Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate Hashimoto’s thyroiditis: Patients with Hashimoto’s thyroiditis are symptom-free for a long time. Initially, symptoms of hyperthyroidism (overactive thyroid) are occasionally prominent. The so-called “Hashitoxicosis” is an initial phase in which mild hyperthyroidism usually occurs, which then gradually changes to chronic hypothyroidism (underactive thyroid). Leading symptoms Basal metabolic rate … Hashimoto’s Thyroiditis: Symptoms, Complaints, Signs

Hashimoto’s Thyroiditis: Causes

Pathogenesis (development of disease) In Hashimoto’s thyroiditis, an autoimmune reaction (pathological reaction of the immune system toward the body’s own tissue) – primarily T-cell-mediated – results in infiltration (invasion) with lymphocytes (subgroup of white blood cells) and atrophy (regression) of the follicles (= vesicles inside which the hormones are stored in an inactive form as … Hashimoto’s Thyroiditis: Causes

Hashimoto’s Thyroiditis: Therapy

General measures Nicotine restriction (refraining from tobacco use) – smoking worsens the course of Hashimoto’s thyroiditis. Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day) – There may be a possible alcohol intolerance in Hashimoto’s thyroiditis. Aim for normal weight! In Hashimoto’s thyroiditis, weight gain is characteristic … Hashimoto’s Thyroiditis: Therapy

Hashimoto’s Thyroiditis: Diagnostic Tests

Obligatory medical device diagnostics. Thyroid ultrasonography (ultrasonography of the thyroid gland) – as a basic examination to determine thyroid size and volume and any structural changes such as nodules; if necessary. With fine-needle biopsy (fine-needle tissue sample) (usually not indicated)[echo-poor parenchyma (“tissue”) with reduced vascularization (vascular drawing) or, in addition, inhomogeneous parenchyma and presence of … Hashimoto’s Thyroiditis: Diagnostic Tests

Hashimoto’s Thyroiditis: Micronutrient Therapy

The following vital substance (micronutrient) is used for supportive micronutrient therapy: Selenium (200 ug/die) – TPO antibody ↓ by circa 36% in 3 months (i.e., disease activity ↓). The above vital substance recommendations were made with the help of medical experts. All statements are supported by scientific studies with high levels of evidence. For a … Hashimoto’s Thyroiditis: Micronutrient Therapy

Hashimoto’s Thyroiditis: Medical History

Medical history (history of illness) represents an important component in the diagnosis of Hashimoto’s thyroiditis. Family history Are there any hereditary diseases in your family? Social anamnesis Current medical history/systemic medical history (somatic and psychological complaints). Have you noticed any weight gain? Please tell us your body weight (in kg) and height (in cm). Has … Hashimoto’s Thyroiditis: Medical History

Hashimoto’s Thyroiditis: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90). Secondary hypothyroidism (hypothyroidism) in anterior pituitary insufficiency (HVL insufficiency; hypopituitarism/ hypopituitarism). Struma multinodosa – nodular change in thyroid tissue. Cardiovascular system (I00-I99) Heart failure (cardiac insufficiency) Neoplasms – tumor diseases (C00-D48) Thyroid carcinoma (thyroid cancer). Further Chronic iodine excess, mainly triggered by amiodarone (antiarrhythmic drug).

Hashimoto’s Thyroiditis: Complications

The following are the most important diseases or complications that may be contributed to by Hashimoto’s thyroiditis: Respiratory system (J00-J99) Pleural effusion – accumulation of water in the lung/lung pleural space. Endocrine, nutritional, and metabolic diseases (E00-E90). Hypothyroidism (underactive thyroid; manifest or latent); rate of progression from latent to definite hypothyroidism In patients with exclusively … Hashimoto’s Thyroiditis: Complications

Hashimoto’s Thyroiditis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of eye) [dull shaggy hair, doughy/cool dry skin especially on face and hands and feet, cyanosis (bluish discoloration of skin), alopecia diffusa … Hashimoto’s Thyroiditis: Examination

Hashimoto’s Thyroiditis: Test and Diagnosis

1st order laboratory parameters – obligatory laboratory tests. Thyroid parameters – TSH (thyroid-stimulating hormone), fT3 (triiodothyronine), fT4 (thyroxine)[At onset: latent hyperthyroidism (hypothyroidism): TSH ↓, fT3 normal, fT4 possibly. slightly to moderately elevated; In the course: manifest hypothyroidism: TSH level ↑, fT3 + fT4 decreased; manifest hyperthyroidism (hyperthyroidism) is rare] Laboratory parameters 2nd order – depending … Hashimoto’s Thyroiditis: Test and Diagnosis

Hashimoto’s Thyroiditis: Drug Therapy

Therapeutic target Establishment of a euthyroid metabolic state (= thyroid values in the normal range). Therapy recommendations T4 substitution; indications for therapy: Manifest hypothyroidism (underactive thyroid) or TSH level ↑ to > 8-10 µU/ml or 5- to 10-fold increase in TPO antibodies. Latent hypothyroidism + markedly elevated TPO antibodies (therapy may be considered). In hyperthyroidism … Hashimoto’s Thyroiditis: Drug Therapy