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The Link Between Hashimoto’s and Thyroid Dysfunction (Part 1)

Dr. Numan Niaz

3 min read

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Hashimoto’s disease is an autoimmune condition in which the immune system attacks the Thyroid Peroxidase Enzyme found in the thyroid gland by producing antibodies against it. This inflames the gland, eventually leading to ‘hypothyroidism’ (under-production of thyroid hormones), hence also referred to as ‘Hashimoto’s Thyroiditis’, or ‘Chronic Lymphocytic Thyroiditis’. In this article, we will explore this link between Hashimoto’s and thyroid dysfunction and try to see what are the alarm bells that should indicate a doctor’s appointment. 

Difference Between Hashimoto’s And Hypothyroidism:

Hashimoto’s Disease, in addition to being a common cause of hypothyroidism, can equally affect men, women, and children of all ages, whereas the risk of hypothyroidism usually increases with age, with a large number of affected individuals being over 40. Other factors that set the condition apart from Hypothyroidism include:

  • Hashimoto’s-caused thyroid gland dysfunction, i.e. its inability to produce thyroid hormones is the result of the gradual destruction of the gland itself by the antibodies.
  • Before entirely losing their thyroid hormone productivity, most patients experience a brief hyperthyroid phase resulting from excess thyroid hormone leakage during the initial antibody attacks. Moreover, certain individuals may also alternately experience hyper and hypothyroid symptoms before eventually settling on hypothyroidism.

Symptoms:

Hashimoto’s Disease progressively develops over many years, hence the lack of definitive symptoms during the early stages. However, the condition’s symptoms often mirror those of hypothyroidism such as:

  • Hair loss
  • Infertility
  • Depression
  • Constipation
  • Pale, dry skin
  • Facial swelling
  • Slow heart rate
  • Memory lapses
  • Chronic fatigue
  • Muscular weakness
  • Brittle nails and hair
  • Tongue enlargement
  • Inability to get warm
  • Oedema (fluid retention)
  • Unexplained weight gain
  • Increased cold sensitivity
  • Menorrhagia (excess or prolonged menstrual bleeding)
  • Tender, stiff, and aching muscles and joints
Diagnosis

Normally, your doctor will speculate Hashimoto’s disease if you have the following symptoms:

  • Dry skin,
  • Hoarse voice,
  • tiredness,
  • medical history of thyroidal issues.

Upon speculation, the doctor will instruct some tests. A correct diagnosis can only be made based on the results of blood tests that ascertain the amount of thyroid hormone and thyroid-stimulating hormone (TSH) in your pituitary gland. 

Some of the tests are: 

  • Hormone test;  This test measures the thyroid hormone and TSH levels using a blood test. If the thyroid hormones are less, this means that the thyroid is underperforming. This will be associated with high levels of TSH because the pituitary gland will try to stimulate the thyroid to produce more hormones. 
  • Antibody test; Hashimoto’s disease is an autoimmune condition because of which it leads to the creation of antibodies. The blood test will again indicate the presence of antibodies against a specific enzyme. This is the thyroid peroxidase which is countered by TPO antibodies. Thyroid peroxidase is present in the thyroid and helps in the production of thyroid hormones. However, TPO antibodies can be present in someone without thyroidal issues, which is a limitation of this test. 

The TSH levels are good indicators of Hashimoto’s disease. Your doctor will most likely test for them and then conduct a hormone test. All in all, these tests will help your doctor make the right diagnosis and assign the correct medication dosage, leading to a better recovery of your body. 

Complications:

In addition to brain and kidney problems and possibly fatal infections, an untreated hypothyroid condition caused by Hashimoto’s can lead to the following complications:

1- Goiter:

A lump may develop at the front of the throat as a direct result of the thyroid gland swelling due to constantly being stimulated for hormone release. Although more unsightly than discomforting, an over-swollen goiter may obstruct breathing and swallowing in some cases.

2- Heart Problems:

Since the thyroid gland is largely responsible for regulating metabolism and heart rate, a continued deficiency of thyroid hormones may result in heart disease, heart enlargement, and even cardiac failure due to an accumulation of ‘bad’ LDL cholesterol.

3- Mental Health Issues:

Early stage Hashimoto’s Disease may also trigger depression that worsens with time. Moreover, some individuals may also experience sexual dysfunction and, resultantly, decreased mental functioning.

4- Myxedema:

Characterized by excess lethargy, drowsiness, and extreme sensitivity to low temperatures, this rare condition may induce a coma in an untreated individual with Hashimoto’s; in which case urgent medical attention is required.

5- Birth Defects:

Pregnant women with an undiagnosed or untreated under active thyroid caused by Hashimoto’s Disease may put their babies at a higher risk of congenital defects, such as cleft palate, heart and kidney problems, and intellectual defects.

6- Thyroid Lymphoma:

Albeit rarer than myxedema, certain untreated or undertreated individuals may develop cancerous tumors in the thyroid gland. However, the condition is completely treatable if detected early, making regular examinations for thyroid lumps or nodules imperative in those diagnosed with Hashimoto’s-induced hypothyroidism.

When To See A Doctor:

In addition to seeing a medical specialist in case of any of the above-mentioned symptoms, certain individuals may also require periodic testing for optimum thyroid function if they’ve had:

  • Thyroid surgery
  • Radioactive iodine or anti-thyroid medication treatment
  • Radiation therapy to the head, neck, upper chest, or Hodgkin’s disease (a form of blood cancer)
  • A high blood cholesterol

Hashimoto’s may be a lifelong condition, but it is easily manageable if diagnosed early on. Get regular thyroid function tests to ensure adequate gland functioning. You can also book an appointment with a top Endocrinologist in Peshawar, Karachi and Multan through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your thyroid concerns.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Numan Niaz - Author Dr. Nauman Niaz is a Internal Medicine Specialist practicing in Islamabad. Dr. Nauman Niaz has the following degrees: MBBS (Pb), MRCP (UK), FRCP (Glasgow), FRCP (Ireland), FRCP (London), FRCP (Edin), Ph.D (WA), Post Doc (Oxford) and has 24 years of experience.
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