How Do You Diagnose Hashimoto’s Disease?
Hashimoto’s disease considered an autoimmune disorder causes hypothyroidism (underactive thyroid). It is also known as chronic lymphocytic thyroiditis, Hashimoto’s thyroiditis or autoimmune thyroiditis. In this disease, the immune system attacks its own thyroid gland leading to thyroid damage; thus, there is less production of thyroid hormone in the body. It is the leading cause of hypothyroidism in the United States. It is 8 times more common in females than in males and is more prevalent in middle-aged adults in the age group of 40-60.
Symptoms Of Hashimoto’s Disease?
Hashimoto’s disease is a slow progressing disease that does not show any symptoms initially, but over the years it causes thyroid damage leading to decreased production of thyroid hormone. Thyroid hormones (triiodothyronine or T3, tetraiodothyronine/thyroxine or T4 and calcitonin) regulate the basic metabolism in the body, and its growth and maturation. It may also present with a swelling on the anterior neck/throat area leading to goiter formation. The signs and symptoms of Hashimoto’s disease include fatigue, malaise, lethargy, increased cold sensitivity, constipation, dry skin, brittle nails, hoarse voice, dry hair, hair fall/thinning, puffy face, tongue enlargement, weight gain, muscular pain/stiffness/weakness, joint pain/stiffness, decreased heart rate, abnormal menstrual bleeding, memory problems and/or depression.
Risk Factors For Hashimoto’s Thyroiditis.
Hashimoto’s disease is an autoimmune disease in which auto-antibodies are produced against thyroid gland, the cause of which is unknown, but is thought to be a trigger by a bacterium or virus. A combination of heredity, gender and age play a role in determining the likelihood of developing the disease. The various risk factors for developing Hashimoto’s disease include:
Gender: It is considered 8 times more common in females than males.
Age: It is more common in middle-aged individuals between 40 to 60 years of age.
Heredity: An individual with a family history of Hashimoto’s disease is at a greater risk of developing the disease.
Autoimmune Diseases: There is an increased chance of developing Hashimoto’s disease if an individual has another autoimmune disease such as Addison’s disease, autoimmune hepatitis, lupus, celiac disease, type 1 diabetes, pernicious anemia, Sjogren’s syndrome, vitiligo or rheumatoid arthritis.
Exposure to Radiation: People exposed to head and neck radiation are at a greater risk of developing Hashimoto’s disease.
How Do You Diagnose Hashimoto’s Disease?
It is important to visit a doctor when an individual notices any of the above symptoms. The doctor will take a full medical history and will perform physical examination. He will also order blood tests to check for hypothyroidism, which will show increased TSH production and decreased level of free T3 and free T4 hormones. TSH is increased in hypothyroidism as the level of thyroid hormone production is managed by pituitary gland by the production of thyroid stimulating hormone (TSH). In hypothyroidism the thyroid hormone production is diminished due to various reasons, so the pituitary sends repetitive signals to the thyroid gland for more production of thyroid hormones by producing TSH, thus there is elevated TSH in blood of hypothyroid patient. T3 and T4 hormone levels are diminished in the body of hypothyroid patient due to various reasons, one of them being Hashimoto’s thyroiditis. If there is an enlargement of the thyroid gland, which is also known as goiter, the doctor will also order blood tests for antithyroid antibodies that include anti-thyroid peroxidase (anti-TPO) antibody and anti-thyroglobulin (anti-Tg) antibody. These antibodies are found in about 90% of people suffering with Hashimoto’s disease.
Generally, no other test is needed to confirm Hashimoto’s disease, but if a doctor is suspecting Hashimoto’s disease and the antibody test is negative then the medical practitioner may order an ultrasound of thyroid. The ultrasound will show the size of the thyroid and other confirming features of Hashimoto’s disease. The ultrasound will also rule out other causes of enlarged thyroid including thyroid nodules.
The treatment of Hashimoto’s disease causing hypothyroidism is simple with the replacement by synthetic thyroid hormone in the form of levothyroxine. The patient needs to follow up with doctor regularly with thyroid tests and for dosage adjustment of the medication.