Hashimoto's thyroiditis (hypothyroidism)
Hashimoto's thyroiditis or Hashimoto's disease (also known as chronic lymphocytic thyroiditis) is an autoimmune disease affecting thyroid function, where the body's immune system creates antibodies that attack and inflame the thyroid.
Hashimoto's thyroiditis is the most common cause of hypothyroidism (or underactive thyroid or low thyroid) in the United States. Hypothyroidism is an endocrine disorder in which the thyroid gland does not produce enough thyroid hormone called T4 (thyroxine), which is used to help the body use energy as well help maintain function of the brain, heart, muscle, and other organs.
Signs and symptoms[edit | edit source]
Symptoms of an underactive thyroid (hypothyroidism) due to Hashimoto's include:
- Weight gain
- Hair loss (or thinning)
- Sensitivity to cold
- Joint pain and muscle pain
- Excessive or prolonged menstrual bleeding
Causes[edit | edit source]
There are many risk factors and potential causes for thyroid disease. Hashimoto's is the number one cause of hypothyroidism in the United States.
Causes of hypothyroidism include:
- Hashimoto's thyroiditis, which is an acquired form of thyroiditis
- Congenital hypothyroidism, which is when a person is born with hypothyroidism
- Thyroid surgery that removes all or part of the thyroid
- Past radiation treatment of the thyroid
- Other causes include certain medicines, too much or too little iodine in the diet, or pituitary disease (which is another endocrine disease).
Hashimoto's thyroiditis[edit | edit source]
The exact cause of Hashimoto's thyroiditis is unknown. Many researchers and physicians believe genetics and/or a virus could play a role in the development of this autoimmune disease.
Cellular hypothyroidism[edit | edit source]
Some patients may exhibit Hashimoto's hypothyroid symptoms, yet display normal ranges in their thyroid blood tests. This could be an indication of “cellular or peripheral hypothyroidism”, where there's a deficiency at the cellular level. While thyroid hormone production may be functioning properly, the transportation of thyroid hormone into cells will be hindered if there is mitochondrial dysfunction.
Viral triggers[edit | edit source]
Viruses are common triggers of Hashimoto's thyroiditis, and hypothyroidism. Epstein-Barr virus (EBV) and Human Herpesvirus 6 (HHV-6) are perhaps two of the most common viral triggers for Hashimoto. Others include Herpes Simplex 1 and 2 (HSV), Cytomegalovirus (CMV), Enterovirus, and Parvovirus B19.
ME/CFS[edit | edit source]
A 2001 Swedish study of 219 chronic fatigue patients (90% women), used fine-needle aspiration (FNA) cytology to test thyroid function. 87 of 219 (40%) were diagnosed with cytological lymphocytic thyroiditis.
[edit | edit source]
Studies suggesting a viral trigger for Hashimoto's thyroiditis and autoimmune thyroiditis (AIT) that are also viruses commonly associated with ME/CFS.
|Epstein-Barr virus serology in patients with autoimmune thyroiditis
J Vrbikova, I Janatkova, V Zamrazil, F Tomiska, T Fucikova
|1996||Endocrinology study shows significantly higher presence of active Epstein-Barr virus (EBV) in those with autoimmune thyroiditis compared to healthy controls.
7 of 22 (32%) patients were positive for EBV early antigen (EA-D) antibodies, versus 2 of 35 (6%) controls.
|Virologic and Immunologic Evidence Supporting an Association between HHV-6 and Hashimoto's Thyroiditis
Elisabetta Caselli, Maria Chiara Zatelli, Roberta Rizzo, Sabrina Benedetti, Debora Martorelli, Giorgio Trasforini, Enzo Cassai, Ettore C. degli Uberti, Dario Di Luca, Riccardo Dolcetti
|2012||Study using fine needle aspirates (FNA) thyroid biopsies found HHV-6 DNA in 28 of 34 (82%) Hashimoto's thyroiditis patients and 3 of 28 (10%) controls.|
|Inflammation and Increased Myxovirus Resistance Protein A Expression in Thyroid Tissue in the Early Stages of Hashimoto's Thyroiditis
Sara Salehi Hammerstad, Frode Lars Jahnsen, Sisko Tauriainen, Heikki Hyöty, Trond Paulsen, Ingrid Norheim, and Knut Dahl-Jørgensen
|2013||Study found Enterovirus RNA in 11% of Hashimoto's thyroiditis (HT) patients, versus 0% of controls.|
|The role of Epstein-Barr virus infection in the development of autoimmune thyroid diseases
Andrea Janegova, Pavol Janega, Boris Rychly, Kristina Kuracinova, Pavel Babal
|2015||Graves' and Hashimoto's disease specimens were used in this study, finding a high prevalence of EBV infection. "We assume that high prevalence of EBV infection in cases of Hashimoto's and Graves' diseases imply a potential aetiological role of EBV in autoimmune thyroiditis"|
