Hashimoto's disease is often perceived as a rare condition known only from textbooks. In fact, it occurs in 3–4% of the world's population, and clinically overt forms in about 1%. Let us explain how autoimmune thyroiditis manifests and which signs actually indicate something.
What autoimmune thyroiditis and Hashimoto's disease are
Autoimmune thyroiditis (AIT, Hashimoto's thyroiditis) is a chronic autoimmune inflammation of the thyroid gland. The immune system produces antibodies against the body's own thyrocytes, the cells are gradually destroyed, and thyroid function declines up to primary hypothyroidism. The disease was described by the Japanese surgeon Hakaru Hashimoto in 1912. The disease begins slowly: months and even years may pass before hormone levels fall below normal. AIT is more common in people with a family history of thyroid disease and is also associated with other autoimmune conditions — type 1 diabetes, vitiligo, rheumatoid arthritis.
How AIT manifests: main symptoms
In the euthyroid phase and the subclinical hypothyroidism phase, there are usually no symptoms. Signs appear when hypothyroidism develops and increase gradually. Among them are marked fatigue, cold intolerance, weight gain, constipation, difficulty concentrating, low mood or depression, dry skin, dry hair or hair loss, a hoarse voice, irregular or heavy menstruation.
- Persistent fatigue and feeling cold more often than usual
- Weight gain and a tendency to constipation
- Difficulty concentrating and thinking clearly, low mood
- Dry skin, hair loss, hoarse voice
- Enlargement of the neck or goiter — sometimes the only early sign
Symptoms of autoimmune thyroiditis in women and in men
Most often the disease is detected in women over 60 years of age — in the population this is 6–11%. In women, irregular or heavy menstruation is added to the general signs. Women with AIT outnumber men by 4–8 times; no separate signs characteristic only of men are identified in this disease. Postpartum thyroiditis is distinguished separately — in approximately 5–6% of women; pregnancy and childbirth can act as triggering factors.
A lump in the throat and other local signs
Locally, AIT manifests as enlargement of the thyroid gland — goiter, which may be the only early symptom. In the hypertrophic variant the gland is diffusely firm, in the atrophic form it is reduced. Any discomfort or sensation of a lump in the neck area is a reason to see a doctor, who will examine the gland and order tests. Later, as the disease progresses, the gland may become small or shrunken.
How AIT symptoms differ from other thyroid diseases
Some symptoms of hypothyroidism in AIT are common and may be caused by other conditions, so they need to be checked by a doctor. Against the background of AIT, temporary thyrotoxicosis is also possible — increased hormone production, which changes the picture. Therefore, AIT is differentiated from subacute thyroiditis, nodular goiter, thyroid cancer, and other chronic thyroiditides. Tests are needed to clarify the cause.
How the diagnosis is confirmed and when to see a doctor
The doctor asks about symptoms, clarifies the family history of thyroid disease and autoimmune conditions, recent pregnancy, and examines the neck for gland enlargement. Thyroid function is assessed in the laboratory: free T4, TSH, thyroid antibodies. Imaging and fine-needle biopsy are usually not needed to diagnose Hashimoto's thyroiditis. Consult a doctor if signs of chronic thyroiditis or hypothyroidism appear — especially if close relatives have had thyroid disease.
In itself it is not a reason to call an ambulance. 103 or 112 — if, against the background of severe untreated hypothyroidism, altered consciousness appears, up to coma: this is a life-threatening condition requiring hospital treatment.
The material is for reference: a diagnosis is not made based on symptoms alone, and it does not replace a conversation with a doctor.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer