals living with Hashimotos syndrome.

Diets such as paleo or gluten-free diets can be effective for individuals with Hashimotos syndrome, as can diets that focus on the following foods:

  • Lean Meats
  • Vegetables
  • Nuts
  • Legumes

Congenital And Developmental Anomalies Of Thyroid Gland

10 Common Signs And Symptoms Of Hypothyroidism In Men And ...

The thyroid gland primordium develops from median eminence in the floor of primitive pharynx during 4th week of gestation. From foramen cecum, the primitive primordium descends through anterior midline portion of the neck to reach its final position below thyroid cartilage by 7th week of gestation. During this descent, the developing thyroid gland retains an attachment to the pharynx by a narrow epithelial stalk known as thyroglossal duct. This duct usually becomes obliterated by 8th-10th week of gestation. Thyroid hormone synthesis normally begins at about 11th week of gestation.

Thyroglossal cyst in a patient who presented with midline neck swelling. Ultrasound neck shows a well-defined anechoic cystic lesion with multiple low level internal echoes and posterior acoustic enhancement. Multiple low level internal echoes within the cyst may be due to hemorrhage or infection. X-ray neck lateral view of the same patient shows large, soft tissue/cystic midline swelling

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Hashimoto’s Thyroiditis And Problems During Pregnancy

Uncontrolled Hashimoto’s thyroiditis during pregnancy can have long-term effects on the baby, for example, birth defects or developmental delays. There is a relationship between thyroid levels in the mother and brain development of her child. A woman can have hypothyroidism with no symptoms or signs. The more significant the hypothyroidism, the greater the likelihood of developmental problems in the child.

    Symptoms and signs of Hashimoto’s thyroiditis resemble those of hypothyroidism generally and are often subtle. They are not specific and are often attributed to aging. Patients with mild hypothyroidism may have no signs or symptoms. The symptoms generally become more obvious as the condition worsens, and the majority of these complaints are related to a metabolic slowing of the body. Common symptoms and signs of Hashimoto’s thyroiditis include:

    • Vague aches and pains
    • Swelling of the legs

    As hypothyroidism becomes more severe, there may be puffiness around the eyes, a slowing of the heart rate, a drop in body temperature, and heart failure. In its most profound form, severe hypothyroidism may lead to a life-threatening coma . In a severely hypothyroid individual, myxedema coma tends to be triggered by severe illness, surgery, stress, or traumatic injury. This condition requires hospitalization and immediate treatment with thyroid hormone.

    Other symptoms and signs include:

      What Does It Mean When The Ultra Sound Says Heterogeneous Atrophic Thyroid

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      At And Blocking Hypothyroidism In Pregnancy

      In Graves disease and in Atrophic Thyroiditis, maternal TSAb and TBAb antibodies can be transferred to the fetus during pregnancy.

      As explained by the 2017 ATA guidelines for thyroid disease in pregnancy ,

      In mothers with autoimmune thyroid disease, autoantibodies to TPO, Tg, and the TSH receptor can be transmitted to the fetus.

      Whereas TPO antibodies and Tg antibodies do not significantly affect fetal or neonatal thyroid function, antibodies to the TSH receptor can stimulate or block thyroid hormonogenesis.

      Bucci et al in 2017 reviewed several studies showing how fetal and maternal health can be affected by the TSH receptor blocking antibody. In one US study of 788 neonates with congenital hypothyroidism,

      the neonatal screening program in US demonstrated potent TSHR-blocking activity in 11 cases.

      The 11 babies were born to 9 mothers, all of whom were receiving thyroid replacement because of autoimmune hypothyroidism, and 3 had been treated initially for Graves disease.

      TPO antibodies, although detectable in all mothers, did not predict the neonatal thyroid dysfunction, while the presence of TBAbs was confirmed in the serum of eight mothers: all newborns had transient congenital hypothyroidism.

      Bucci also summarized another study:

      Affected infants may have significantly impaired cognitive outcomes despite early and adequate postnatal treatment if maternal hypothyroidism was present and untreated during gestation.

      Diagnosis Of Hashimoto Thyroiditis

      5 Signs of End Stage Hashimoto’s

      Physical findings are variable and depend on the extent of the hypothyroidism and other factors, such as age. Examination findings may include the following:

      • Puffy face and periorbital edema typical of hypothyroid facies

      • Cold, dry skin, which may be rough and scaly

      • Peripheral edema of hands and feet, typically nonpitting

      • Thickened and brittle nails

      • Bradycardia

      • Elevated blood pressure

      • Diminished deep tendon reflexes and the classic prolonged relaxation phase

      • Macroglossia


      Laboratory studies and potential results for patients with suspected Hashimoto thyroiditis include the following:

      • Serum thyroid-stimulating hormone levels: Sensitive test of thyroid function; levels are invariably raised in hypothyroidism due to Hashimoto thyroiditis and in primary hypothyroidism from any cause

      • Free T4 levels: Needed to correctly interpret the TSH in some clinical settings; low total T4 or free T4 level in the presence of an elevated TSH level further confirms diagnosis of primary hypothyroidism

      • T3 levels: Low T3 level and high reverse T3 level may aid in the diagnosis of nonthyroidal illness

      • Thyroid autoantibodies: Presence of typically anti-TPO and anti-Tg antibodies delineates the cause of hypothyroidism as Hashimoto thyroiditis or its variant; however, 10-15% of patients with Hashimoto thyroiditis may be antibody negative

      Imaging tests

      Chest radiography and echocardiography are not usually performed and are not necessary in routine diagnosis or evaluation of hypothyroid patients.

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      What Lab Results Are Absolutely Confirmatory

      There is no confirmatory test for atrophic thyroiditis as a cause of hypothyroidism.

      It has been suggested that the best confirmation of hypothyroidism is an evaluation of response to a trial administration of thyroid supplement in patients with symptoms of hypothyroidism.

      Lone TSH testing may not be predictive of autoimmune disorders in which TSH may be normal, elevated, or depressed.

      What Is Hashimoto’s Thyroiditis Where Is Ithe Thyroid Gland Located And What Does It Look Like

      Hashimoto’s thyroiditis is an autoimmune condition that is a common cause of hypothyroidism. In Hashimoto’s thyroiditis, the body mounts an immune reaction against its own thyroid gland tissue, leading to inflammation of the gland .

      The thyroid is a butterfly-shaped gland located in the lower part of the neck, below Adam’s apple. The thyroid gland wraps around the windpipe and has a shape that is similar to a butterfly – formed by two wings or lobes ;and is attached by a middle part.

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      Citation Doi And Article Data

      Citation:DOI:Dr Yuranga WeerakkodyRevisions:see full revision historySystem:

      • Primary hypothyroidism with thyroid atrophy
      • Ord’s disease

      Primary idiopathic hypothyroidism with thyroid atrophy is one of the causes of hypothyroidism. Some authors consider this entity as being on the same spectrum as Hashimoto disease;1,3;while others consider it as distinct entities.

      What Does Hashimotos Disease Do To Your Body


      Hashimotos disease is an autoimmune disease that produces antibodies that attack your thyroid like it would a virus. Over time, this can cause tissue damage in your thyroid. This damage can decrease your thyroids ability to produce thyroid hormones, resulting in hypothyroidism. The damage to your thyroid can also cause a goiter, which is the swelling of your thyroid gland. A goiter can make your throat look and feel swollen and can impact your breathing or swallowing. Decreased thyroid hormones also slow the function of your bodys organs, which can decrease your heart rate, cause weight gain, slow your mental functioning, decrease functioning in your intestines , and more.

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      What Causes Atrophic Thyroiditis

      Atrophic thyroiditis is defined in various ways, but in this article, I consider atrophic thyroiditis as autoimmune-caused severe thyroid gland atrophy necessitating lifelong thyroid hormone replacement.

      Atrophic Thyroiditis is a HYPOthyroid form of Graves disease.;Jara, et al, 2008, explains that Atrophic Thyroiditis patients usually have a Graves disease genetic profile, which is quite distinct genetically from Hashimotos.

      The normal form of Graves HYPERthyroidism is caused by TSH-Receptor;*stimulating*;antibodies that overstimulate the thyroid gland to produce hormone, even in the absence of TSH.

      But Atrophic Thyroiditis is associated with the presence of TSH-Receptor;*blocking*;antibodies that cause HYPOthyroidism.

      The blocking antibody prevents TSH from stimulating TSH receptors in the thyroid gland and other tissues where the receptor is expressed. Therefore, even in patients with extremely high TSH levels over 100 can have no TSH stimulation of their thyroid gland when the antibody is strong enough to block the receptors.

      • As demonstration that the blocking antibody is a Graves disease-associated antibody, according to Fröhlich & Wahl, 2017, Thyroid Autoimmunity, blocking anti-TSH-Receptor antibodies occur in 2575% of Graves Disease patients.

      Therefore, current science points to the copresence of both blocking and cleavage TSH receptor antibodies as the likely cause of thyroid gland atrophy .

      Advanced Ultrasound Techniques In Thyroid Imaging

      Contrast-enhanced ultrasound is a newly developed technique that helps in characterizing a thyroid nodule. On CE-US, enhancement patterns are different in benign and malignant lesions. Ring enhancement is predictive of benign lesions, whereas heterogeneous enhancement is helpful for detecting malignant lesions. However, overlapping findings seem to limit the potential of this technique in the characterization of thyroid nodules. Use of specific contrast and pulse inversion harmonic imaging further improves the efficacy of ultrasound in diagnosing a malignant thyroid nodule.

