Autoimmune hypothyroidism and autoimmune thyroiditis. Autoimmune thyroiditis Aitis and hypothyroidism a dangerous diagnosis

The thyroid gland is a very important organ in our body. It stores all the iodine that enters the body, the gland produces hormones that regulate metabolism and are involved in the process of cell growth. Autoimmune thyroiditis leading to hypothyroidism is the most common disease affecting the thyroid gland.

Notably, autoimmune thyroiditis is more common in women than in men. Statistics note that the incidence rate of the female population is about 10 times higher. But not only the fair sex is at risk of getting sick, the diagnosis of the lesion thyroid gland can put a teenager, and even a child. However, male thyroiditis is more aggressive, the disease passes much faster into a more complex form - hypothyroidism.

The essence of autoimmune thyroiditis is a violation immune function of the whole organism when the defense system fails, and thyroid begins to be recognized as a foreign object. As a result, the body begins to produce special cells that attack the "harmful organ", eventually destroying the thyroid gland.

If the disease is left unattended, then after some time it will flow into hypothyroidism, and after it it can turn into a myxematous coma, which is very dangerous and often even fatal.

Opened and described this disease was a little over a hundred years ago by the Japanese surgeon Hashimoto. He found that the thyroid gland becomes inflamed when the body begins to produce lymphocytes, and they, in turn, create antibodies to thyroid tissues. So she gets hurt.

Most often, the disease affects women during menopause or before it - the age of 45-50 years. Autoimmune thyroiditis is not yet fully understood by scientists, but they know for sure that the disease is clearly hereditary. An autoimmune process with aggravated heredity can trigger any negative external factor like an acute viral infection or a chronic infectious focus. Such infections can be considered otitis media, sinusitis, sinusitis, chronic tonsillitis, and even a tooth affected by caries. There are cases when an autoimmune process starts in the thyroid gland as a result of taking iodine preparations for a long time and without proper control. And also the cause of autoimmune thyroiditis can be abundant radiation.

Causes of the disease

The development of autoimmune thyroiditis is provoked by the following factors:

• severe infections and viral diseases;
• damage to the thyroid gland and penetration into the blood of its components;
• strong concentration of radioactive substances;
• an overdose of iodine;
• prolonged and abundant penetration of toxins into the body (methanol, phenol, toluene, thallium, benzene).

As a rule, patients genetically predisposed to this disease are accompanied by diseases such as:

• chronic hepatitis of an autoimmune nature;
• diabetes;
• rheumatoid arthritis;
• vitiligo (disturbance of pigmentation, the appearance of white spots on the skin);
• primary autoimmune hypocorticism;
• pernicious anemia.

It should be noted that with autoimmune thyroiditis there is a sharp jump in the amount of thyroid hormones, and after the transition of the disease to hypothyroidism, the content of these hormones in the blood decreases sharply and steadily.

Autoimmune thyroiditis is of two types:

1. Hypertrophic - with it, the thyroid gland increases in size. At the same time, its function may remain normal, decrease or greatly increase. In the neck, pain and pressure are felt, the mucous membrane of the larynx swells. The patient has increased sweating, trembling hands, heat, as well as other signs of increased thyroid function. With the course of the disease, hyperthyroidism turns into hypothyroidism against the background of autoimmune thyroiditis (sluggish, weakened state).
2. Atrophic - in this case, the thyroid gland decreases. This form of the disease is more common in older people. They have frequent drowsiness, weakness and lethargy, hearing goes down, the voice becomes hoarse, its timbre changes, the face swells, the skin becomes dry.

The disease proceeds rather slowly, sometimes imperceptibly, and progressing, it passes into hypothyroidism.

Symptoms of autoimmune thyroiditis

Symptoms this disease, in principle, is similar to other diseases of the thyroid gland, where there is a decline in its activity:

• mental activity decreases, memory deteriorates;
• physical activity falls, a person becomes lethargic, slow, weakens;
• many parts of the body and even internal organs swell;
• appearance noticeably worsens: the skin turns yellow, begins to peel off, becomes dry, hair and nails often break;
• there are malfunctions in the work of the heart and blood vessels, breathing is disturbed, suffers nervous system, there is a severe arrhythmia;
• in women, there is a lack of menstruation, sometimes infertility develops, and in men, as a rule, the level of potency decreases.

Diagnosis of the disease

An experienced endocrinologist immediately recognizes a patient with autoimmune thyroiditis, because external signs speak for themselves. But still, clinical studies are needed here:

For the prevention and treatment of thyroid diseases, our readers advise Monastic Tea. It consists of 16 most useful medicinal herbs, which have extremely high efficiency in the prevention and treatment of the thyroid gland, as well as in cleansing the body as a whole. The effectiveness and safety of Monastic tea has been repeatedly proven clinical research and many years of therapeutic experience. The opinion of doctors ... "

