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Information to the clinical picture Hashimoto Thyreoiditis Definition Causes Diagnosis Progress of disease Symptoms Therapy The Hashimoto Thyreoiditis is generally considered as a harmless illness, which causes no complaints and which must be observed, but not necessarily be treated. Frequently it is an accidental finding during a routine examination, but sometimes it is diagnosed after a long tale of woe. In view of this the insufficient knowledge of physicians is a scandal. About 10 % of the population is afflicted with this disease. The Hashimoto Thyreoiditis is no trifle, which can be neglected, but a chronic disease which requires a consistent and individually adapted treatment. This thyroid illness durably impaired in the quality of life means no expression of being exaggerated sniveling nor sign of will weak. The Hashimoto Thyreoiditis is no psychosomatic disease. In many cases the late beginning of treatment is the main cause that not all symptoms are reversible. By the way it is a problem that only the hypothyroidism can be treated and not the causes of the autoimmune process which makes also complaints. The thyroid is part of the neck. It lies before the air tube, scarce underneath the larynx. The thyroid is reminiscent of the form of a butterfly. With 15 – 25 g the thyroid is very small, but those of it produced hormones are genuine multi-talents. Almost all organs are influenced by the thyroid homones thyroxin (T4) and trijodthyronin (T3). Zum Seitenanfang Definition: The Hashimoto Thyreoiditis (autoimmune thyreoiditis) is a chronic inflammation of the thyroid. This inflammation is not caused by viruses or bacteria, but goes back on a defect in the immune system. The defense cells from the immune system normally arranged against body-stranger intruders do falsely attack body-own tissue. Relevant to this the Hashimoto-Thyreoiditis is the frequent autoimmune disease of human beeings. The Hashimoto-Thyreoiditis is named after its disoverer, the japanese physician Dr. Hakaru Hashimoto, who described this disease 1912. Relative to the Hashimoto Thyreoiditis there are two different variants. On the one hand the hypertrophe variant (enlargement of the thyroid) and on the other hand the atrophe variant (reduction of the thyroid). Zum Seitenanfang Causes: The exact causes for the raise of the Hashimoto thyreoiditis are not scientifically investigated. Presumable there is not only one cause, but several factors must assemble before it comes to the outbreak of disease. A genetic predisposition, chronic infections, stress, iodine exposition, smoking, quicksilver or changes of sexual hormones (puberty, pregnancy, climacteric period) are discussed causes. Zum Seitenanfang Diagnosis: First reference to the existance of thyroid disease give the results of a blood test. Referring to the Hashimoto Thyreoiditis it must be differentiated between the hormones (TSH, fT4, fT3) an the anti-bodies (TPO-AK, TG-AK, TRAK). The hormones describe the thyroid function, the antibodies are important for the diagnosis. Independently whether these blood values are still in the normal range, there should be enforced an ultrasonic diagnosis. Because in the initial stage of the Hashimoto Thyreoiditis there is no restriction of the thyroid function. The inflammatory destruction process runs slowly and for a period of months or years there is no measurable loss of function. Therefore a TSH about 2 uIU/ml can be a hint to hypothyroidism. Also the absence of anti-bodies does not exclude a Hashimoto Thyreoiditis. Decisive is the ultrasonic diagnosis of the thyroid which showes the inflammation. If on this occasion a thyroid volume smaller than 10 ml is determined this fact point to hypothyroidism. In individual cases further examinations can be necessary. Zum Seitenanfang Progress of disease: At the beginning of the inflammation the thyroid hormone cells are destructed. The elevated hormones get released and effect symptoms of hyperthyroidism (for example: sweating, restlessness, trembling, diarrhea, loss in weight). This phase is also called hashitoxicosis. In the progress of disease the inflammation leads to a complete destruction of the thyroid. There are no longer enough hormones to supply the organism. This phase is called hypothyroidism. There is no possibility to restore the Hashimoto Thyreoiditis. Zum Seitenanfang Symptoms: The complaints, which can be caused by a Hashimoto Thyreoiditis are very versatile because they do not only affect the thyroid, but also different organ systems can be afflicted. The way and mode oft the symptoms is individually different. The following impairments are possible: Local symptoms: Throat feels full, sore throat, hoarseness, local skin rash, pain of the neck and facial muscles, toothache Skin and hair: Swelling around the eyes (eyelid edemas), dry skin, itching, rough hair, loss of hair, fingernails bittle and break Cardiovascular system: Heart beating, heart trouble, vertigo, diastolic high blood pressure (rare: slow blood pressure), slow pulse, difficulties in breathing Metabolism: Increase in weight, unable to lose weight, weakness, fatigue, lethargy, low body temperature, high cholesterin Stomach intestine system: Loss of appetite, nausea, heartburn, stomachache, flatulance, obstruction Muscles and joints: Muscular ache, loss of muscular strength, muscular atrophy, pain in the limbs, rheumatism, carpal tunnel syndrom Psyche: Tearful, depressing, restless, irritability, nervousness, anxiousness, panic attacks, difficulty to concentrate or remember things, sleeplessness Sexual hormones: Irregular menstruation, sterile Zum Seitenanfang Therapy: The Hashimoto Thyreoiditis is treated by the lifelong substitution of the missing thyroid hormones. Normally by the daily income 30 to 60 minutes before breakfast. The cause of Hashimoto Thyreoiditis is not influenced by the thyroid homone therapy. In this coherence it is important that the thyroid hormone dose does only slowly increased (25 µg per week). Bloodtests are regularly necessary – normally every 3 to 6 months. Before the blood tests do not take your medicament! There are different possibilities of treatment: treatment only with T4, treatment with T4 plus T3 or treatment with natural hormone. Many patients feel fine under this therapy, but there is a little group of patients which have continuing problems. For these patients there is unfortunately hardly any alternative treatment. The treatment with iodine makes no sense. On the contrary the inflammation will be stimulated. The daily income of 200 µg selenium can sink the concentration of the thyroid anti-bodies. This is proved by several studies. Selenium affects as a antioxidans. But selenium is even important for the conversion of the inactive hormon T4 to the metabolist active hormon T3. An operation is rarely necessary, only in case of a present goiter. Zum Seitenanfang Homepage erstellt am 02.07.05, aktualisiert am 25.09.09
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Information to the clinical picture Hashimoto Thyreoiditis

