Hashimoto’s Disease
(AKA Hashimoto’s Thyroiditis or Chronic Thyroiditis)
DEFINITION
Hashimoto’s disease is an inflammation of the thyroid gland that frequently results in hypothyroidism (lowered thyroid function).
CAUSES
Hashimoto's disease is a common thyroid gland disorder that can occur at any age, but it is most often seen in middle aged women. It is caused by a reaction of the immune system against the thyroid gland.
The onset of the disease is slow, and it may take months or even years for the condition to be detected. Chronic thyroiditis is most common in women and individuals with a family history of thyroid disease. It is estimated to affect between 0.1% and 5% of all adults in Western countries.
Hashimoto's disease may rarely be associated with other endocrine disorders caused by the immune system.
SYMPTOMS
• Intolerance to cold
• Mild weight gain
• Fatigue
• Constipation
• Enlarged neck or presence of goiter
• Small or atrophic thyroid gland (late in the disease)
• Dry skin
• Hair loss
• Heavy and irregular menses
• Difficulty concentrating or thinking
ADDITIONAL SYMPTOMS
• Weight gain (unintentional)
• Joint stiffness
• Facial swelling
EXAMS AND LABORATORY TESTS TO DETERMINE THYROID FUNCTION INCLUDE
• Free T4 test (low)
• Serum TSH (high)
• T3 (low or normal)
• Thyroid autoantibodies are frequently present:
o antithyroid peroxidase antibody
o antithyroglobulin antibody
THIS DISEASE MAY ALTER THE RESULTS OF THE FOLLOWING TESTS:
• Radioactive iodine uptake
• Complete blood count
• Total cholesterol
• Serum sodium
• Serum prolactin
TREATMENT
A deficiency of thyroid hormone may develop at a later time. Replacement therapy with thyroid hormone (levothyroxine or triiodothyronine or both) is given if the hormone is deficient or may be given if there is evidence of mild thyroid failure (such as elevated TSH), also known as subclinical hypothyroidism. If there is no evidence of thyroid hormone deficiency, treatment may be limited to regular observation by a health care provider.
OUTLOOK (PROGNOSIS)
The outcome is usually very good because the disease remains stable for years or progresses slowly to a condition of thyroid hormone deficiency (hypothyroidism) that can be treated with thyroid replacement therapy.
POSSIBLE COMPLICATIONS
It can be associated with other autoimmune disorders
WHEN TO CONTACT A MEDICAL PROFESSIONAL
Call your health care provider if symptoms of chronic thyroiditis develop.
PREVENTION
There is no known way to prevent this disorder. AwThe importance of vitamin D deficiency is finally gaining increasing attention. This nutrient deficiency is critical, causing tens of thousands of unnecessary deaths in the U.S. each year. Vitamin D deficiency is common. In fact, a review in the Mayo Clinic Journal showed that approximately 36% of healthy young adults and 57% of general medicine inpatients in the United States have inadequate levels of vitamin D. Vitamin D deficiency is even more common in people with chronic pain.THE PROBLEM
Doctors have given the poor advice to avoid sunshine—and 90% of our vitamin D comes from sunshine. This misguided advice was given to decrease the number of dangerous skin cancers called melanomas. What doctors forget is that most of these melanomas are not in sun exposed areas (they are under our clothes). It is likely that the increase in melanomas is mostly occurring because of changes in diet, environment, and sleep which are resulting in weakened immune systems. The skin cancers usually caused by sunshine (e.g., basal cell cancers) are usually quite benign and easy to treat. Many other cancers increase in the face of vitamin D deficiency and, as 90% of our vitamin D comes from sun exposure, it is currently estimated that the advice to avoid sunshine is resulting in as many as 85,550 unnecessary cancer deaths each year! Sunshine is healthy—avoid sunburn, not sunshine!
VITAMIN D DEFICIENCY LEADS TO SICKNESS AND DISEASE
areness of risk factors may allow earlier diagnosis and treatment.
