Hashimoto’s goiter is an inflammatory process in the thyroid gland of a chronic nature, which is caused by any autoimmune disorders. In this case, the human immune system begins to produce antibodies to the cells of its own thyroid gland , considering them foreign, which leads to inflammation and death of the gland tissue. It is Hashimoto ‘s autoimmune thyroiditis that, in many cases, is a provoking factor for primary hypothyroidism.  

It is believed that Hashimoto’s Goiter occurs in 1 person out of 100, and men get sick 4 times less often than women. Most often this disease is diagnosed after 40 years, but in some cases it develops already after 30 years. Hashimoto’s goiter is also called lymphomatous goiter, lymphocytic goiter , and Hashimoto ‘s disease or thyroiditis . This disease was named after the Japanese surgeon Hashimoto , who first described this pathology in 1912. The autoimmune nature of the disease was established only in 1956, researchers Roth and Denich .

CLINICAL PICTURE

Clinical options for the development of Hashimoto ‘s autoimmune thyroiditis :

• Hyperplastic (hypertrophic) form , which is characterized by the formation of a goiter.
• An atrophic form , in which tissue hardening occurs , that is, replacement of the thyroid tissue with connective tissue. Due to the death of thyrocytes , the size of the thyroid gland itself decreases, and hypothyroidism also develops (a lack of hormones produced by the thyroid gland). This is already the terminal stage of the autoimmune process.
• Focal form , which is characterized by damage to only one lobe of the thyroid gland.

SYMPTOMS OF THE DISEASE

In most cases, Hashimoto’s goiter develops rather slowly, in the initial stages it is quite difficult to detect it due to the absence of patient complaints. Then there is a feeling of fatigue and increased fatigue, general weakness, but an increase in the size of the thyroid gland occurs unnoticed and is often detected completely by accident. If the goiter has already acquired a large size, then it begins to squeeze the surrounding tissues and organs, especially the esophagus and trachea.

The patient begins to complain of pressure in the neck, discomfort, difficulty swallowing, choking, shortness of breath, but attributes this to any other diseases – from sore throat to cardiovascular pathologies.

REASONS FOR THE DEVELOPMENT OF A ZOBE

Modern medicine believes that the main reason for the development of this pathology is some congenital disorders of immunity, which gives the right to talk about a related mechanism of development of diffuse toxic goiter and autoimmune thyroiditis. In many cases, these diseases are accompanied by diseases that have nothing to do with the endocrine system, for example, vitiligo, arthritis, colitis.

Violations of the recognition mechanism of their own and foreign cells and leads to the fact that the immune system begins to produce antibodies to various components of the thyroid gland. If cytostimulating antibodies predominate , then the hypertrophic form of the disease develops, if the cytotoxic ones are atrophic, but in the focal form, the mutual ratio of the number of antibodies may be different.

Risk factors for developing Hashimoto’s goiter include:

• Previously transferred diffuse toxic goiter; 
• Previous operations on the thyroid gland;
• Any autoimmune disease;
• Hereditary factor, if the presence of close relatives with diseases of the endocrine system; 
• Chronic inflammation and infection.

TREATMENT

An endocrinologist can prescribe treatment to a patient only after an examination and some clinical studies. With regard to laboratory parameters, the most important of them is the high content of special antibodies in the blood. It is possible to talk about autoimmune thyroiditis on the basis of hypothyroidism and an increase in the size of the thyroid gland, as well as its compaction. It is important to distinguish autoimmune thyroiditis from thyroid cancer, especially if there is a dense nodular goiter. In this case, you need to pay attention to the titer of antibodies to the tissues of the thyroid gland, since in cancer it is absolutely normal, and in thyroiditis it is increased. A very informative examination method is a puncture biopsy, which is used to determine the functional state of the gland. In this case, the degree of absorption of radioactive iodine, the level of thyrotropin , thyroid hormones are studied , and a test with thyroliberin is also carried out . 

To treat Hashimoto’s goiter , conservative and surgical methods of treatment are used . Conservative treatment involves the appointment of hormonal agents that are necessary to suppress the influence of the pituitary gland, which stimulates the thyroid gland to produce more hormones and causes it to increase in size. Such therapy is extremely long, sometimes it lasts for years, until the size of the thyroid gland decreases and the functions return to normal. The dose of the hormone is selected for each specific patient individually, and depending on his age, general health. If the density of the goiter is too high or there is a suspicion of the possibility of the formation of a malignant tumor, there is pressure on the trachea or esophagus, then surgical intervention is indicated in order to excise excess tissue.  

HOW TO FORGET ABOUT THYROID DISEASES?

Lumps on the neck, shortness of breath, sore throat, dry skin, dullness, hair loss, brittle nails, puffiness, puffiness of the face, dull eyes, fatigue, drowsiness, tearfulness, etc. – it’s all a lack of iodine in the body. If the symptoms are “on the face” – perhaps your thyroid gland is no longer able to work normally … You are not alone, according to statistics, up to a third of the entire population of the planet suffers from thyroid problems.