Definition

Causes

Diagnosis

Progress of disease

Symptoms

Therapy

The Hashimoto Thyreoiditis is generally considered as a harmless illness, which causes no complaints and which must be observed, but not necessarily be treated. Frequently it is an accidental finding during a routine examination, but sometimes it is diagnosed after a long tale of woe. In view of this the insufficient knowledge of physicians is a scandal. About 10 % of the population is afflicted with this disease.

The Hashimoto Thyreoiditis is no trifle, which can be neglected, but a chronic disease which requires a consistent and individually adapted treatment. This thyroid illness durably impaired in the quality of life means no expression of being exaggerated sniveling nor sign of will weak. The Hashimoto Thyreoiditis is no psychosomatic disease.

In many cases the late beginning of treatment is the main cause that not all symptoms are reversible. By the way it is a problem that only the hypothyroidism can be treated and not the causes of the autoimmune process which makes also complaints.

The thyroid is part of the neck. It lies before the air tube, scarce underneath the larynx. The thyroid is reminiscent of the form of a butterfly. With 15 – 25 g the thyroid is very small, but those of it produced hormones are genuine multi-talents. Almost all organs are influenced by the thyroid homones thyroxin (T4) and trijodthyronin (T3).

Zum Seitenanfang

Definition:

The Hashimoto Thyreoiditis (autoimmune thyreoiditis) is a chronic inflammation of the thyroid. This inflammation is not caused by viruses or bacteria, but goes back on a defect in the immune system. The defense cells from the immune system normally arranged against body-stranger intruders do falsely attack body-own tissue. Relevant to this the Hashimoto-Thyreoiditis is the frequent autoimmune disease of human beeings. The Hashimoto-Thyreoiditis is named after its disoverer, the japanese physician Dr. Hakaru Hashimoto, who described this disease 1912. Relative to the Hashimoto Thyreoiditis there are two different variants. On the one hand the hypertrophe variant (enlargement of the thyroid) and on the other hand the atrophe variant (reduction of the thyroid).