1. Blood test for the amount of thyroid hormones. In addition, it is necessary to diagnose the activity of the pituitary gland, which synthesizes thyroid-stimulating hormone (TSH). This is the main hormone of the thyroid gland, which completely controls its activity. Low or high values ​​allow a positive diagnosis.
2. Examination of blood serum for the presence of antibodies to thyroperoxidase (AT-TPO) and thyroglobulin (AT-TG).
3. Ultrasound of the thyroid gland - allows you to determine the size of the organ, its structure and consistency, as well as the presence of tumors and nodes.
4. Thyroid scintigraphy is a method that determines its functional activity. A special apparatus examines whether the gland is able to capture iodine from the bloodstream, because thyroid hormones are then synthesized from it. Sufficient supply of the gland with iodine ensures its stable operation.
5. Fine-needle biopsy - is carried out after all of the above activities, if, according to their results, everything indicates the presence of a disease, and even more so if nodular formations are recorded. During the biopsy procedure, the doctor uses a special needle to take a small piece of thyroid tissue for histological examination. Using this method, you can find out the nature of the tumor and exclude malignant neoplasms.

Treatment of autoimmune thyroiditis

This disease proceeds very slowly, over several years, the treatment is also long and comprehensive. The therapy includes the following steps:

• Replacement therapy - drugs based on thyroid hormones, can be synthetic or natural.
• Reception of glucocorticoids - eliminate autoimmune disorders. Since the disease is associated with failure immune system, these drugs suppress its vigorous activity so that the cells do not destroy their own body. Synthetic drugs can be used here, as well as hormones of the adrenal cortex.
• Immunomodulators that correct failures in the work of the protective system. Since glucocorticoids suppress the immune system, the body is endangered. In this state, it can easily be attacked by bacteria and viruses that are both inside the body and getting there from the outside. Therefore, reliable protection is required. For such purposes, the attending physician prescribes drugs that partially replace immunity, that is, they perform its functions, albeit partially, but the body does not remain without protection.
• Special diet and individually tailored exercise program. Hypothyroidism is characterized by a slow metabolism, which leads to edema and obesity. It is necessary to take active measures: observe a diet, do not overeat, reduce fluid intake, reduce the amount of food consumed, remove sweets, canned food, fatty and fried foods from the diet.

Diet for hypothyroidism

Revising your diet and gastronomic habits is not a panacea for autoimmune thyroiditis, however, some simple tips can slow down relapses and improve overall well-being:

• it is necessary to exclude soy - it belongs to the so-called antithyroid products, that is, it stimulates the production of estrogens that inhibit the secretion of thyroid hormones;
• It is recommended to avoid polyunsaturated fats and switch to saturated fats. The latter maintain normal sugar levels and regulate the activity of stress hormones, the increase of which directly affects the occurrence of hypothyroidism;
• regularly eat seafood - they have a lot of iodine and selenium, they normalize the activity of the thyroid gland. In addition, their assimilation directly from seafood is much better than from artificial food additives;
• include fruits in the diet as often as possible - they contain potassium, which affects the normalization of the amount of sugar in the blood, thereby reducing the level of the stress hormone;
• use broth on the bone - rich in easily digestible nutrients that relieve the symptoms of autoimmune thyroiditis. In such a broth there are amino acids that act positively on the body and fight inflammation;
• limit the amount of fluid you drink per day - the maximum amount of water is 1.5 liters. It should not be exceeded due to swelling and stagnation of fluid in the body, characteristic of hypothyroidism;
• Refusal of refined foods - thanks to them, blood sugar rises, and consequently, stress hormones. Toxins in such products interfere with the activation of thyroid hormones;
• it is recommended to drink coffee - the B vitamins and magnesium contained in it help the thyroid gland to work properly. A day should be limited to a couple of cups of coffee.

So serious illness do not ignore and hope for a quick favorable outcome without any effort.

active treatment for early stages prevent hypothyroidism against the background of autoimmune thyroiditis. And if the disease has already taken this form, then the earliest medical intervention will protect the body from more serious damage.

It still seems that it is not easy to cure the thyroid gland?

Given that you are now reading this article, we can conclude that this ailment still haunts you.

You probably also had thoughts about surgery. It is clear, because the thyroid gland is one of the most important organs on which your well-being and health depends. And shortness of breath, constant fatigue, irritability and other symptoms clearly interfere with your enjoyment of life...

But, you see, it is more correct to treat the cause, not the effect. We recommend reading the story of Irina Savenkova about how she managed to cure the thyroid gland...

Autoimmune processes of the thyroid gland are accompanied by euthyroidism, hypothyroidism or hyperthyroidism, nodular or diffuse changes, can have isotrophic, hypertrophic and hypotrophic volume. In the population, autoimmune thyroiditis occurs from 1% to 12%, depending on the age of the patients (according to different authors). As with other thyroid diseases, the incidence of chronic autoimmune events in women compared with men is 2-3 to 15 times more frequent, according to different authors. The disease occurs in all age periods but more often in 40-50 years.

Lecture on the erroneous understanding of the processes occurring in the thyroid gland in autoimmune thyroiditis. Common misconceptions.

Proof of restoration of thyroid tissue in autoimmune thyroiditis.

