Hashimoto’s Disease

While hypothyroidism is a condition, Hashimoto’s is a disease. Hypothyroidism is commonly caused by Hashimoto’s disease, but not always. Sometimes known as Hashimoto’s thyroiditis, autoimmune thyroiditis, or chronic lymphocytic thyroiditis, Hashimoto’s is an autoimmune disease where antibodies interact with proteins in the thyroid gland, causing a gradual degradation of the gland, and decreasing the gland’s production of thyroid hormones. Possible symptoms include those common in hypothyroidism and is usually diagnosed with a clinical examination demonstrating one or more of the following:

• A goiter (enlargement of the thyroid)
• A radioactive uptake scan showing diffuse
• uptake in an enlarged thyroid
• An ultrasound revealing an enlarged thyroid
• Fine needle aspiration (biopsy) of the thyroid showing lymphocytes and macrophages
• High antibody levels against thyroid peroxidase (TPO) and thyroglobulin (TG) detected with a blood test

Periods of anxiety, diarrhea, insomnia, and/or weight loss may come and go or be followed by periods of constipation, depression, fatigue, and/or weight gain as Hashimoto’s causes fluctuations in thyroid performance. Such cycling can be typical with Hashimoto’s but is not always evident

Often Hashimoto’s is caused by environmental triggers such as iodine, infection, pregnancy, or cytokine therapy, resulting in the generation of large numbers of T helper cells, cytotoxic lymphocytes, and autoantibody-producing B cells. Immune cells accumulate in the thyroid and lead to a prevalence of T helper mediated autoimmune responses and cytotoxic effects of T lymphocytes. All of this results in apoptosis (destruction) of thyrocytes, which is the ultimate cause of Hashimoto’s thyroiditis.