Course of disease
Experts are not yet in agreement as to whether the disease progresses in relapses. Some experts speak of relapses of Hashimoto thyreoidits when several criteria coincide: specific symptoms: Pressure or lump feeling in the throat Pulling pain, reddened, overheated skin in the area of the thyroid gland Flu feeling (especially having a hot head) Measurable effects: Decrease in thyroid gland size In the blood: increase in antibodies (TPO antibodies, TG antibodies), change in thyroid parameters (TSH increases, thyroid hormones fT3 and fT4 decrease) Trigger: stress Infectious diseases previously Iodine intake in high doses in the long term Hormone fluctuations Stopped smoking
- Specific symptoms:
- Pressure or lump feeling in the neck
- Pulling pain, reddened, overheated skin in the area of the thyroid gland
- Flu feeling (especially having a hot head)
- Measurable effects:
- Size reduction of the thyroid gland
- In blood: antibody increase (TPO-antibody, TG-antibody), change in thyroid parameters (TSH increases, thyroid hormones fT3 and fT4 decrease)
- Shutter release:
- Stress
- Infectious diseases before
- Iodine intake in high doses in the long term
- Hormone Fluctuations
- Stopped smoking
- Pressure or lump feeling in the neck
- Pulling pain, reddened, overheated skin in the area of the thyroid gland
- Flu feeling (especially having a hot head)
- Size reduction of the thyroid gland
- In blood: antibody increase (TPO-antibody, TG-antibody), change in thyroid parameters (TSH increases, thyroid hormones fT3 and fT4 decrease)
- Stress
- Infectious diseases before
- Iodine intake in high doses in the long term
- Hormone Fluctuations
- Stopped smoking
Diagnostics
In order to detect the disease, it is necessary to examine the blood on the one hand and an ultrasound examination on the other hand. Patients usually come with symptoms (an over- or under-function), other times there is a random finding. The doctor can see in the blood whether antibodies are circulating (these antibodies are TPO antibodies, microsomal antibodies (MAK) or TG antibodies), whether the body is still producing enough thyroid hormones (called fT3, fT4) and whether the body is already involved in a mechanism of counter regulation (the so-called TSH value is then increased in the case of hypofunction and decreased in the case of hyperfunction).
However, it must be said that even normal thyroid values are not a criterion for excluding Hashimoto thyroiditis, since the body is often not yet in an overactive state, let alone underactive. In addition, an ultrasound of the thyroid gland is therefore performed to see whether the thyroid gland already shows signs of destruction. In this case, the thyroid gland would look uneven and often small.
The ultrasound image often shows black oval structures in the tissue.A total volume of about 18ml for women and 25ml for men would be conspicuous, which could indicate an increased thyroid volume. A total volume of less than 6ml in women and less than 8ml in men could indicate a tissue shrinkage of the thyroid gland. In addition, when measuring the blood flow in the thyroid (Doppler examination), an increased blood flow may indicate an inflammation. If there is any uncertainty, a scintigraphy and histological tissue sampling in the sense of a puncture can be performed.