Classification of autoimmune thyroiditis

The most practically applicable is the division of autoimmune thyroiditis into two types: autoimmune hyperthyroidism and, in fact, autoimmune thyroiditis. If in autoimmune hyperthyroidism, the diagnostic search is focused on the detection of AT-rTTH in the blood, then in euthyroid and hypothyroid autoimmune thyroiditis, it is on the determination of AT-TPO and AT-TG.

In addition, autoimmune thyroiditis is classified comprehensively, in accordance with morphological, etiological, functional, age and other features. Therefore, they distinguish:

In accordance with the ideas of the first group of specialists, the phases of autoimmune thyroiditis are distinguished: euthyroid, subclinical, hypothyroid, hyperthyroid (thyrotoxic). But the lack of a full-fledged scientific justification for such a multi-phase thyroiditis, together with the empirical linking of immune changes to the supply of hormones to the body, contributes to practical errors and therefore reduces the value of such a classification.

In the essential Clinical classification proposed by us (Clinic of Dr. A.V. Ushakov, 2010), the autoimmune process is defined as a compensatory phenomenon that has varying degrees activity. In accordance with the titer of antibodies in the blood, a small, moderate and significant degree of the autoimmune process is released. For example, usually, an increase in AT-TPO up to 300-500 U / l is considered to be a small degree, from 500 to 1000 U / l - as a moderate degree, and more than 1000 U / l - as a significant degree. This assessment takes into account the reference data of the laboratory.

Each degree of activity closely correlates with the magnitude of morphological changes in the gland. Such a classification division allows us to assess the intensity of immune events and determine the prognosis of thyroid disease.

Bad ecology and lead to the fact that all more people have thyroid problems. The most common deviation in the work of this body is called. Approximately 3-4% of the population is diagnosed with autoimmune thyroiditis.

Moreover, women are more susceptible to this disease than men. Against the background of this disease, autoimmune hypothyroidism can develop. In this publication, we will describe in detail what autoimmune thyroiditis and hypothyroidism are, their symptoms and treatment.

It should be noted that autoimmune thyroiditis is a complex name for inflammatory diseases of the thyroid gland, which are of an autoimmune nature. Doctors quite often use the second name, which captures the name of the scientist who first described these diseases - Hashimoto's thyroiditis. For convenience, the short name HAIT was introduced - chronic autoimmune thyroiditis.

When a disease develops in the human body, the immune system produces antibodies. In autoimmune diseases, autoantibodies are produced that take the cells of the body as foreign, and begin to actively fight them. The immune system makes a "retaliatory move" - ​​it produces antibodies. According to the results of a blood test for antibodies, the doctor sees that the patient has an autoimmune disease.

In autoimmune thyroiditis, autoantibodies destroy thyroid cells. This organ synthesizes thyroid hormones (T3 and T4), which affect the processes occurring in the body of a lady and the work of almost all systems.

About the disease in the picture.

The more thyroid cells are destroyed, the less it will be able to produce its own hormones. Against the background of ongoing processes, primary hypothyroidism develops - a persistent deficiency of thyroid hormones.

It is called primary because it occurs due to a violation of the size and structure of the thyroid gland. Its gradual destruction by autoantibodies will eventually lead to such a state that it can no longer produce hormones.

Expert opinion

Alexandra Yurievna

Doctor general practice, associate professor, teacher of obstetrics, work experience 11 years.

If you do not start treatment, then such changes will lead to complications. The most serious consequence is the development of hypothyroid coma. Thus, autoimmune hypothyroidism develops against the background of autoimmune thyroiditis.

What are the symptoms of AIT

Autoimmune thyroiditis of the thyroid gland can develop in a woman's body for a long time without revealing its presence with any symptoms. But still, the disease has one very characteristic symptom - the appearance of a goiter (a nodular formation in the thyroid gland). Over time, the goiter will increase in size.

What happens in the body?

This process results in the following complaints:

• discomfort in the thyroid gland;
• swallowing makes it difficult to feel a lump in the throat;
• with not strong pressure on the thyroid gland, mild pain occurs.

For some ladies, even wearing a scarf causes unpleasant discomfort. You should know that, despite the absence of pronounced manifestations, the thyroid gland is slowly destroyed.

Therefore, if you find the sensations described above in yourself, the lady should visit an endocrinologist who will conduct a comprehensive diagnosis and be able to identify hypothyroidism in the initial stage of development.

Symptoms of autoimmune hypothyroidism

Once again, we focus your attention on the fact that HAIT is a disease, while autoimmune hypothyroidism is a condition that occurs against the background of ongoing Hashimoto's thyroiditis. Hypothyroidism in AIT develops in certain stages.

At the very beginning, the thyroid gland increases in size. Therefore, there will be manifestations of hyperthyroidism - an excess amount of thyroid hormones in the blood.

About illness.

In particular:

1. The lady will begin to lose weight without taking any action for this. She did not change the diet, did not introduce additional physical activity into the daily routine, and the weight is reduced.
2. Blood pressure will be elevated.
3. There will be a noticeable tremor (trembling) of the hands.
4. Insomnia may develop.

