Hashimoto’s Thyroiditis (Lymphocytic Thyroiditis) 101: What you need to know.
1.The term “Thyroiditis” refers to “inflammation of the thyroid gland”.
2.Hashimoto’s thyroiditis CHT, also known as chronic lymphocytic thyroiditis, is the most common cause of hypothyroidism in the United States. Many patients do not know they have it because the physician tells them only that they are hypothyroidism.
3. If you are hypothyroid and did not have surgery or radiation treatment to the neck you have CHT.
4. It is an autoimmune disorder in which antibodies directed against the thyroid gland lead to chronic inflammation.
5. This condition tends to run in families. First degree relatives are at risk and need thyroid evaluation after age 7.
6. A firm bumpy surface of the thyroid, borderline high TSH, and positive antibodies make the diagnosis.
7.Impaired ability of the thyroid gland to produce thyroid hormone, leading to gradual decline in function and eventually an underactive thyroid (hypothyroidism) may take years, meanwhile if not treated early goiter nodules and cancer can occur.
8. Hashimoto’s thyroiditis occurs most commonly in middle aged women, but can be seen at any age, and can also affect men, and children down to age 7.
9. There are no signs or symptoms that are unique to Hashimoto’s thyroiditis as it smolders subclinically for years growing nodules and cancer before the patient becomes clinical sick with hypothyroidism.
10.Because the condition usually progresses very slowly over many years, people with Hashimoto’s thyroiditis may not have any symptoms early
11.Late onset hypothyroid symptoms may include fatigue, weight gain, constipation, increased sensitivity to cold, dry skin, depression, muscle aches and reduced exercise tolerance, and irregular or heavy menses.
12.The disease may be diagnosed early on, especially in people with a strong family history of thyroid disease.
13.Case finding in families even before the patient develops symptoms of hypothyroidism can detect subclinical CHT with already formed nodules and even cancer down to 7 years old.
14. Isolated mild elevation of serum TSH is seen, with normal levels of thyroid hormones and positive TPO antibodies firm goiter and ultrasound evidence of goiter formation and nodules and even cancer.
15. Patients with borderline TSH, elevated TPO antibodies, firm early goiter, abnormal ultrasound with or without nodules require early treatment with thyroid hormone.
16. Treatment prevent further goiter growth nodule formation and stimulation by TSH of cancer growth.
17. Thyroid cancer is more common in TSH driven CHT without thyroid hormone therapy.
18.Youngest child age 7 untreated for 4 years after CHT diagnosed until patient was hypothyroid and had papillary thyroid cancer.
19. Most patients with Hashimoto’s thyroiditis will require lifelong treatment with levothyroxine.
21. Many generics have different components than Synthroid with different amounts released in the blood with the same pill size.
22. Switching from one generic to another is not recommended.
23. The appropriate dose, particularly at the beginning may require testing with TSH every 6-8 weeks.
24. Synthroid needs to be taken on an empty stomach one hour before food or pills.
25. A once a week system to check that you took all the weeks pills will decrease the error rate from 20 to 3% over daily dose checking only.
Call 310-393-8860 for first degree family testing for CHT.