Autoimmune thyroiditis( Hashimoto's thyroiditis, Hashimoto's disease, Hoshimoto's goiter) is one of the most common autoimmune inflammatory lesions of the thyroid gland. According to medical statistics, this pathology is found in half of women aged 30 to 50 years, in men, she is diagnosed ten times less often. The first autoimmune thyroiditis was described by the Japanese surgeon Hashimoto in 1912.
- 1 Causes of autoimmune thyroiditis
- 2 Symptoms of autoimmune thyroiditis
- 3 Diagnosis of autoimmune thyroiditis
- 4 Treatment of autoimmune thyroiditis
- 5 Nutrition for autoimmune thyroiditis
Causes of autoimmune thyroiditis
Factors provoking autoimmune thyroiditis have not been established. Meanwhile, there are reports that the disease is caused by a specific defect in the immunological defense of the body, in which autoantibodies to the tissue of the thyroid system appear in the serum of the patient's blood.
Self-reactive T-lymphocytes appear in the patient's body, their activity in the usual state is easily suppressed by the suppressor system. With autoimmune thyroiditis, self-reactive T-lymphocytes begin to interact freely with complementary thyroid cell antigens and cause a local cell-mediated immune response. Under the influence of T-lymphocytes, B-lymphocytes are transformed into plasma cells and form polyclonal autoantibodies to the thyroid gland. Thyroid cells, damaged or lost as a result of the autoimmune process, can no longer perform their functions fully. As a result, the disease is complicated by hypothyroidism - a prolonged, persistent lack of hormones.
It is suggested that the triggering mechanism in the development of autoimmune thyroiditis may be:
- suffered acute respiratory viral diseases;
- available in the body of chronic foci of infection;
- excess chlorine, iodine and fluoride compounds in water, food and in the environment;
- bad ecology;
- long-term, uncontrolled intake of hormonal or iodine-containing drugs;
- long exposure to the sun;
- radiation radiation;
- stress, psycho-traumatic factors( loss of work, death of a loved one, etc.).
Symptoms of autoimmune thyroiditis
In most cases, autoimmune thyroiditis with a preserved thyroid function is asymptomatic. Occasionally, patients complain of discomfort in the neck when wearing high collars, neck scarves and scarves. With hypothyroidism, the clinical picture of the disease becomes more pronounced. The main symptoms of complicated autoimmune thyroiditis are:
- a change in the appearance of the patient( pronounced pallor and puffiness of the face, appearance of spots of painful blush on the cheekbones and tip of the nose, hair loss);
- edema of the tongue;
- speech intelligibility;
- slowness of movements;
- shortness of breath;
- permanent fatigue, poor performance, memory impairment;
- lack of independent stool;
- menstrual cycle disorder;
- permanent dry mouth.
A clinical examination of the patient reveals a noticeable increase in the thyroid gland or, on the contrary, its hypoplasia. In any case, the iron acquires uneven contours, on its surface there are knolls and knots.
Diagnosis of autoimmune thyroiditis
Before the appearance of the first signs of hypothyroidism, it is extremely difficult to diagnose autoimmune thyroiditis. As a rule, the diagnosis is established according to the characteristic clinical picture and on the basis of the data obtained as a result of the following laboratory tests:
- a general blood test( an increase in the number of lymphocytes);
- immunogram( antibodies to thyroglobulin, a second colloid antigen, thyroid peroxidase and thyroid hormones of the thyroid gland are found);
- ultrasound of the thyroid gland( ascertaining the increase or decrease in the thyroid gland in volumes, the change in its structure);
- thyroid biopsy( an increased number of lymphocytes and other cells characteristic of autoimmune thyroiditis).
The main criteria for diagnosing autoimmune thyroiditis are:
- increasing the level of antibodies to the thyroid gland;
- signs of development of hypothyroidism;
- revealing hypoechoic thyroid gland during ultrasound.
In the absence of at least one of the above criteria, the diagnosis can only be of a probabilistic character.
Treatment of autoimmune thyroiditis
Special therapy for Hashimoto's disease has not been developed so far. Despite all the modern advances in the field of medicine, endocrinology has not yet revealed safe and effective methods for correcting the pathology of the thyroid gland, which would not allow the disease to progress to hypothyroidism.
In the thyrotoxic phase of autoimmune thyroiditis, physicians abstain from the appointment of thyreostatics - drugs that suppress the function of the thyroid gland. With clearly expressed symptoms of cardiac failure, beta-blockers are used.
With the appearance of signs of hypothyroidism, substitution therapy with thyroid hormones of the thyroid hormones is carried out. Treatment is carried out under strict medical control of the clinical picture and the level of T-lymphocytes in the blood serum.
In case of complication of autoimmune thyroiditis subacute thyroiditis shows glucocorticoids( prednisolone).Simultaneously, non-steroidal anti-inflammatory drugs are used to reduce the titer of autoantibodies: methindole, indomethacin, voltaren.
In addition, patients are prescribed drugs for correction of immunity, adaptogens and vitamins. At a hypertrophy of a thyroid gland and appreciable squeezing it of organs of a mediastinum spend surgical treatment.
Nutrition for autoimmune thyroiditis
Eating a patient with autoimmune thyroiditis should be enriched with proteins, fiber and vitamins. The patient is recommended to include in the diet cereals, vegetables, cottage cheese, greens, sour-milk products, fruits, meat and fish. When compiling a diet menu, special attention is paid to walnuts, seafood, feijoa and persimmon.