Since the cells of the thyroid gland are gradually destroyed by autoantibodies, after a while the excess of thyroid hormones will be replaced by their deficiency.

The lady will have signs of hypothyroidism:

• she begins to get better for no reason;
• she will stop menstruating;
• decreased libido (sex drive);
• there will be sensations constant fatigue or general weakness of the whole organism;
• there will be swelling of the limbs;
• the skin will become pale and excessively dry, and the hair will begin to fall out intensely;
• memory will noticeably worsen;
• speech disorders are possible.

Such a difference in the state of the body, over a short period of time, should alert a woman. She definitely needs to contact an endocrinologist for a comprehensive diagnosis. Only based on its results, the doctor will be able to make an accurate diagnosis and prescribe an effective treatment.

How to diagnose

How to treat AIT?

In order to diagnose autoimmune hypothyroidism, it is necessary to undergo the following set of measures:

1. Examination by an endocrinologist.
   During which the specialist will be able to identify whether there are deviations from the normal size of the thyroid gland. The doctor will find out from the woman what symptoms bothered her. Based on the information received and the results of the examination, he will be able to make a preliminary diagnosis of whether autoimmune thyroiditis preceded hypothyroidism.
2. Examination of the thyroid gland by ultrasound, MRI, as well as radioisotope diagnostics.
   As a result of the studies carried out, changes in the size and structure of the thyroid gland will be revealed.
3. Blood donation for hormone tests: TSH, free T3 and T4.
   In addition, analyzes for antibodies and general biochemical analysis blood.

Such a comprehensive examination will allow the doctor to obtain the maximum amount of information for diagnosing CAI with an outcome in hypothyroidism.

A blood test will allow the doctor to identify the disease at the subclinical stage of development. This is when there are no obvious symptoms yet, and the disease is already developing in the body. Subclinical hypothyroidism is characterized by normal indicators T3 and T4 at elevated level TSH. By starting treatment at this stage, a woman will be able to stop the destruction of the thyroid gland.

What are the treatment approaches?

How to treat autoimmune thyroiditis and nodular goiter, and hypothyroidism? Since the cause of all these diseases is the resulting deficiency of thyroid hormones, they can be cured with the help of preparations containing artificial hormones. For example, the drug levothyroxine effectively fights a decrease in the size of the thyroid gland. It can stop the development of HAIT and autoimmune hypothyroidism.

In the case when autoimmune hypothyroidism of the thyroid gland was treated with medication, but there was no improvement, the patient will be offered surgical treatment removal of part or all of the thyroid gland.

The operation is prescribed when the goiter has grown too much and prevents the lady from breathing or swallowing. Surgical intervention carried out for aesthetic reasons - an overgrown goiter spoils the appearance of the neck.

In the treatment of autoimmune hypothyroidism, the following algorithm is followed:

1. Assign, which contains artificial hormones similar to those produced by the thyroid gland. This eliminates the original cause of the development of the disease. Hormonal drugs and their dose is prescribed only by the attending physician.
2. Daily use of a homeopathic remedy or folk recipe to maintain immunity. It is not possible to cure HAIT only with homeopathy.
3. Take enough vitamins and minerals daily. Depending on the stage of hypothyroidism, the doctor will either prescribe a vitamin complex or advise you to include more fresh vegetables and fruits in the menu.
4. Use a special diet for. It is aimed at maintaining the proper functioning of the thyroid gland. The basis of the diet is fresh vegetables and fruits, seafood, lean varieties meat, meat broths. The use of natural coffee is allowed. Sugar and all soy products should be completely eliminated from the diet. Try to reduce your fat intake. And, all: vegetable and butter, oily fish, nuts and avocados.

Many ladies are interested in how to lose weight with autoimmune HAIT? Stick to the diet we have reviewed and increase physical activity. To do this, it is advisable to include in your daily routine morning exercises, doing a feasible sport, swimming, shaping, yoga or dancing. A half-hour walk in the park area will bring great benefits.

ethnoscience

Treatment folk remedies autoimmune hypothyroidism can only have an auxiliary character. In other words, the patient takes the medicines prescribed to her and at the same time improves her condition with the help of herbal decoctions. This is due to the fact that herbal treatment helps to reduce the intensity of the symptoms of the disease.

Here are some traditional medicine recipes that are popular with autoimmune hypothyroidism:

1. Herbal decoction of leaves, strawberries, cherries or currants.
2. Rosehip infusion.
3. Infusion of nettle leaves. In order to prepare it, you need 2 tbsp. spoons of dry raw materials pour a glass of boiling water. Infuse for an hour and strain. Drink a quarter cup three times a day half an hour before meals.
4. Pharmacy tincture of ginseng. It is taken 30 drops 3 times a day. The course of treatment is 30 days. After that, be sure to take a two-week break. If necessary, the course of treatment is repeated.
5. 20% propolis tincture. Mix 30-40 drops of tincture with 50 ml of milk or warm water and drink before going to bed. The course of treatment is 30 days.
6. Often use sugary kelp. It can be added to salads, to ready meals as a condiment.
7. White cabbage juice can significantly improve metabolism. Freshly prepared juice is drunk half a cup three times a day.