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      Thyroid Volume Distribution In Hypothyroid Patients Vs Controls

      A right-skewed distribution of thyroid volume was observed in both patients and controls, which is in accordance with other studies reporting this in patients with autoimmune thyroiditis, independent of biochemical status . Patients had a statistically lower thyroid volume than controls but with a large overlap. The dispersion of thyroid volumes was considerably larger in hypothyroid patients than in controls, illustrating that indeed some patients tend to have an increase and other a decrease in thyroid volume. On the other hand, the distribution of thyroid volumes was Gaussian with no sign of distinct subgroups. This finding was somewhat unexpected because primary autoimmune hypothyroidism is often divided into two clinical subtypes : Ords hypothyroidism with atrophic thyroid gland, and Hashimotos hypothyroidism with glandular hypertrophy and/or goiter. The volume distribution in patients diagnosed with autoimmune hypothyroidism was the same in both sexes, and Q-Q plots illustrated a pearls-on-a-string pattern with no sign of a bimodal distribution. Our findings indicated that patients with a small or large thyroid gland represent only extremes of a continuous Gaussian distribution.

      How Is Thyroiditis Diagnosed

      What is the Thyroid Gland and How Do You Know if You Have A Thyroid Issue?

      Tests for thyroiditis may include:

      • Thyroid function tests measure the amounts of hormones in the blood. TSH comes from the pituitary gland and stimulates the thyroid gland to produce T4 and T3. The thyroid gland produces the hormones T4 and T3 that exert the action of thyroid hormone in the body. T3 and T4 are called thyroid hormones.
      • Thyroid antibody tests measure thyroid antibodies that include antithyroid antibodies or thyroid receptor stimulating antibodies .
      • Erythrocyte sedimentation rate indicates inflammation by measuring how fast red blood cells fall. The ESR is high in sub-acute thyroiditis.
      • Ultrasound , sonogram of the thyroid, is used very frequently to evaluate the anatomy of the thyroid gland. It can show a nodule in the thyroid gland, a change in blood flow and echo texture of the gland.
      • Radioactive iodine uptake measures how much radioactive iodine is absorbed by the thyroid gland. The amount is always low in the thyrotoxic phase of thyroiditis.

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      Study Strengths And Limitations

      We studied a cohort of patients, all newly diagnosed with primary overt autoimmune hypothyroidism. Other studies on thyroid volume in autoimmune hypothyroidism included patients with subclinical hypothyroidism and euthyroid patients with thyroid autoantibodies . The patients were diagnosed in a population cohort and included independent on referral to specialized hospital departments. Hypothyroid patients referred to a hospital unit may differ substantially from the entire population of patients with regard to age but also presence of goiter, difficulty in swallowing, and neck discomfort .

      Some of the patients had received L-T4 replacement therapy for a short period before they joined our investigation. Therapy may influence the echopattern , thyroid volume , and antibody concentration , although this is not a consistent finding . We split the entire group of patients into those who joined the comprehensive program within 50 d after the first blood test indicating hypothyroidism had been taken vs. later . Comparing the two groups, we found no difference in concentrations of TPOAb or TgAb and no difference in the prevalence of TRAb . Thus, initiation of L-T4 therapy before the ultrasound investigation did not introduce major bias on thyroid volume estimates.

      Patients with autoimmune thyroiditis may be biochemically euthyroid, subclinically hypothyroid, or overtly hypothyroid. Our study gives insight only into the fraction of patients being overtly hypothyroid.

      Genotyping Quality Control And Imputation

      All participants were genotyped using Illumina Infinium HumanCoreExome genotyping platform that contains 551 839 markers. We performed quality control of genotype data, using PLINK and R software, following the standard procedure.

      In the sample QC, we excluded all samples with call rate less than 95% and all samples with heterozygosity rate deviating more than three standard deviations from the mean. We cross-checked reported sex with the sex inferred from the genotypes no exclusions were made based on this criterion. We checked for ethnicity by performing multidimensional scaling analysis and visually inspecting the MDS plot . No individuals were excluded based on this criterion. We also checked pair-wise identity by descent and did not detect duplicate samples. Twenty-five individuals did not pass QC, thus leaving a total of 345 individuals for imputation and GWAS. After removal of individuals failing QC, we excluded all genetic variants with call rate less than 98% and all variants deviating from Hardy-Weinberg equilibrium .

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      What Causes Thyroids To Swell

      An enlarged thyroid can have various causes. In many cases, the bodys immune system attacks the thyroid, causing it to stop functioning properly and produce too much or too little thyroid hormone . A swollen thyroid, or goiter, can also be caused by an infection, a drug interaction, nodules in the gland, inflammation, iodine deficiency or as a reaction after pregnancy.;


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