The symptoms of Hashimoto’s disease. What should be of concern?

Hashimoto’s disease is a chronic inflammatory disease of the thyroid gland that can cause a variety of symptoms such as fatigue, cold, dry, and flaky skin, reduced libido, and erection problems. Symptoms usually result from changes in the gland and increasing hypofunction.

Hakaru Hashimoto’s disease is a chronic lymphocytic thyroiditis, which is part of the group of autoimmune diseases, including autoimmune diseases. The immune system recognizes thyroid proteins as hostile and begins to destroy them, impairing the activity of the enzyme responsible for the synthesis of thyroid hormones.

The thyroid is an important organ that produces and stores hormones, which are necessary for the development of the nervous system, sexual maturation, metabolism, bone growth, regulation of body temperature, and the metabolism of proteins, carbohydrates, and fats. Antibodies that cause Hashimoto’s disease destroy the thyroid gland and prevent the production of hormones, which results in chronic inflammation and hypothyroidism. It affects 1–6% of adults and children, mostly women, up to 10 times more often than men.

Symptoms of Hashimoto’s disease

Hashimoto’s disease can be hidden or worsen slowly, but in people with hyperthyroidism, it progresses more rapidly. The main symptoms are hypothyroidism and hormone deficiency.

  • tiredness and drowsiness,
  • feeling cold all the time
  • mood swings,
  • problems with concentration and memory,
  • depression,
  • dry skin, brittle nails, hair,
  • constipation or diarrhoea, 
  • gaining weight (to check your correct weight,  use the BMI calculator ),
  • weight gain,
  • menstrual disorders,
  • decreased libido,
  • erection problems,
  • sterility,
  • low blood pressure
  • slowing down the heart rate.

Hashimoto’s disease is usually asymptomatic, but with the decrease in thyroxine and triiodothyronine levels, the symptoms become more and more troublesome.

If you notice any changes in the neck region, such as an increase in its circumference, a palpable lump, or pain, you should always see a doctor. Weight gain despite following a calorie-reduction plan, persistent fatigue, feeling chilly, flaky skin, and menstrual disorders are additional symptoms that need to be taken seriously.

Hashimoto’s disease can cause serious health problems, such as heart disease, infertility, and neurological complications, but it is usually detected only through thyroid hormone tests.

Unusual symptoms of Hashimoto’s disease

Hashimoto’s disease can manifest itself with unusual symptoms, the sources of which patients often look for long and unsuccessfully. This, for example:

  • muscle pains,
  • muscle cramps,
  • muscle weakness,
  • skin tingling,
  • aggressive behavior,
  • psychiatric symptoms: dementia, psychoses,
  • delayed puberty in children,
  • growth arrest. 

In such cases, it is worth checking your thyroid hormone levels, although it is not the first thing we would think of with the above symptoms. 

A localized form of Hashimoto’s disease

Hashimoto’s disease can manifest in terms of changes in the size of the thyroid gland, with hyperthyroidism with gland enlargement and difficulty swallowing, a feeling of pressure in the neck, coughing or shortness of breath. When the gland becomes hard, cohesive, uneven, but not painful to the touch, the destroyed thyroid disappears, as evidenced by the ultrasound examination. Thyroid nodules may also appear.

Blood tests for Hashimoto’s disease reveal its symptoms

The symptoms of Hashimoto’s disease are also abnormal laboratory test results. The blood test may show:

  • elevated TSH (but decreased TSH in hyperthyroidism),
  • decreased or normal levels of thyroid hormones FT3 and FT4,
  • high anti-TPO  and/or elevated anti-Tg,
  • high cholesterol,
  • anemia ,
  • increased blood glucose level,
  • increased activity of aspartate aminotransferase,
  • low sodium or high calcium levels.

Fortunately, usually, in the course of Hashimoto’s disease, no additional abnormalities are observed. There are primarily changes in the concentration of thyroid hormones and antibodies.

Causes of Hashimoto’s disease

The causes of Hashimoto’s disease, like those of other autoimmune disorders, are unknown. Since the disease’s description in 1920, the body of knowledge regarding its etiology has remained static. Hashimoto’s disease has been linked to the following risk factors:

  • someone else had it in the family,
  • the patient has another autoimmune disease, e.g. rheumatoid arthritis ,
  • there is a weakened immunity, especially during stressful periods,
  • severe infections have occurred,
  • occurs in women after childbirth.

Diagnosis of Hashimoto’s disease (tests)

Consult an endocrinologist if you think you might have a thyroid issue. Depending on the results of the tests, the specialist will decide if Hashimoto’s disease is present. Standard thyroid exams include:

  • TSH designation (check: TSH norms ),
  • marking FT3 and FT4,
  • thyroid ultrasound ,
  • antithyroid antibodies.

Thyrotropic hormone (TSH) is secreted by the pituitary gland and its concentration rises when the thyroid gland produces too little hormone. In Hashimoto’s disease, TSH levels are elevated and FT3 and FT4 are below normal. Antithyroid antibodies (anti-TPO) should also be tested. An ultrasound will show the size of the gland, changes in its structure, post-inflammatory thyroid nodules or adhesions. If the results are inconclusive, the doctor will refer the patient for additional tests and recommend a fine needle biopsy. Depending on the degree of thyroid damage, he will recommend appropriate treatment.



4th Professional Medical Student. Karachi Medical and Dental College.

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