(Hashimoto's Thyroiditis; Underactive Thyroid)En Español (Spanish Version)More InDepth Information on This Condition
Hypothyroidism happens when the thyroid gland does not produce enough thyroid hormone. The thyroid gland is a butterfly-shaped gland in the front of the neck. It produces hormones that control metabolism. The most common form is Hashimoto's thyroiditis.
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Hashimoto's thyroiditis occurs when:
- Immune system produces antibodies that attack cells of the thyroid gland, causing chronic thyroid swelling and loss of function
- Idiopathic thyroid atrophy—destruction of thyroid tissue for unknown reasons
- Iodine deficiency—when a thyroid gland needs iodine to produce thyroid hormone (rare in the US)
- Subacute thyroiditis—following a viral upper respiratory tract infection
- Medical treatments— radiation to the head and neck or surgical removal of part of the thyroid gland (called subtotal thyroidectomy )
- Medications (eg, lithium , iodine, alpha-interferons, thiourea, amiodarone , interleukins)
- Certain diseases (eg, cancer or infection)
- Pituitary adenoma —benign tumor of the pituitary gland
These factors increase your chance of developing hypothyroidism:
Risk factors include:
- Age: risk increases with age, especially over 65 years old
- Sex: more common in females
- Genetics: multiglandular autoimmune syndrome
- Ethnicity: Caucasian, Hispanic
- History of family members with hypothyroidism
- History of other autoimmune diseases:
Tell your doctor if you have any of these risk factors.
Years may pass before you notice symptoms.
- Coarse, brittle hair; hair loss
- Facial puffiness
- Dry skin
- Swollen hands or feet
- Cold intolerance
- Weight gain
- Achy feeling all over
- Depression and irritability
- Memory loss
- Difficulty with concentration
- Blurred vision
- Menstrual abnormalities or infertility
Symptoms of severe or prolonged cases include:
The doctor will ask about your symptoms and medical and family history, and perform a physical exam. To confirm the diagnosis, blood tests will be done, which include:
- Thyroid stimulating hormone (TSH)
- Free T4 and free T3
- Antibodies that attack the thyroid gland
In the early stages of Hashimoto's thyroiditis, there is no specific treatment. But, in most cases, you will end up developing hypothyroidism. Treatment includes:
The American Thyroid Association
Canadian Institute for Health
Thyroid Foundation of Canada
American Association of Clinical Endocrinologists. AACE medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocrine Practice . 2002;8:457-469.
Braunwald E. Harrison's Principles of Internal Medicine. 15th ed. New York, NY: McGraw Hill; 2001.
Escobar-Morreale HF, Botella-Carretero JI, Escobar del Rey F, et al. Treatment of hypothyroidism with combinations of levothyroxine plus liothyronine. J Clin Endocrinol Metab . 2005;90:4946-4954.
Hypothyroidism. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 2008. Accessed July 7, 2008
Roberts CG, Ladenson PW. Hypothyroidism. Lancet . 2004;363:793-803.
Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management JAMA . 2004;291:228-238.
Last reviewed March 2008 by David Juan, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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