autoimmune thyroiditis

Autoimmune thyroiditis, also called Hashimoto's thyroiditis, is a chronic thyroiditis in which the immune system turns against the body's thyroid tissue. It is therefore one of the autoimmune diseases and is the most common cause of hypothyroidism.

Autoimmune reaction against the thyroid gland

In autoimmune diseases is an error of the immune system, which some body cells are suddenly regarded as foreign. To combat the supposed foreign body, lymphocytes - a type of white blood cells - are used, which mistakenly form weapons against the body's own tissue, called autoantibodies. In case of autoimmune thyroiditis autoantibodies are TPO-AK and Tg-AK. It initiates an inflammatory process that destroys thyroid tissue and produces less and less thyroid hormone.

Autoimmune thyroiditis: causes still unclear

Ultimately, why this immune system attack occurs is not yet clear. It is believed that a previous bacterial or viral infection can act as a trigger. On the other hand, there is also a familial accumulation.

Women are much more affected than men, preferably between the ages of 30 and 50 years. It is striking that the disease is often associated with other autoimmune diseases, such as white spot disease (vitiligo) or diabetes type 1.

Autoimmune Thyroiditis: Symptoms begin gradually

The disease begins almost imperceptibly and painlessly, so that those affected initially barely notice the symptoms. Initially, some sufferers, due to the destruction of the hormone storage a short-term phase of hyperthyroidism through, which then gradually leads to a chronic hypofunction. Symptoms of overfunction are:

  • unrest
  • insomnia
  • Increased sweating
  • hair loss
  • Weight loss despite increased appetite
  • Trembling of the hands
  • diarrhea
  • Fast, irregular pulse
  • Cycle disorders in women

The symptoms of hyperfunction are superseded by the signs of hypofunction if less and less thyroid hormone is produced in the course of autoimmune disease:

  • fatigue
  • lack of concentration
  • Shaggy, dull hair
  • constipation
  • Easy to freeze
  • hair loss
  • Dry, cool, doughy skin
  • hoarseness
  • Cycle disorders in women

Since the disease is common in women around 50, the symptoms can easily be mistaken for menopausal symptoms and thus misjudged. In most cases, a shrinkage of the thyroid gland to determine (atrophic form), less frequently, despite the loss of function, an enlargement of the thyroid (goiter) is observed (hypertrophic form).

Autoimmune thyroiditis: diagnostics with blood tests and ultrasound

If the symptoms lead to the doctor, the history and palpation of the thyroid indicate the direction, leading the way in diagnostics but are blood examination and ultrasound examination. More than 90 percent of those affected receive the typical TPO antibodies and 70 to 80 percent the Tg antibodies.

Indicator of hypofunction is an elevated level of TSH (thyroid stimulating hormone) - a hormone of the pituitary gland - even though thyroid hormone levels are still within the norm. The ultrasound examination reveals typical changes in autoimmune thyroiditis. Only occasionally further examinations such as scintigraphy or the removal of a tissue sample are required to exclude other diseases.

Autoimmune thyroiditis therapy: replacement therapy

Unfortunately, autoimmune thyroiditis is not curable yet. With the therapy, however, a normalization of the hormone balance can be achieved. For this the lifelong replacement of the missing thyroid hormone is necessary. Levothyroxine is initially prescribed in low doses, then increased until the individually appropriate amount is reached. This is shown by the normalization of the TSH level (possibly by 1 μU / ml), which is monitored by regular blood tests.

Of utmost importance is the therapy during pregnancy to prevent physical and mental damage to the unborn child. The ingestion of the trace element iodine should be avoided as it further fuels the autoimmune process. On the other hand, studies have shown that selenium has a positive influence on the well-being and level of antibody levels.

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