The chronic thyroiditis (Hashimoto’s thyroiditis)
Chronic thyroiditis according to Hashimoto is an autoimmune disease, i.e. a disease in which the body’s own cells mistakenly attack other functional cells. This process takes place slowly in the thyroid gland and is irreversible. However, the function of the thyroid gland can be replaced very well and without great effort by medication.
The chronic thyroiditis of the Hashimoto’s type runs for a long time without any real symptoms, because the destruction of the thyroid cells is slow and the loss of function only becomes manifest when a large number of cells are affected. If too many cells are lost to maintain normal thyroid gland function, the result is hypothyroidism with its typical symptoms such as general fatigue and weakness, weight gain, constipation, increased sensation of cold, slowing of reflexes, rheumatic complaints, swelling of the skin, particularly well visible on the eyelids, muscle cramps and loss of potency. In chronic thyroiditis according to Hashimoto, the thyroid gland is attacked by the body’s own cells of the immune system (T lymphocytes and plasma cells), which cause the destruction of the functional thyroid cells (thyroocytes).
As with other autoimmune diseases (Graves’ disease et al. ), the exact reason for the attack of endogenous cells is not yet fully understood. Due to various factors, no specific therapy is indicated for chronic thyroiditis until the appearance of hypothyroidism.
The course of the disease is asymptomatic, no symptom-oriented therapy is necessary. Also, the destruction of thyroid cells cannot be treated with medication, as the side effects on the general immune system would be too serious. In addition, the final stage, hypothyroidism, with a once-daily administration of Levo-Thyroxine in tablet form is very patient-friendly, has few side effects and is easy to adjust.
The therapy thus consists of a treatment of the hypothyroidism resulting from the chronic inflammation. Due to the absence of symptoms, chronic thyroiditis is diagnosed relatively late in the course of the disease. It is then based on the appearance of the patient who has the symptoms of hypothyroidism described above.
The diagnosis is confirmed on the basis of the blood count, which is specifically searched for thyroid hormones and antibodies against the thyroid gland. The thyroid hormones are lowered despite an increased thyroid drive hormone “TSH“, and there are also so-called anti-TPO antibodies.In addition, a diagnosis can also be confirmed by ultrasound of the thyroid gland, which appears to be low in echoes, meaning that there is little functional tissue left. Despite the dangerous sounding “final course” of chronic thyroiditis, its prognosis is very good, and only dangerous for the patient if the thyroid gland is not treated.
Patients can be considered healthy if thyroid hormones are replaced in tablet form. A general prophylaxis of thyroiditis is unfortunately not possible. Bacterial and viral infections of the thyroid gland cannot be prevented, nor can the auto-immune infestation of the thyroid cells be deliberately prevented or influenced.
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