What Are The Symptoms And Complications Of Hashimotos Thyroiditis
Signs and symptoms of Hashimotos disease can vary greatly from person to person and they are often similar to those of other conditions. Because HT progresses slowly over the years, many people do not notice signs or symptoms of the disease until the later stages. Symptoms of Hashimotos disease may include:
- Trouble swallowing or breathing
One of the most serious complications associated with Hashimotos thyroiditis is a rare, but life-threatening condition known as myxedema. The condition can develop as a result of long-term, severe untreated hypothyroidism. Signs and symptoms of myxedema include drowsiness, intense lethargy, and unconsciousness.
According to researchers at Mayo Clinic, exposure to cold, sedatives, infection, or other stress on the body can trigger a myxedema coma in people living with HT. Myxedema requires immediate medical attention. This is yet another reason why it is so important for people living with this conditions to wear a MedicAlert medical ID for Hashimotos thyroiditis.
Recovery From Another Illness
If you’ve recently been hospitalized due to a serious or chronic illness that’s not related to your thyroid, it’s possible that your TSH level is just temporarily elevated due to the illness.
Examples of these non-thyroidal illnesses include:
- Gastrointestinal diseases such as gastroesophageal reflux disease , peptic ulcer disease, and Crohn’s disease
- Pulmonary diseases like chronic obstructive pulmonary disease , lung cancer, and chronic bronchitis
- Cardiovascular diseases such as heart failure, coronary heart disease, and peripheral arterial disease
- Inflammatory diseases like rheumatoid arthritis, multiple sclerosis , and systemic lupus erythematosus
- Bone marrow transplantation
If your healthcare provider thinks your elevated TSH level may be due to recovery from a non-thyroidal illness, here’s what the plan may look like:
In all cases, you’ll likely have your TSH and free T4 levels tested again in four to six weeks after you’ve completely recovered from the illness.
What Do The Results Mean
Your results may show one of the following:
- Negative: no thyroid antibodies were found. This means your thyroid symptoms are probably not caused by an autoimmune disease.
- Positive: antibodies to TPO and/or Tg were found. This may mean you have Hashimoto disease. Most people with Hashimoto disease have high levels of one or both of these types of antibodies.
- Positive: antibodies to TPO and/or TSH receptor were found. This may mean you have Grave’s disease.
The more thyroid antibodies you have, the more likely it is that you have an autoimmune disorder of the thyroid. If you are diagnosed with Hashimoto disease or Grave’s disease, there are medicines you can take to manage your condition.
Learn more about laboratory tests, reference ranges, and understanding results.
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What Exactly Is Hashimotos Thyroiditis
An estimated 20 million Americans have some form of thyroid disease. This includes more than 14 million cases of Hashimotos thyroiditis. Also known as Hashimotos disease, chronic lymphocytic thyroiditis, and chronic autoimmune thyroiditis, Hashimotos is an autoimmune disorder that affects a persons thyroid, which is the small, butterfly-shaped gland in the front of the neck. When a person has an autoimmune disorder, their immune system misidentifies healthy cells as foreign invaders. When this happens, the immune system attacks and destroys these healthy cells, causing a host of symptoms.
In Hashimotos thyroiditis, immune-system cells lead to the death of hormone-producing cells in the bodys thyroid gland. The disease usually results in a decline in hormone production known as hypothyroidism. Thyroid hormones are responsible for controlling how the body uses energy, so they affect nearly every organ in your bodyincluding your heart.
Why Almost Only Women Suffer From Hashimotos
The disease affects seven times as many women as men. This most likely has hormonal causes, but the exact connection is currently unknown.
There is another very rare variant of the disease, Hashimotos encephalopathy, which attacks the brain. There, however, they have not yet been able to show that the disease is related to the thyroid gland. In this case too, the anti-TPO is elevated, it has a special histological picture,and this encephalitis responds very well to steroids.
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What Blood Tests Are Done To Test The Thyroid
Thyroid blood tests include:
These tests alone arent meant to diagnose any illness but may prompt your healthcare provider to do additional testing to evaluate for a possible thyroid disorder.
Additional blood tests might include:
- Thyroid antibodies: These tests help identify different types of autoimmune thyroid conditions. Common thyroid antibody tests include microsomal antibodies , thyroglobulin antibodies , and thyroid receptor antibodies .