|Association of active human herpesvirus-6 (HHV-6) infection with autoimmune thyroid gland diseases||2017||A study comparing the involvement of HHV-6 infection between autoimmune thyroiditis (AIT) patients and healthy controls. Thyroid gland biopsies confirmed active persistent HHV-6 infection in 18 of 44 (41%) AIT patients and 1 of 17 (6%) healthy controls.|
|Human herpesvirus 6A active infection in patients with autoimmune Hashimoto's thyroiditis
Noorossadat Seyyedi, Gholamreza Rafiei Dehbidi, Mozhgan Karimi, Amir Asgari, Babak Esmaeili, Farahnaz Zare, Ali Farhadi, Mohammad Hossein Dabbaghmanesh, Forough Saki, Abbas Behzad-Behbahani
|2019||In this study, 38% of patients with Hashimoto’s disease had active HHV-6A infections.|
|Study of Epstein–Barr virus serological profile in Egyptian patients with Hashimoto’s thyroiditis: A case-control study
Samir Naeim Assaad, Marwa Ahmed Meheissen, Eman Tayae Elsayed, Saher N. Alnakhal, Tarek M. Salema
|2020||This study included 60 Hashimoto's thyroiditis patients and 60 healthy controls. Epstein-Barr virus (EBV) Early Antigen (EA) was positive in 20 of 60 (33%) HT patients and 4 of 60 (7%) healthy controls, indicating a higher prevalence of active EBV in Hashimoto patients.|
|HHV-6 Infection and Chemokine RANTES Signaling Pathway Disturbance in Patients with Autoimmune Thyroiditis
Alina Sultanova, Maksims Cistjakovs, Liba Sokolovska, Katerina Todorova, Egils Cunskis, Modra Murovska
|2020||Markers of active HHV-6 infection were predominantly found in patients with autoimmune thyroiditis (AIT). 56% of AIT patients (vs. 6% controls) were found to have active HHV-6 infection in thyroid gland tissue.|
Sleep apnea[edit | edit source]
Hashimoto's thyroiditis (HT) and sleep apnea can both result in extreme fatigue. New evidence suggests a connection between Hashimoto's and obstructive sleep apnea (OSA). In fact, the association could be bi-directional, where either condition could potentially develop as a consequence of the other.
HLA risk alleles[edit | edit source]
Variations in several human leukocyte antigen (HLA) complex family of genes have been studied as possible risk factors for Hashimoto thyroiditis. Associations have been found between Hashimoto's disease and the following HLA alleles:
ME/CFS and Hashimoto's genetics[edit | edit source]
- Hashimoto's thyroiditis
- Rheumatoid arthritis
- Alopecia areata
- Crohn’s disease or ulcerative colitis
Diagnosis[edit | edit source]
Hashimoto's thyroiditis is usually diagnosed based on multiple examinations, often beginning with hypothyroid symptom evaluation. This can be accompanied by blood tests and ultrasound.
Blood tests indicating Hashimoto's disease include elevated levels of thyroperoxidase antibodies (TPO), and elevated levels of thyroid stimulating hormone (TSH). Other lab testing can include Thyroglobulin antibodies (Tg), Free thyroxine (T4), or Free triiodothyronine (T3).
This might be followed by an ultrasound to confirm an enlarged thyroid gland, and other features of Hashimoto's thyroiditis.
Treatments[edit | edit source]
Hormone Replacement[edit | edit source]
Levothyroxine - If you are found to have a thyroid hormone deficiency, resulting in elevated TSH levels, your doctor might prescribe hormone replacement therapy. Levothyroxine is a synthetic thyroid hormone used to normalize TSH and hormone levels, leading to hypothyroid symptom improvement.
Target Infection[edit | edit source]
Antivirals - If your Hashimoto's was triggered by a bacterial or viral infection, then suppressing the infection using antiviral treatment might improve symptoms.
Supplementation[edit | edit source]
Selenium - Selenium has been shown to decrease thyroperoxidase (TPO) antibody levels and improve overall symptoms associated with Hashimoto's Thyroiditis. A 2017 study demonstrated that the combination of Selenium and Myo-inositol had an even greater effect.
Supplements most commonly used to treat Epstein-Barr Virus (EBV) triggered Hashimoto's include:
- Olive leaf extract
- Licorice root (glycyrrhizic acid)
- St. John’s wort
- Vitamin C
- Vitamin D
Immunomodulator[edit | edit source]
Low-dose naltrexone (LDN) - LDN is an immunomodulating medication that many claim has improved their Hashimoto's symptoms. However, there is a lack of scientific studies to back up this claim.
See also[edit | edit source]
- Autoimmune disease
- Female predominant diseases
- Thyroid disease
- Thyroid gland
Learn more[edit | edit source]
- Hashimoto's - Thyroid UK
References[edit | edit source]
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