Using infusions, decoctions and other folk recipes female body will receive enough natural vitamins and minerals. The lady will increase the level of immunity and stabilize the work of all body systems.

Outcome

The state of autoimmune hypothyroidism appears against the background of ongoing chronic autoimmune thyroiditis of the thyroid gland. It is very important to suspect a pathology as soon as possible based on the identified symptoms and consult a doctor.

Comprehensive treatment, started at an early stage, will allow you to get good effect. We wish you good health!

What do you know about autoimmune hypothyroidism?

One of the most important organs in human body, is the thyroid gland. It contains the entire supply of iodine that enters the body, produces the necessary hormones, which in turn help the metabolism to function properly and affect the development of cells. However, like all other organs, the thyroid gland can suffer from the effects of various diseases, and the most common of them is hypothyroidism due to autoimmune thyroiditis.

Subclinical hypothyroidism caused by autoimmune thyroiditis leads to an increase in TSH, which is a consequence of the reaction of the pituitary gland to a malfunction of the thyroid gland. As a result, the "surviving" thyroid cells begin to work hard, maintaining a sufficient level of thyroid hormone. Due to such a reaction of the body, no symptoms may even appear that indicate a violation. That's why, this species hypothyroidism is called subclinical.

The body's response to illness

Since the thyroid gland affects all organs and systems in the body, the symptoms can manifest themselves from different sides. A sufficient amount of iodine is necessary for good organ performance. However, if the body feels a lack of it for quite a long time, then this can lead to a decrease in the rate of growth and cell division, which causes negative changes in the gland, as well as nodular formations.

Nodular goiter with AIT phenomena of subclinical hypothyroidism can be formed due to many reasons, such as:

• lack of iodine;
• pollution and toxins;
• viral infections;
• constant stress;
• smoking;
• long period of admission medicines;
• genetics.

Periodically visiting an endocrinologist, you can monitor the condition, as well as the health of the thyroid gland. Thanks to this, it will be possible to recognize any manifestations of disorders and begin immediate treatment. Treatment options include the following:

• proper use of radioactive iodine;
• the use of drugs that stop the production of thyroids;
• surgical intervention.

Autoimmune thyroiditis and hypothyroidism

AIT is sometimes called Hashimoto's thyroiditis. With such a diagnosis, the immune system begins to destroy the proteins of the thyroid gland, which is why it is destroyed. Primary hypothyroidism against the background of autoimmune thyroiditis can develop due to genetic or acquired disorders of the thyroid gland. However, this outcome can be prevented.

Symptoms of AIT hypothyroidism

With autoimmune thyroiditis, there may be no obvious symptoms. The disease progresses slowly and progresses to hypothyroidism. However, in most cases, one of characteristic features may be the appearance of a goiter, which can grow and increase, and the result will be other manifestations of the disease. If a nodular formation has arisen in the tracheal area, then it will interfere with breathing and swallowing, but most often the discomfort is felt simply from touching or when wearing scarves and ties.

Some symptoms of the disease can be expressed as follows:

• insomnia;
• disorders in the digestive system;
• anxiety;
• fatigue;
• sudden changes in weight;
• pain in the body, muscles, joints;
• mood changes and depression.

Diagnosis of AIT

passing regular examinations with a specialist, you can monitor the state of the thyroid gland and identify at an early stage various deviations from the norm of its work. An endocrinologist may identify the following:

• deviations from the norm in the size of the body;
• based on a blood test, you can determine the level of thyroglobulin, thyroperoxidase and antibodies, as well as their ratio;
• a biopsy will help detect lymphocytes and macrophages;
• using a radioisotope study, one can see diffuse absorption in an enlarged thyroid gland.

Treatment of AIT hypothyroidism

In cases where there is an increase in the size of the organ, the endocrinologist will prescribe the patient therapy with the help of hormones. Artificial hormones, such as levothyroxine, help fight the shrinking thyroid. However, if drug treatment is not effective, then the attending physician may advise partial or complete removal of the gland.

If the patient was diagnosed with autoimmune thyroiditis subclinical hypothyroidism, then doctors can prescribe the hormone L-thyroxine or iodomarin, and after a month - TSH.

Some doctors are of the opinion that if the presence of thyroid antibodies is observed in autoimmune thyroid, then it is necessary to begin immediate treatment with small doses of hormones, such as those produced by the thyroid gland. Most practitioners advise using the drug levothyroxine if the level of TSH is within the normal range. This drug helps to resist the development of the disease, even suspend it. The reason for this result is that the level of antibodies and the content of lymphocytes are significantly reduced, which means that inflammation also disappears.

Treatment with hormonal therapy has a number of significant advantages. Of course, a person suffering from this disease must understand their dependence on drugs for the rest of their lives. However, this fact should not cause concern, since the treatment involves saturating the body with the missing hormones that the thyroid gland itself can no longer produce. Thanks to treatment with hormones, the following changes will soon be observed:

• restoration of the thyroid gland;
• absence of ailments;
• relief comes very quickly, thanks to which the person suffering from the disease can return to normal life very quickly;
• after three months, you can restore the level of hormones;
• the dose of the drug does not change throughout the course, if there is no fact of pregnancy or significant changes in weight;
• the cost of medicines also makes treatment quite affordable.

