Hashimoto’s thyroiditis

Hashimoto’s thyroiditis is an inflammation of the thyroid gland that often leads to a reduction in function (hypothyroidism).
According to conventional medicine, Hashimoto’s thyroiditis is an autoimmune disease, that is, the body mistakenly attacks the thyroid gland as if it were foreign tissue.
The cause of this process is still unclear.
The disease starts slowly and it can take months or years before the problem is noticed.

At the first stage of the disease, the patient may suffer from hyperthyroidism or thyroid hormone levels may be normal.

The thyroid gland is a gland located at the front of the neck that produces hormones to control metabolism (the speed with which the body uses the calories consumed in food) and heart rate.

Hashimoto’s thyroiditis is often hereditary (genetic predisposition) and may be associated with other autoimmune diseases such as type 1 diabetes or celiac disease. Hashimoto’s thyroiditis occurs 5 to 10 times more often in women than in men and often appears in adulthood. Blood tests of people with Hashimoto’s thyroiditis show an increase in the number of antibodies to specific proteins of the thyroid gland, such as thyroid peroxidase and thyroglobulin.
The T-lymphocytes, a type of cell involved in inflammatory processes, penetrate the thyroid gland and cause painless inflammation of the gland, decreasing the production of thyroid hormones.
This situation is called hypothyroidism.


Causes of Hashimoto’s thyroiditis

Chronic thyroiditis can occur at any age, but most often appears in middle-aged women.
Chronic thyroiditis is more common in women and people with a positive family history of thyroid disease.
In Western countries, this disease affects between 0.1% and 5% of the adult population.

Less commonly, Hashimoto’s disease occurs along with insufficiency of the adrenal cortex and parathyroid gland, or fungi on the nails and mouth (in this case, polyglandular syndrome type 1 – APS I).

Hashimoto’s disease can occur along with other hormonal disorders caused by the immune system, such as adrenal insufficiency and type 1 diabetes (in these cases called polyglandular autoimmune syndrome type 2 – APS II).

Symptoms of Hashimoto’s thyroiditis

The thyroid gland can quickly enlarge: sometimes breathing and swallowing difficulties may occur due to the pressure exerted by the gland on the neck structures.
Rarely, the pain is so severe that it does not respond to drug therapy and only surgical intervention can help.
The signs and symptoms of hypothyroidism may be present in about 20% of patients from the beginning.
In other cases, the disease initially proceeds asymptomatically, and then develops its effects over the course of years.
Symptomatology includes:

  • Tiredness, dry skin and weight gain
  • Goiter (swollen thyroid gland protruding around the neck)
  • Cold intolerance
  • Muscle pain, weakness
  • Joint pain
  • Constipation and constipation
  • Decreased sweating
  • Bradycardia (slowed heartbeat)
  • Irregular menstruation (typically an extended period of menstrual bleeding, called menorrhagia)
  • Difficulty getting pregnant
  • Depression, dementia and memory loss
  • Hair loss
  • Myxedema and atrophic thyroid gland

What examinations are required? Diagnosis and instrumental examinations in Hashimoto’s thyroiditis

The diagnosis of Hashimoto’s thyroiditis is established both by the clinical picture and by histological examination (tissue examination).
Usually, there is also a marked atrophy of the parenchyma (supporting tissue) of the thyroid gland.

The following confirmatory tests can also be performed:

  • Examination of TSH levels: the levels of the hormone TSH are usually elevated in hypothyroidism;
  • study of antibodies Tpo-Ak and Tg-Ak;
  • Echography of the thyroid gland: usually not required to diagnose Hashimoto’s thyroiditis, but useful for assessing thyroid condition;
  • Scintigraphy and radioiodine uptake test are used to classify a lump as hot or cold. A cold thyroid nodule indicates an increased risk of malignancy and requires a biopsy for analysis.

This is followed by other examinations to evaluate complications of primary hypothyroidism, for example a lipid metabolism disorder (dyslipidemia).

How is Hashimoto’s thyroiditis treated?

Hashimoto’s thyroiditis responds well to drug therapy. Usually, one tablet of levothyroxine must be taken per day, i.e. an artificial form of the hormone TSH.
This therapy brings TSH levels back to normal because a damaged thyroid gland cannot produce it sufficiently.
Doctors recommend taking this drug for a lifetime.
The dose of the drug varies depending on:

  • Age
  • Weight
  • Severity of hypothyroidism
  • Other health problems
  • Use of other drugs that may interfere with levothyroxine.

When to operate?
If the goiter is too large, the doctor may advise a complete or partial thyroidectomy (removal of the thyroid gland).

There are no natural remedies or treatments that cure Hashimoto’s thyroiditis or reduce symptoms.

Controls for Hashimoto’s thyroiditis

Before starting therapy, a follow-up examination is necessary so that the doctor can determine the correct dose of the drug.
This therapy works slowly and may take a few months before the symptoms pass and the swelling decreases.

If the dose of the drug is too strong, the thyroid hormone level becomes too high. This situation is called hyperthyroidism, which can lead to heart disease and osteoporosis.
If the TSH is normalized, the check is carried out once a year. The dose of medication may remain the same for years or may need to be adjusted in some situations, such as pregnancy, heart disease, and menopause.
The treatment of hypothyroidism without symptoms is still the subject of debate. Some doctors believe that drug treatment can help most patients because it prevents symptoms before they can occur. In addition, mild hypothyroidism could increase the likelihood of heart disease. However, it has not yet been proven that drug treatment really reduces the risk.

