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Chronic thyroiditis (Hashimoto disease)
Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis; Chronic autoimmune thyroiditis; Lymphadenoid goiter - Hashimoto; Hypothyroidism - Hashimoto; Type 2 polyglandular autoimmune syndrome - Hashimoto; PGA II - Hashimoto
Chronic thyroiditis is caused by a reaction of the immune system against the thyroid gland. It often results in reduced thyroid function ( hypothyroidism ).
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....
The disorder is also called Hashimoto disease.
The thyroid gland is located in the neck, just above where your collarbones meet in the middle.
Causes
Hashimoto disease is a common thyroid gland disorder. It can occur at any age, but is most often seen in middle-aged women. It is caused by a reaction of the immune system against the thyroid gland.
Reaction of the immune system
An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of aut...
The disease begins slowly. It may take months or even years for the condition to be detected and for thyroid hormone levels to become lower than normal. Hashimoto disease is most common in people with a family history of thyroid disease.
In very rare cases, the disease may be related to other hormone problems caused by the immune system. It can occur with poor adrenal function and type 1 diabetes. In these cases, the condition is called type 2 polyglandular autoimmune syndrome (PGA II).
Sometimes, Hashimoto disease occurs as part of a condition called type 1 polyglandular autoimmune syndrome (PGA I), along with:
- Poor function of the adrenal glands
- Fungal infections of the mouth and nails
- Underactive parathyroid gland
Symptoms
Symptoms of Hashimoto disease may include any of the following:
- Constipation
- Difficulty concentrating or thinking
- Dry skin
-
Enlarged neck or presence of
goiter
, which may be the only early symptom
Goiter
A simple goiter is an enlargement of the thyroid gland. It is usually not a tumor or cancer.
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Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
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- Heavy and irregular periods
-
Intolerance to cold
Intolerance to cold
Cold intolerance is an abnormal sensitivity to a cold environment or cold temperatures.
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- Small or shrunken thyroid gland (late in the disease)
Exams and Tests
Laboratory tests to determine thyroid function include:
-
Free
T4 test
T4 test
T4 (thyroxine) is the main hormone produced by the thyroid gland. A laboratory test can be done to measure the amount of free T4 in your blood....
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Serum TSH
Serum TSH
A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It tells the thyroid gla...
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T3
T3
Triiodothyronine (T3) is a thyroid hormone. It plays an important role in the body's control of metabolism (the many processes the body does to func...
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Thyroid autoantibodies
Thyroid autoantibodies
Microsomes are found inside thyroid cells. The body produces antibodies to microsomes when there has been damage to thyroid cells. The antithyroid ...
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Imaging studies and fine needle biopsy are generally not needed to diagnose Hashimoto thyroiditis.
This disease may also change the results of the following tests:
- Complete blood count
- Serum prolactin
- Serum sodium
- Total cholesterol
Treatment
If you have findings of an underactive thyroid, you may receive thyroid replacement medicine.
Not everyone with thyroiditis or goiter has low levels of thyroid hormone. You may just need regular follow-up by a health care provider.
Outlook (Prognosis)
The disease stays stable for years. If it does slowly progress to thyroid hormone deficiency (hypothyroidism), it can be treated with thyroid replacement therapy.
Possible Complications
This condition can occur with other autoimmune disorders. In rare cases, thyroid cancer or thyroid lymphoma may develop.
When to Contact a Medical Professional
Call your provider if you develop symptoms of chronic thyroiditis.
Prevention
There is no known way to prevent this disorder. Being aware of risk factors may allow earlier diagnosis and treatment.
References
Amino N, Lazarus JH, De Groot LJ. Chronic (Hashimoto's) thyroiditis. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 86.
Brent GA, Weetman AP. Hypothyroidism and thyroiditis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 13.
Garber JR, Cobin RH, Gharib H; American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract . 2012;18(6):988-1028. PMID: 23246686 www.ncbi.nlm.nih.gov/pubmed/23246686 .
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Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
-
Thyroid enlargement - scintiscan - illustration
This image shows enlargement of the thyroid gland and extension down behind the breastbone (retrosternal space). The image, called a scintiscan, was generated using a radioactive isotope.
Thyroid enlargement - scintiscan
illustration
-
Hashimoto's disease (chronic thyroiditis) - illustration
Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflammation of the thyroid which frequently leads to hypothyroidism, a decreased function of the thyroid gland. Middle-aged women are most commonly affected.
Hashimoto's disease (chronic thyroiditis)
illustration
-
Thyroid gland - illustration
The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.
Thyroid gland
illustration
-
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
-
Thyroid enlargement - scintiscan - illustration
This image shows enlargement of the thyroid gland and extension down behind the breastbone (retrosternal space). The image, called a scintiscan, was generated using a radioactive isotope.
Thyroid enlargement - scintiscan
illustration
-
Hashimoto's disease (chronic thyroiditis) - illustration
Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflammation of the thyroid which frequently leads to hypothyroidism, a decreased function of the thyroid gland. Middle-aged women are most commonly affected.
Hashimoto's disease (chronic thyroiditis)
illustration
-
Thyroid gland - illustration
The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.
Thyroid gland
illustration
Review Date: 2/3/2016
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
