The Thyroid

The thyroid gland is the “master controller” of metabolism.
Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis

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What is Hashimoto’s thyroiditis?

Hashimoto’s thyroiditis is an autoimmune disease in which the body’s immune system turns against itself and attacks the thyroid.1 This leads to the gradual, long-term destruction of the thyroid gland, and eventually lead to insufficient production of thyroid hormones, resulting in hypothyroidism.1

Who is at risk?

Hashimoto’s thyroiditis can affect any individual at any age but mostly occurs in women aged 30‒50 years old,2 and in people with a family history of autoimmune thyroid disorders.1 The exact reason why the immune system attacks the thyroid gland is not yet known, but genetic and environmental factors such as viral or bacterial infection are thought to play a role.

Symptoms of Hashimoto’s thyroiditis

Some individuals with Hashimoto’s thyroiditis have a normal thyroid function initially but may progress to hypothyroidism after a period of time.2 This disease can go unnoticed for a long time. In the course of the disease, the thyroid gland produces less and less thyroid hormones, and you might develop symptoms of hypothyroidism, such as:1,4

  • Fatigue and drowsiness and/or weakness
  • Cold intolerance
  • Difficulty concentrating or thinking
  • Depression
  • Weight gain
  • Enlarged neck or presence of goiter, which may be an early symptom, and, later in the disease, a small or shrunken thyroid gland
  • Abnormal menstrual periods with heavy/irregular menses
  • Constipation
  • Joint or muscle pain
  • Hair loss
  • Dry skin

Diagnosing Hashimoto’s thyroiditis

People with Hashimoto’s thyroiditis often present with symptoms of hypothyroidism, sometimes accompanied by the finding of a goiter.4 Symptoms alone are not a reliable proof of this disease. A blood test known as thyroid function test to check the level of thyroid-stimulating hormone (TSH) and thyroid hormones in your blood is needed to make a valid diagnosis. If you have high levels of TSH in the blood and low levels of thyroid hormones, you have hypothyroidism.5 Antibodies against thyroid peroxidase, an enzyme involved in the production of thyroid hormones, are usually elevated in cases of Hashimoto’s thyroiditis.4

Treatment for Hashimoto’s thyroiditis

If you are diagnosed with hypothyroidism from Hashimoto’s thyroiditis, your doctor will prescribe thyroid hormone replacement therapy to treat this condition.1 Most patients with hypothyroidism from Hashimoto’s thyroiditis will require lifelong thyroid hormone replacement treatment.4 Finding the appropriate dose, particularly at the beginning, may require thyroid function blood testing every 6‒8 weeks after any dose adjustment until the correct dose is determined. After that, monitoring of TSH once a year is generally sufficient.4


Useful Websites

<p style="color:#fe369c;font-weight: bold;">American Thyroid Association</p>

http://www.thyroid.org

Patient information on thyroid health published by the American Thyroid Association.

 

<p style="color:#fe369c;font-weight: bold;">Thyroid Federation International</p>

http://www.thyroid-fed.org

Patient information from Thyroid Federation International – a network of patient support organisations from around the world.

Summary

  • Hashimoto’s thyroiditis is an autoimmune thyroid disease that causes hypothyroidism
  • Diagnosis of Hashimoto’s thyroiditis is confirmed via blood tests that checks thyroid function and the presence of antibodies
    against thyroid peroxidase 
  • Treatment of hypothyroidism due to Hashimoto’s thyroiditis is thyroid hormone replacement therapy.

References

  1. Medline Plus. Chronic thyroiditis (Hashimoto’s disease). Available at http://www.nlm.nih.gov/medlineplus/ency/article/000371.htm. Last accessed February 2022.
  2. Yeo JLS, Yong NTWM, Mahendran DCJ, et al. Approach to goitre in family medicine. Singapore Med J.2022; 63: 604‒614.
  3. Mayo Clinic. Hashimoto’s disease. Symptoms and causes. Available at: https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855. Last accessed June 2023.
  4. American Thyroid Association. Hashimoto’s thyroiditis (lymphocytic thyroiditis). Available at: https://www.thyroid.org/wp-content/uploads/patients/brochures/Hashimoto_Thyroiditis.pdf. Last accessed June 2023.
  5. British Thyroid Foundation. Thyroid function tests. Available at: https://www.btf-thyroid.org/thyroid-function-tests. Last accessed June 2023.
SG-NONT-00025 | December 2023