© 1997-2008 A.D.A.M., Inc.
Hashimoto’s disease is an inflammation of the thyroid gland that frequently results in hypothyroidism (lowered thyroid function).
CAUSES
Hashimoto's disease is a common thyroid gland disorder that can occur at any age, but it is most often seen in middle aged women. It is caused by a reaction of the immune system against the thyroid gland.
The onset of the disease is slow, and it may take months or even years for the condition to be detected. Chronic thyroiditis is most common in women and individuals with a family history of thyroid disease. It is estimated to affect between 0.1% and 5% of all adults in Western countries.
Hashimoto's disease may rarely be associated with other endocrine disorders caused by the immune system.
SYMPTOMS
• Intolerance to cold
• Mild weight gain
• Fatigue
• Constipation
• Enlarged neck or presence of goiter
• Small or atrophic thyroid gland (late in the disease)
• Dry skin
• Hair loss
• Heavy and irregular menses
• Difficulty concentrating or thinking
ADDITIONAL SYMPTOMS
• Weight gain (unintentional)
• Joint stiffness
• Facial swelling
EXAMS AND LABORATORY TESTS TO DETERMINE THYROID FUNCTION INCLUDE
• Free T4 test (low)
• Serum TSH (high)
• T3 (low or normal)
• Thyroid autoantibodies are frequently present:
o antithyroid peroxidase antibody
o antithyroglobulin antibody
THIS DISEASE MAY ALTER THE RESULTS OF THE FOLLOWING TESTS:
• Radioactive iodine uptake
• Complete blood count
• Total cholesterol
• Serum sodium
• Serum prolactin
TREATMENT
A deficiency of thyroid hormone may develop at a later time. Replacement therapy with thyroid hormone (levothyroxine or triiodothyronine or both) is given if the hormone is deficient or may be given if there is evidence of mild thyroid failure (such as elevated TSH), also known as subclinical hypothyroidism. If there is no evidence of thyroid hormone deficiency, treatment may be limited to regular observation by a health care provider.
OUTLOOK (PROGNOSIS)
The outcome is usually very good because the disease remains stable for years or progresses slowly to a condition of thyroid hormone deficiency (hypothyroidism) that can be treated with thyroid replacement therapy.
POSSIBLE COMPLICATIONS
It can be associated with other autoimmune disorders
WHEN TO CONTACT A MEDICAL PROFESSIONAL
Call your health care provider if symptoms of chronic thyroiditis develop.
PREVENTION
There is no known way to prevent this disorder. AwThe importance of vitamin D deficiency is finally gaining increasing attention. This nutrient deficiency is critical, causing tens of thousands of unnecessary deaths in the U.S. each year. Vitamin D deficiency is common. In fact, a review in the Mayo Clinic Journal showed that approximately 36% of healthy young adults and 57% of general medicine inpatients in the United States have inadequate levels of vitamin D. Vitamin D deficiency is even more common in people with chronic pain.THE PROBLEM
Doctors have given the poor advice to avoid sunshine—and 90% of our vitamin D comes from sunshine. This misguided advice was given to decrease the number of dangerous skin cancers called melanomas. What doctors forget is that most of these melanomas are not in sun exposed areas (they are under our clothes). It is likely that the increase in melanomas is mostly occurring because of changes in diet, environment, and sleep which are resulting in weakened immune systems. The skin cancers usually caused by sunshine (e.g., basal cell cancers) are usually quite benign and easy to treat. Many other cancers increase in the face of vitamin D deficiency and, as 90% of our vitamin D comes from sun exposure, it is currently estimated that the advice to avoid sunshine is resulting in as many as 85,550 unnecessary cancer deaths each year! Sunshine is healthy—avoid sunburn, not sunshine!
VITAMIN D DEFICIENCY LEADS TO SICKNESS AND DISEASE
- Increases breast cancer risk.
- Research findings show that “higher intakes of vitamin D and calcium from food and supplements are related to lower levels of breast density among premenopausal women. They suggest that increasing intakes of vitamin D and calcium may represent a safe and inexpensive strategy for breast cancer prevention."