Treatment of subclinical AIT

For the treatment of this disease, no significant features are required, the main task of the therapy being carried out is to maintain thyroid hormones at the proper level. Such treatment is carried out as follows:

• drugs are prescribed that contain hormones produced by the thyroid gland itself;
• treatment of the underlying cause of the disease;
• daily maintenance of the balance of the body, with the help of vitamins, as well as minerals;
• proper nutrition. Since the metabolism is disturbed, thanks to the simple rules of the diet, it is possible to maintain the health and proper functioning of the gland.

If you take a closer look at the diet for healthy eating It is important to exclude the following foods:

• sugar;
• reduce water intake to 600 ml per day;
• reduce the consumption of fats: vegetable and butter, oily fish, nuts, avocados;
• soy products.

In a diet that will help counter hypothyroidism, you need to include the following foods:

• fresh vegetables and fruits;
• beef, turkey and other poultry meat;
• seafood, because it is they that contain the most a large number of iodine;
• meat broths;
• natural coffe.

Advanced forms of the disease are much more difficult to treat, especially since the outcome can have very serious consequences, such as coma and disruption of other organs. In addition, prevention is always much more best method than the actual treatment of the disease. However, unfortunately, at the moment it is possible to prevent only those types of this disease that are caused by an insufficient content of iodine entering the body. In order to prevent the development of pathology inside the womb, a pregnant woman must pass the necessary tests and take timely measures to combat the disease.

The main factor in the occurrence of autoimmune thyroiditis- violation of the immune system. It manifests itself as a family disease. In the families of patients, there are other pathologies of an autoimmune nature. May occur after childbirth.

The precipitating factors include: chronic infections nasopharynx, caries; infections; yersiniosis (transmitted from livestock, dogs, rodents); contamination of soil, air and water with chlorine, fluorine, nitrates; radiation and solar exposure; stressful situations; prolonged, uncontrolled use of iodine-containing drugs or hormones; treatment with interferon drugs for blood diseases; trauma and thyroid surgery.

Iodine is important in quantities exceeding the physiological norm. This applies to food (red food colorings, preservatives, iodine additives in flour, salt), but more often to medicines and dietary supplements.

The classification of the forms of Hashimoto's goiter includes latent, hypertrophic, atrophic.

The disease progresses several stages- euthyroid, subclinical, thyrotoxic,.

Signs of the disease found with significant destruction of the gland. Apart from clinical manifestations hypothyroidism (weakness, impaired thermoregulation, drowsiness, low arterial pressure) its consequence may be infertility. If, however, conception has occurred, then during gestation it has an adverse effect on the mother and child.

Most patients are at the subclinical and euthyroid stage They don't know they have thyroiditis. At this time, the thyroid gland retains its size, is not painful, the hormonal background is not disturbed. In the first years of the disease, autoimmune thyroiditis is usually manifested by hyperthyroidism. More commonly found in children: tendency to tearfulness, anxiety, agitation; increased irritability, aggressiveness; accelerated heartbeat; increase in the upper pressure indicator; sweating, poor heat tolerance; trembling of the eyelids, fingers; weight loss.

With hypertrophic form signs of compression of neighboring tissues come to the fore. Patients have difficulty breathing, swallowing, hoarseness of voice, short-term bouts of dizziness or fainting.

Before the onset of hypothyroidism, autoimmune thyroiditis is difficult to identify. Diagnosis includes: general blood test, blood immunology; blood hormones; ultrasound; . To confirm chronic autoimmune Hashimoto's thyroiditis, need the simultaneous presence of the most important features: antibodies to thyroid peroxidase greater than 34 IU / l, hypoechogenicity on ultrasound and symptoms of hypothyroidism.

Treatment is reduced only to compensation for violations of the formation of hormones.. Thyreostatics (Mercazolil, Espa-carb) are not used for hashitoxicosis, since hyperthyroidism is associated with the destruction of the thyroid gland, and not with increased thyroxine synthesis. With palpitations, tachycardia, increased pressure, hand trembling, the beta-blocker Anaprilin is indicated.

With the development of hypothyroidism appointed replacement therapy levothyroxine (L-thyroxine,). To reduce the antibody titer, selenium (Cefasel) is added to the treatment for three months. Glucocorticoids (Prednisolone, Dexamethasone) are used for exacerbation of inflammation. With mild inflammatory process use nonsteroidal drugs(Voltaren, Indomethacin). For large sizes, an operation is performed to remove the gland.

Read more in our article about autoimmune thyrotoxicosis, its manifestations and treatment.

Read in this article

Reasons for the development of autoimmune thyroiditis

The main factor in the occurrence of this disease is a violation of the immune system, which begins to perceive the cells of its thyroid gland as foreign and produce antibodies against them. Autoimmune thyroiditis manifests itself as a family disease. Patients and their blood relatives have antibodies to enzymes (thyroid peroxidase) and that are involved in the formation of hormones - thyroxine and triiodothyronine.