Zum Seitenanfang

Causes:

The exact causes for the raise of the Hashimoto thyreoiditis are not scientifically investigated. Presumable there is not only one cause, but several factors must assemble before it comes to the outbreak of disease. A genetic predisposition, chronic infections, stress, iodine exposition, smoking, quicksilver or changes of sexual hormones (puberty, pregnancy, climacteric period) are discussed causes.

Zum Seitenanfang

Diagnosis:

First reference to the existance of thyroid disease give the results of a blood test. Referring to the Hashimoto Thyreoiditis it must be differentiated between the hormones (TSH, fT4, fT3) an the anti-bodies (TPO-AK, TG-AK, TRAK). The hormones describe the thyroid function, the antibodies are important for the diagnosis. Independently whether these blood values are still in the normal range, there should be enforced an ultrasonic diagnosis. Because in the initial stage of the Hashimoto Thyreoiditis there is no restriction of the thyroid function. The inflammatory destruction process runs slowly and for a period of months or years there is no measurable loss of function. Therefore a TSH about 2 uIU/ml can be a hint to hypothyroidism. Also the absence of anti-bodies does not exclude a Hashimoto Thyreoiditis. Decisive is the ultrasonic diagnosis of the thyroid which showes the inflammation. If on this occasion a thyroid volume smaller than 10 ml is determined this fact point to hypothyroidism. In individual cases further examinations can be necessary.

Zum Seitenanfang

Progress of disease:

At the beginning of the inflammation the thyroid hormone cells are destructed. The elevated hormones get released and effect symptoms of hyperthyroidism (for example: sweating, restlessness, trembling, diarrhea, loss in weight). This phase is also called hashitoxicosis. In the progress of disease the inflammation leads to a complete destruction of the thyroid. There are no longer enough hormones to supply the organism. This phase is called hypothyroidism. There is no possibility to restore the Hashimoto Thyreoiditis.

Zum Seitenanfang

Symptoms:

The complaints, which can be caused by a Hashimoto Thyreoiditis are very versatile because they do not only affect the thyroid, but also different organ systems can be afflicted. The way and mode oft the symptoms is individually different.

The following impairments are possible:

Local symptoms:

Throat feels full, sore throat, hoarseness, local skin rash, pain of the neck and facial muscles, toothache

Skin and hair:

Swelling around the eyes (eyelid edemas), dry skin, itching, rough hair, loss of hair, fingernails bittle and break

Cardiovascular system:

Heart beating, heart trouble, vertigo, diastolic high blood pressure (rare: slow blood pressure), slow pulse, difficulties in breathing

Metabolism:

Increase in weight, unable to lose weight, weakness, fatigue, lethargy, low body temperature, high cholesterin

Stomach intestine system:

Loss of appetite, nausea, heartburn, stomachache, flatulance, obstruction

Muscles and joints:

Muscular ache, loss of muscular strength, muscular atrophy, pain in the limbs, rheumatism, carpal tunnel syndrom

Psyche:

Tearful, depressing, restless, irritability, nervousness, anxiousness, panic attacks, difficulty to concentrate or remember things, sleeplessness

Sexual hormones:

Irregular menstruation, sterile

Zum Seitenanfang

Therapy:

The Hashimoto Thyreoiditis is treated by the lifelong substitution of the missing thyroid hormones. Normally by the daily income 30 to 60 minutes before breakfast. The cause of Hashimoto Thyreoiditis is not influenced by the thyroid homone therapy. In this coherence it is important that the thyroid hormone dose does only slowly increased (25 µg per week). Bloodtests are regularly necessary – normally every 3 to 6 months. Before the blood tests do not take your medicament!

There are different possibilities of treatment: treatment only with T4, treatment with T4 plus T3 or treatment with natural hormone. Many patients feel fine under this therapy, but there is a little group of patients which have continuing problems. For these patients there is unfortunately hardly any alternative treatment.

The treatment with iodine makes no sense. On the contrary the inflammation will be stimulated. The daily income of 200 µg selenium can sink the concentration of the thyroid anti-bodies. This is proved by several studies. Selenium affects as a antioxidans. But selenium is even important for the conversion of the inactive hormon T4 to the metabolist active hormon T3.

An operation is rarely necessary, only in case of a present goiter.

Zum Seitenanfang

Homepage erstellt am 02.07.05, aktualisiert am 25.09.09

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