Hashimoto’s thyroiditis

Of autoimmune origin, Hashimoto’s thyroiditis is a chronic inflammatory pathologist that causes hypothyroidism.

The thyroid is an endocrine gland, that is, it produces hormones that it pours into the blood. It has a butterfly-like shape and is located in the front of the neck, between the trachea and larynx.

It secretes 90% of the hormone thyroxine (also called T4) and 10% of the hormone triiodothyronine (also called T3).

The thyroid plays a fundamental role in sexual development, nervous system and skeleton, regulates body temperature, affects the sleep-wake rhythm and the health of skin and hair.

It may happen, however, that the gland begins to no longer function as it should: the reasons for this phenomenon are not yet fully known, although experts believe that female hormones play an important role, given the high incidence of disorders that the malfunction of this gland causes among women.

Tiredness is the first symptom

Patients with Hashimoto’s thyroiditis often do not perceive any sensation of pain and do not have any particular symptoms.

When they occur, among the most common is the increase in thyroid volume, the so-called goiter, which generally does not cause particular disorders, except in cases where it is very evident.

Signs of the disease can instead appear when aggression by the cells of the immune system causes an alteration in the functioning of the gland. In these cases the person feels tired, sensitivity to cold, difficulty concentrating, memory loss and weight gain. Children may also experience learning difficulties and reduced growth speed.

Unfortunately, since the symptoms of thyroiditis are often mild, sufferers do not talk about it with the doctor, with the result that, little by little, the thyroid works less and less, until it results in a real hypothyroidism.

In rare cases, however, excessive secretion of thyroid hormones (hyperthyroidism) may occur and, consequently, symptoms such as increased number of heartbeats, hyperexcitation, weight loss and a characteristic protrusion of the eyeballs, called exophthalmos, due to which the eyes seem to “come out of the sockets”.

Familiarity also counts

The presence in the family of other cases of Hashimoto’s thyroiditis increases the risk of developing this disease. In other words, the appearance of this pathology is more frequent among the members of some families rather than others.

An interesting feature concerns the age of its appearance: often, when it affects children, the pathology occurs at a lower age than that at which it manifested itself in the parents.

Although Hashimoto’s thyroiditis is therefore characterized by familiarity, it has never been proven that a single gene is responsible for the appearance of the disease. Therefore, it is more correct to speak of predisposition and not of heredity.

The control of thyroid activity should be more frequent if there are other cases of autoimmune diseases in the family and in pregnancy, when the gland undergoes more work and can trigger the problem in predisposed people.

Useful exams

Often the symptoms are mistaken for the consequences of a prolonged period of stress or convalescence. The diagnosis is therefore made by chance, following the results of examinations performed for other reasons.

If, on the other hand, the doctor suspects Hashimoto’s thyroiditis, in addition to visiting a specialist, he will prescribe some blood tests to evaluate the three main indicators of thyroid function.

The first two are the circulating hormones that the thyroid itself produces: free triiodothyronine (Ft3) and free thyroxine (Ft4), while the third is the dosage of TSH, the hormone produced by the pituitary gland that stimulates thyroid activity and which first indicates whether the gland is working at its best or not.

In case of Hashimoto’s thyroiditis, the dosage of thyroid hormones is lower than normal. If alterations are present, it may be necessary to know the level of anti-serum globulin and anti-thyroperoxidase antibodies, even if they are negative in 10-15% of people with this disease.

Through an ultrasound it is also possible to evaluate the size of the gland and its structure. If the presence of nodules is found, the doctor may also prescribe some cytological tests, including needle aspiration, a minimally invasive technique that allows cells to be taken from cysts to be analyzed in the laboratory.

Sometimes, however, these tests are not enough to diagnose the disease with certainty and the specialist can subject the person to a scintigraphy. The examination is based on the fact that iodine is one of the fundamental components of thyroid hormones. By administering a minimum amount of radioactive iodine, it is possible to verify the functionality of the thyroid and obtain a real map of the gland that signals, in addition to inflammation, also the presence of any tumors.

Possible cures

While it is not always necessary to resort to medication to treat Hashimoto’s thyroiditis, it is nevertheless important to follow a healthy lifestyle and proper nutrition, give up smoking and perform regular physical activity.

In addition, it is essential to keep your guard up, undergoing checks every six months, in order to intervene as soon as possible in case of a worsening of hormonal dosages.

When, despite these recommendations, the symptoms do not improve or the values tend to worsen, it is necessary to resort to pharmacological treatment. In these cases, the doctor may prescribe replacement therapy, which consists of taking one tablet of L-thyroxine every day, a synthetic hormone identical to that produced by the thyroid.

L-thyroxine should be taken 30-60 minutes before breakfast; In some people this condition can create difficulties in following the treatment correctly. To overcome this drawback, liquid L-thyroxine can be used, which can also be taken during breakfast, a solution appreciated by most patients.

Yes to movement

Practiced regularly at least three times a week, physical activity helps speed up the metabolism.

Recommended sports are running, swimming and tennis, but also walking at a brisk pace and cycling. In addition to improving mood and allowing good joint mobility, they help fight asthenia, fatigue and depression, all characteristic symptoms of Hashimoto’s thyroiditis.

Nutrition also plays an important role

Iodine is the fundamental element that allows the thyroid to produce its own hormones. Therefore, it is necessary to introduce a sufficient amount every day (equal, in an adult person, to 150 micrograms), for example by resorting to the use of iodized salt.

However, it is good to know that the consumption of substances containing large amounts of iodine, such as seaweed, is considered one of the factors that can favor the appearance of Hashimoto’s thyroiditis in predisposed people.

In addition, one of the concerns of those suffering from hypothyroidism is to gain weight. In reality, the risk is due more to an incorrect diet than to the consumption of foods that can slow down the effect of the hormone taken by mouth.

Foods yes and foods no

Among the foods to limit are cauliflower, Brussels sprouts, broccoli, turnips, sweet potatoes, soybeans and beans. The same goes for red meats, cold cuts, eggs, cheeses, sugar and whole milk: better to eliminate them completely in the acute phases or exacerbation of the disorder.

To foods rich in gluten such as wheat, spelled or kamut, prefer rice, oats, millet, barley, corn, quinoa and buckwheat.

Foods rich in omega 3, which have an anti-inflammatory action, are also preferred. Green light, therefore, to blue fish, flaxseed oil, walnuts, pumpkin seeds, almonds, hazelnuts, rosemary, bananas and beets.

Yes also to foods rich in vitamin A (including tomatoes, carrots, red chili, yellow pumpkin, radicchio and parsley), vitamin C (contained in oranges, mandarins, lemons, kiwi, currants, nettle and parsley) and vitamin E (found in hazelnuts, almonds, wheat germ, extra virgin olive oil, pine nuts, sage and dried rosemary).