In addition, in the families of patients there are other pathologies of an autoimmune nature - type 1 diabetes mellitus, rheumatoid arthritis, hepatitis, pernicious anemia, vitiligo. The very presence of antibodies is not a guarantee of the development of an active process. Therefore, even with a genetic predisposition, exposure to a provoking factor is necessary. The role of such reasons is proved:

• chronic infections of the nasopharynx, especially tonsillitis, sinusitis, caries;
• acute viral infections, especially hepatitis;
• intestinal infectious diseases, yersiniosis (transmitted from livestock, dogs, rodents);
• pollution of soil, air and water with chlorine, fluorine, nitrates (stimulate the activity of T and B lymphocytes responsible for cellular immunity and formation of antibodies).
• radiation and solar exposure;
• stressful situations;
• prolonged, and especially uncontrolled use of iodine-containing drugs or hormones;
• treatment with interferon drugs for blood diseases;
• trauma and thyroid surgery.

Recent studies on the significance of these factors have shown that an important, and perhaps the main one, is the use of iodine in quantities exceeding the physiological norm. This applies to food (red food colorings, preservatives, iodine additives in flour, salt), but more often to medicines and dietary supplements.

It should be noted that self-treatment or prevention of iodine deficiency with iodine or Lugol's solution is extremely dangerous. Similar conditions can also occur when the dose of multivitamins is exceeded, long-term use of Kordaron.

Autoimmune thyroiditis can occur after childbirth. Its development is associated with the activation of the body's defenses after a period of oppression during pregnancy. If the patient does not have a hereditary predisposition, then it can stop spontaneously. There is also a painless ("mute, silent") variant of the disease that is not associated with pregnancy or any other known cause.

Hashimoto goiter classification

Depending on the severity of symptoms and changes in the thyroid gland, the disease can have several clinical forms.

Latent

Antibodies are found in the blood, but there are no signs of changes in the functioning of the thyroid gland. Possible erased symptoms of a slight increase or decrease in the formation of hormones. During the study, there may be a slight increase in the size of the organ, seals are not detected.

Hypertrophic

With the development of goiter, there may be a uniform growth of tissues - a diffuse increase or nodes form against its background (diffuse-nodular form). Sometimes a node is found in unchanged tissue (). In the initial stage, there is an excessive synthesis of hormones (hyperthyroidism,), but in most patients the function does not change (euthyroidism) or decreases (hypothyroidism).

With the progression of autoimmune inflammation, the thyroid tissue is attacked by antibodies and killer lymphocytes, which leads to its destruction. During this period, the condition of patients worsens, and the production of hormones decreases, a hypothyroid state develops with a decrease in metabolic processes in the body.

atrophic

The most severe form, since the function of the organ is significantly reduced due to the massive destruction of thyroid cells. Its size decreases, and hypothyroidism becomes persistent. It is more common in older patients and with radiation exposure at a young age.

Stages of the disease

The disease goes through several stages in its development. They are not always present in the patient. Possible monophasic for a long period.

Euthyroid

The work of the thyroid gland is normal. This phase of autoimmune thyroiditis lasts several or decades, and can last a lifetime.

subclinical

It begins with an exacerbation due to a massive attack of T-lymphocytes. These cells intensively enter the thyroid gland and begin the destruction of its tissue. In response, the pituitary gland intensively produces thyroid-stimulating hormone (TSH) and thus stimulates the production of thyroxine, maintaining its normal level.

thyrotoxic

With extensive damage to cells, hormones from them enter the bloodstream. This is accompanied by symptoms of thyrotoxicosis (tachycardia, weight loss, sweating, hand tremors). Together with hormones, parts of the follicles also enter the circulatory network. They act as antigens and provoke the formation of antibodies to their own cells.

Hypothyroid

What is terrible autoimmune thyroiditis

In Russia, Ukraine and Belarus, Hashimoto's thyroiditis affects from 4 to 12% of the population, depending on the region. As it gets dirty environment its prevalence is increasing. Difficulty early detection disease is due to the fact that more than one year or even a decade passes from the moment of autoimmune damage to complications. Signs of the disease are detected with significant destruction of the gland, when the patient loses the ability to form hormones.

In addition to the clinical manifestations of hypothyroidism (weakness, impaired thermoregulation, drowsiness, low blood pressure), infertility can be its consequence. Moreover, it occurs not only with an explicit variant of the disease (manifest), but also with a hidden (subclinical) variant.

If, with severe manifestations, the patient cannot become pregnant due to ovulation disorders, then subclinical hypothyroidism is accompanied by habitual miscarriages. An overreaction of the immune system often explains infertility in endometriosis.

If, however, conception has occurred, then during gestation, hypothyroidism has an adverse effect on the expectant mother and child. This manifests itself in such complications:

• the threat of premature birth;
• preeclampsia ( high blood pressure, edema, convulsive syndrome);
• detachment of the placenta;
• slowdown in intrauterine development of the fetus;
• bleeding after childbirth;
• violations of the heart;
• anemia.

