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Hashimoto’s Thyroiditis

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Hashimoto’s Thyroiditis

Various conditions affect various sensitive organs crucial for the functioning of the human body.  One of the vital organs to be considered here is the thyroid gland which is essential for the production of thyroid hormones important in the body. Hashimoto’s thyroiditis is one among the conditions that affect thyroid gland located in the neck. There are some factors which are believed to be the leading causes of this condition which destroys the gland, although the worst thing is that it is not detectable while in its early stages. It is a deadly disease to human life when not controlled.

Hashimoto’s thyroiditis is an autoimmune disease where the immune system attacks and destroys the thyroid gland located in the neck. The thyroid hormones produced by the gland are used to control how the body uses energy and the way the heartbeats. According to Pyzik et al., (8), the Hashimoto’s thyroiditis is the primary cause of hypothyroidism in parts of the United States of America and which results in non-endemic goitre. It may occur at any age, and it affects a larger population of women than men, particularly those aged between 30 to 60 years of age. Ragusa et al., (7) asserts that the disease is more common in regions of high iodine dietary intake, and among genetically vulnerable people. Research suggests that excess iodine may trigger thyroid disorder in susceptible individuals. According to Brix (2) in the twin studies, there is an increase in autoimmune thyroids concordance in monozygotic twins than in dizygotic twins. It implies that the condition is reflected in genes. It is also believed that sex hormones are involved since it is observed that women are more affected by the disease than men. Finally, exposure to radiations has also been found to increase the chances of being affected by Hashimoto’s thyroiditis.

Hashimoto thyroiditis disorder doesn’t present with any distinctive signs and symptoms. The condition continues gradually over a long period, and people with this condition may not have any earlier symptoms. In research regarding hypothyroidism of this disorder (5,6) shows that it is often subclinical meaning that it is mild and without symptoms, particularly at its early stages. Akamizu (1) states that the signs of the disorder which occur after a long period include the feeling of tiredness, increased weight, problems of tolerating cold, experiencing pain in the joints and muscles. Other symptoms include having thin, dry hair, feeling depressed, memory issues, slow heart rates, and irregular menstrual periods and issues when conceiving. The presentation of an individual having hypothyroidism could be sub-clinical and may be identified from a daily screening of the function of the thyroid gland.

The thyroid gland is located lower to the thyroid cartilage in the anteroinferior neck. Akamizu (1) states that the thyroid gland is butterfly-shaped and located in the front of the neck.  In the normal condition, the thyroid gland has two lobes and consists of lower-middle and upper poles linked by a thin bridge of thyroid tissue (isthmus). According to Hu and Rayman (4), the tissue straddles the trachea anteriorly, and the lobes extend on the sides of the trachea, surrounded laterally by carotid arteries and internal jugular veins. The pyramid-shaped lobe when present arises from the isthmus and tapers superiorly just in front of the thyroid cartilage and can be seen in 20 to 30 per cent of patients. The thyroid gland has two kinds of cells, namely; parafollicular and follicular cells. The follicular cells secrete the main thyroid hormones thyroxine (T4) and tri-iodothyronine (T3). According to research (3,7), the size, shape and volume of the thyroid gland vary with age and sex. Healthy thyroid measures 18 to 20milimetres longitudinally and 9 to 10 millimetres anteroposterior (AP) diameter in newly born babies. In adults, it weighs between 40 to 60 mm longitudinally and 13 to 18 millimetres AP. The normal thyroid volume limits are 10 to 15 ml for women and 12 to 18 ml for men. As a result of the variations in volume, the volume of the thyroid is more important in determining gland enlargement.

Once Hashimoto’s thyroiditis affects the thyroid gland, it brings about other complications in the neck structure and to other several body organs. It usually targets the thyroid gland located in the neck as the immune system attacks it. It is at this point where the thyroid gland is prevented from producing enough hormones causing hypothyroidism. When the disorder continues developing, the thyroid gland starts growing larger and larger, resulting in swelling of the front part of the neck. According to Kahaly et al., (6), the enlargement of the thyroid gland, commonly known as goitre, may cause compression of the local structures such as the trachea and the gut. The individual may have shortness of breath which can develop rapidly if the damage to the trachea leads to a collapse of the airway. The enlargement of the thyroid gland can also block the gut leading to problems of swallowing. After an extended period, the thyroid gets damaged, and the swelling starts shrinking and finally disappears. When the Hashimoto thyroiditis is not treated, the prolonged hypothyroidism may cause cardiac complications such as frequent heart failure. Hypothyroidism may result in myxedema coma, which is a life-threatening condition.

The Hashimoto thyroiditis has no cure, but the levels of the hormone can be regulated by replacing the hormones with medication and can also help restore healthy body metabolism. The thyroid hormones made before inflammation can be replaced by thyroid hormone medication.  Caturegli, Remigis and Rose (3) stated that by replacing one or all the two thyroid hormones can relieve the symptoms caused by the total or relative lack of hormones due to the Hashimoto thyroiditis condition. The treatment choice for the thyroiditis condition is typically synthetic T4 or thyroxine. Such medication is supposed to be taken indefinitely. Failure to take this medication would mean that the level of hormones is not maintained to the normal level. According to Caturegli, Remigis and Rose (3), the prognosis for an individual with the condition is excellent with proper treatment. When the thyroid hormone levels are restored through medication, the signs and symptoms of hypothyroidism are reversed. If an individual fails to take medication, the hypothyroidism worsens for an extended period, potentially resulting in organ damage and severe ill health.

In conclusion, the Hashimoto’s thyroiditis is a long-life disorder with no cure and that result from the body immune system detecting the thyroid gland as a foreign substance in the body, and then it attacks it.  It is believed to be the primary cause of hypothyroidism, and it takes a longer time before manifesting the signs and symptoms in the body. It causes inflammation of the thyroid gland and also affects the production of thyroid hormones necessary to the body. It is believed to be caused by various factors including high intake of iodine, exposure to radiations, and also it is found in genes. It can cause impingement on the gullet or trachea. The one thing that can be done to control the effects of Hashimoto’s thyroiditis is to take medication to regulate the levels of hormone and restore body metabolism.

 

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