- Increases prostate cancer risk.
- In a Harvard study, men with the highest levels of vitamin D had significantly lower overall risk (45%) of prostate cancer, including aggressive prostate cancer. This is very important, as prostate cancer is one of the most common types of cancer in men in the U.S., and according to the American Cancer Society it's the second leading cause of cancer death in men. Almost 232,000 new cases will be diagnosed this year, and about 30,000 men will die of prostate cancer.
- Decreases lung cancer survival rate.
- Researchers at Harvard Medical School and Harvard School of Public Health studied the survival data of 456 patients with early stage lung cancer treated between 1992 and 2000. Patients who had high levels of vitamin D and had surgery in sunny months were more than twice as likely to be alive five years after surgery when compared to patients with low levels of vitamin D who had surgery in the winter, the researchers said. Lead researcher, Dr. David Christiani notes "The survival advantage at five years is pretty dramatic. 72% versus 29% when you compare the highest level of intake (of vitamin D) versus the lowest level of intake."
- Increases risk for cancer.
- 47,800 men were studied and found those with an increment in vitamin D levels of 25 nanomoles per liter was associated with a 17% reduction in cancer incidence, a 29% reduction in cancer mortality, and a 45% reduction in digestive tract (colorectal, pancreatic, esophageal and stomach) cancer mortality.
- Another study with an intake of 2,000 units of vitamin D a day (through a mix of sunshine, food and supplements) could decrease both breast cancer and colorectal cancer by over 50%.
- In addition, higher vitamin D levels may slow the progression of breast cancer.
- Contributes to hip fractures in the elderly.
- Low serum levels of vitamin D in the body may make elderly persons more susceptible to falls, researchers reported at the American Society of Mineral and Bone Research (ASBMR) 27th annual meeting. "Low levels of vitamin D were associated with low physical performance," said Ilse Wicherts, "This study shows that neuromuscular performance in those with lower levels of vitamin D was significantly lower than those with adequate levels. These individuals already are fragile. The lack of mobility places them at high risk of falls and fractures."
- Causes osteoporosis (weak bones).
- Vitamin D is low in 98% of the elderly who break their hip. Fortunately, women who take 500 mg of calcium and 700 units of vitamin D daily are much less likely to even have a fall.
- Connected to patients with Multiple Sclerosis & Rheumatoid Arthritis.
- Vitamin D is critical in regulating immune function, and this is likely why Multiple Sclerosis is much more common in northern latitudes which are less sunny. In fact, a very large study has confirmed the long-held theory that multiple sclerosis (MS) may be caused, in part, by a lack of sunlight. Harvard researchers took data from 187,563 women participating in the ongoing Nurses' Health Study and found that women taking a daily multiple with at least 400 international units of vitamin D were 40% less likely to develop MS. While women who had high intake of vitamin D from both foods and supplements were 33% less likely to develop the disease, relying solely on food as the source of vitamin D didn't offer any protection.
- Researchers from the University of Alabama at Birmingham analyzed data from nearly 30,000 women between 55 and 69 years of age who participated in the Iowa Women's Health Study. Vitamin D supplements were associated with a 33% lower rheumatoid arthritis risk.
- Increases the risk of diabetes.
- 61% of patients with diabetes have vitamin D deficiency and higher intakes of vitamin D and calcium can lower the risk of getting diabetes.
- In a 2004 study, subjects with low levels of vitamin D had almost 3 times the risk of metabolic syndrome. Thus, the researchers conclude that low vitamin D leads to insulin resistance.
- This is supported by other research, where investigators noted “Vitamin D deficiency may, therefore, be involved in the pathogenesis [cause] of both forms of diabetes."
- Vitamin D levels also tend to be low in diabetic children and vitamin D may even help to prevent the diabetes if given early.
areness of risk factors may allow earlier diagnosis and treatment.
© 1997-2008 A.D.A.M., Inc.
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