What happens if Hashimoto’s disease is not treated?

Without treatment, Hashimoto’s disease can progress, with symptoms getting worse. In addition, other problems may occur, such as:

  • Infertility
  • Miscarriage
  • Fetal malformations
  • Cholesterol increase
  • Severe hypothyroidism, called myxedema
  • Coma

Does pregnancy affect the thyroid gland?

During pregnancy, TSH levels increase and the thyroid gland enlarges, but not so much that it is noticed. Untreated hypothyroidism can cause problems in pregnancy. At the same time, the symptoms of normal pregnancy, such as tiredness and exhaustion, can hide hypothyroidism.
If swelling of the throat or symptoms suggestive of hypothyroidism are observed, the doctor should be consulted.

Some women develop thyroid disease in the first year after giving birth. This situation is called postpartum thyroiditis. Often the initial symptoms resemble an overactive thyroid gland and can last for over 2-4 months. After that, most women develop symptoms of hypothyroidism that can last up to a year.

If I am pregnant, do I need a thyroid examination?
If the doctor has diagnosed hypothyroidism with or without symptoms during pregnancy, drug therapy is usually started to prevent problems in pregnancy. If there is a pregnancy, it is necessary to talk to the doctor for reasons of greater safety to perform a thyroid examination.

I have Hashimoto’s disease and I want to get pregnant. What should I do before I try to get pregnant?

Women who are undergoing treatment for Hashimoto’s disease can become pregnant. Thyroid function must always be well controlled before pregnancy.
Untreated or poorly treated hypothyroidism can cause problems for the mother, such as:

  • Preeclampsia
  • Anaemia
  • Miscarriage
  • Postpartum hemorrhage

In addition, this can lead to serious problems in the child, such as:

  • Premature birth
  • Low birth weight
  • Stillbirth

If you do not want to get pregnant, you should talk to your doctor about a suitable method of contraception.

Can I breastfeed during drug treatment?
The drug used passes through breast milk, but this does not pose a problem for the child. In addition, in a hypothyroitic situation, breast milk may not be produced in sufficient quantities.

Complications and consequences of Hashimoto’s thyroiditis

  • Bradycardia
  • Hyperlipidaemia
  • Hashimoto’s encephalopathy
  • Myxedema coma (due to extreme hypothyroidism; negative prognosis with high mortality rate)

Diet and nutrition in Hashimoto’s thyroiditis

There are different theories about this, but diet could be a sufficient therapeutic measure; in fact, many patients have been able to restore the proper functioning of the thyroid gland through a change in diet.

1. Conventional medicine treats the disorder with medication and recommends the intake of a sufficient amount of iodine.

2. According to the blood type diet of Dr. D’Adamo (known in Italy as the Dr. Mozzi diet), simple sugars and carbohydrates are responsible for the thyroid’s problems.
That is why for the treatment of Hashimoto’s thyroiditis, it is recommended to abandon fruits, sweets, complex carbohydrates and starch.
Gluten-containing foods should be avoided, as should dairy products.
There are foods that are recommended or should be avoided based on blood type, for example, people in blood type 0 should eat a lot of meat, fish and eggs because they digest the proteins easily. Vegetables should be included in every meal.
Many people became healthy again by following this dietary principle, but the excess of protein could bring side effects, such as constipation, high uric acid levels (leading to gout), overloading of the liver and kidneys.

3. The vegan diet recommends omitting all animal proteins (dairy, eggs, meat and fish). H. Shelton and M. Lezaeta (respected editors of books on natural medicine and health hygiene) recommend the consumption of raw and natural foods, so you should eat plenty of fruits, vegetables and antioxidants.
Since hypothyroidism causes body weight gain, a weight loss diet is recommended.

  1. Green vegetables and cruciferous vegetables (cabbage, spinach, broccoli, Brussels sprouts, cauliflower), peanuts, pine nuts and millet are helpful for thyroiditis.
    Natural medicine is not limited to nutrition, it also recommends daily exercise, mud packs, correction of the lifestyle and possibly a fasting cure.

What foods should you avoid?
Supplements containing iodine should be avoided because they can cause hypothyroidism. Supplements containing iron and soy may interfere with thyroid medications.
Natural medicine advises abstaining from alcohol, tobacco, tea, coffee and sweets.

These diets refer to a more natural lifestyle, avoid dairy products and other substances negative for the body and recommend a lot of vegetables.
Both Dr. D’Adamo and the food hygienists/vegans advise not to mix too many foods during a meal, a maximum of three, to favor digestion.
In this way, unhealthy foods are avoided, such as fast food and sumptuous meals.
There are important differences, but both may be able to fix the problem thanks to a more natural, less processed diet, as well as cutting out dairy, gluten, fried and smoked foods, pork, and alcohol.

Prognosis for patients with Hashimoto’s thyroiditis

Thanks to early diagnosis, the prognosis is excellent and patients can reach normal thyroid levels. But even if the normal levels are reached, a cure is only possible with a change of diet and lifestyle.

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