The newborn has pathologies of the nervous and skeletal systems, delayed heartbeat. The combination of autoimmune thyroiditis and thyroid cancer is not common, but possible.

Symptoms of pathology in adults and children

Most patients in the subclinical and euthyroid stages of the disease are unaware of the presence of thyroiditis. At this time, the thyroid gland retains its size, is not painful, the hormonal background is not disturbed. In some patients, nonspecific signs may appear that do not lead them to a doctor:

• discomfort in the neck
• sensation of a lump in the throat,
• fast fatiguability,
• general weakness,
• flying pains in the joints.

In the first years of the disease, autoimmune thyroiditis is usually manifested by hyperthyroidism. It is called hashitoxicosis. More often found in children in the form of:

• tendency to tearfulness, anxiety, agitation;
• increased irritability, aggressiveness;
• accelerated and increased heartbeat;
• increase in the upper pressure indicator (high systolic and pulse);
• sweating, poor heat tolerance;
• trembling of the eyelids, fingers;
• weight loss.

This stage is short and, unlike toxic goiter, does not lead to the appearance eye symptoms(bulging eyes, increased eye brilliance, enlargement palpebral fissure). In the future, the function of the thyroid gland weakens on average by 5% every year. The phase of relatively normal work lasts a long time, and only with the development of hypothyroidism can autoimmune thyroiditis be suspected.

In the hypertrophic form, signs of compression of neighboring tissues come to the fore. Patients have difficulty breathing, swallowing, hoarseness of voice, short-term bouts of dizziness or fainting. In the case of severe hypothyroidism, patients note:

• apathy, lethargy, drowsiness;
• constant chilliness;
• memory loss;
• swelling of the face, legs;
• sustained increase in body weight;
• hair loss, increased fragility of nails;
• dry skin;
• drop in blood pressure and slow heart rate.

Watch the video about autoimmune thyroiditis:

Analysis for hormones and other diagnostic methods

Before the onset of hypothyroidism, autoimmune thyroiditis is difficult to identify. To make a diagnosis, take into account:

• manifestations of the disease;
• laboratory and instrumental methods research;
• the presence of such pathologies in blood relatives.

When examining a patient, they find:

• general blood test - increased lymphocytes;
• blood immunology - antibodies to thyroglobulin, thyroperoxidase, thyroxine, triioditronine;
• blood hormones - with an increase in TSH, hypothyroidism is detected. If thyroxine is normal, then it is subclinical, and when it decreases, it is obvious;
• Ultrasound - sizes are reduced or increased depending on the shape, echogenicity is reduced;

In order to confirm chronic autoimmune Hashimoto's thyroiditis, the most important features must be simultaneously present: antibodies to thyroid peroxidase greater than 34 IU/L, hypoechogenicity on ultrasound, and symptoms of hypothyroidism. None of these criteria alone provides grounds for an affirmative diagnosis.

Treatment of acute and chronic forms

There is no specific therapy for the disease that would prevent its further progression. Despite the understanding of the causes and mechanisms of development of autoimmune thyroiditis, its treatment is reduced only to compensation for disorders in the formation of hormones.

Thyreostatics (Mercazolil, Espa-carb) are not used for hashitoxicosis, since hyperthyroidism is associated with the destruction of the thyroid gland, and not with increased thyroxine synthesis. With palpitations, tachycardia, increased pressure, hand trembling and sweating, the beta-blocker Anaprilin is indicated.

Taking into account the survey data, hormone intake can be started already at the subclinical stage and during the period of euthyroidism at a minimum dose. Such therapy inhibits the formation of TSH and the progression of autoimmune destruction. To reduce the antibody titer, selenium (Cefasel) is added to the treatment for three months.

Glucocorticoids (Prednisolone, Dexamethasone) are used during exacerbation of inflammation, which most often occurs against the background of viral or bacterial infections in the autumn-winter period. With a mild inflammatory process, nonsteroidal drugs (Voltaren, Indomethacin) are used. If the goiter reaches a large size, then patients undergo an operation to remove the gland.

Prognosis for patients

With timely detection of the disease, it is possible to compensate for thyroid dysfunction and achieve satisfactory well-being of patients. Despite the fact that antibodies continue to be produced throughout life, in many cases it is possible to reduce their number and prevent massive destruction of cells.

It is possible to maintain good performance for 10-15 years, subject to constant monitoring of the state of hormone production.

In women, if antibodies to thyroid peroxidase are detected during pregnancy, hypothyroidism may develop, and postpartum autoimmune thyroiditis may relapse in the future. In every third patient, this process leads to a persistent low activity of the thyroid gland, requiring the use of levothyroxine.

Autoimmune thyroiditis occurs with a hereditary predisposition. When the immune system malfunctions, antibodies to thyroid cells are formed in the body. They gradually destroy the follicles, leading over time to hypothyroidism.

Clinical manifestations may be absent until a persistent decrease in organ function. Diagnosis requires the presence of antibodies in the blood, ultrasound signs and symptoms of thyroid hormone deficiency. For treatment, symptomatic and substitution therapy is used.