- Calcitonin: This test is used to diagnose C-cell hyperplasia and medullary thyroid cancer, both of which are rare thyroid disorders.
- Thyroglobulin: This test is used to diagnose thyroiditis and to monitor treatment of thyroid cancer.
What Are The Symptoms Of Hashimotos Disease
Many people with Hashimotos disease have no symptoms at first. As the disease progresses, you may have one or more of the symptoms of hypothyroidism.
Some common symptoms of hypothyroidism include
- dry skin or dry, thinning hair
- heavy or irregular menstrual periods or fertility problems
- slowed heart rate
Hashimotos disease causes your thyroid to become damaged. Most people with Hashimotos disease develop hypothyroidism. Rarely, early in the course of the disease, thyroid damage may lead to the release of too much thyroid hormone into your blood, causing symptoms of hyperthyroidism.3
Your thyroid may get larger and cause the front of the neck to look swollen. The enlarged thyroid, called a goiter, may create a feeling of fullness in your throat, though it is usually not painful. After many years, or even decades, damage to the thyroid may cause the gland to shrink and the goiter to disappear.
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What To Engrave On Medicalert Medical Ids For Hashimotos Thyroiditis:
MedicAlert offers free custom engraving on all our Hashimotos thyroiditis bracelets and other medical ID products. The engraving on medical IDs for Hashimotos thyroiditis should include any critical medical information that can protect and save lives in case of an accident or a medical emergency, for example:
- Hashimotos thyroiditis
- Designated physician and emergency contact information
- Any additional medical information that needs to be communicated to first responders
Sample engraving. Consult our team if you need help engraving your medical ID for Hashimotos thyroiditis.
What Is Hashimoto’s Thyroiditis
Thyroiditis is when your thyroid gland becomes irritated. Hashimoto’s thyroiditis is the most common type of this health problem. It is an autoimmune disease. It occurs when your body makes antibodies that attack the cells in your thyroid. The thyroid then can’t make enough of the thyroid hormone. Many people with this problem have an underactive thyroid gland. That’s also known as hypothyroidism. They have to take medicine to keep their thyroid hormone levels normal.
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Lab Testing In Mainstream Medicine
If your doctor or healthcare practitioner suspects your symptoms are related to your thyroid, they will often start with ordering a TSH test. Sometimes, they may also order a free T4, but many medical organizations advise only to do this if the TSH is out of the labs reference range.
Although the above is great for SCREENING and overt DIAGNOSIS of hypo- or hyperthyroidism, it is not great at looking at patterns that indicate biological dysfunction, and it will not diagnose Hashimotos. There are some limitations with the above approach, if looking for Hashimotos or even subclinical hypothyroidism.
- It is a limited test panel.
- A labs reference range is not the best range to go off of
- There is no evaluation of lifestyle habits
- There is no imaging testing
- Antibodies are not evaluated.
Quick tangent, on cost for labs. Having worked in both mainstream medicine and functional medicine, I have learned that there are a lot of tests that would be great to run on everyone, but insurance is picky on what they will or will not cover. What they dont cover, the patient has to pay . This is part of the reason that many mainstream practitioners will not run more tests, since they are contracted with insurance companies and insurance will break a contract if the practitioner goes against insurance rules. And although most of my functional medicine colleagues rely on testing, we really dont have to do so much excessive testing .
Does Hashimoto’s Encephalopathy Respond To Natural Treatment
If left untreated, Hashimoto’s encephalopathy can cause permanent brain damage and lasting harm. Although some medical conditions appear to respond to plant-based supplements or alternative therapies like acupuncture or biofeedback, there are currently no reports of patients minimizing symptoms or preventing relapse using “natural” alternatives. Patients should not discontinue treatment without consulting their physicians.
However, nutritional deficiencies, too little sleep, emotional stress, overexertion, and even hormonal fluctuations can trigger symptoms in many people living with autoimmune disorders.
Current evidence suggests that many people diagnosed with thyroid disease and endocrine system disorders are deficient in several essential vitamins and minerals, including vitamin D and selenium. For questions or concerns about nutrition, trouble sleeping, stress management, or the possibility of a vitamin deficiency, consult your healthcare provider.
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What Type Of Doctor Diagnoses And Treats Hashimoto’s Encephalopathy
Since Hashimotos encephalopathy can cause a wide range of symptoms involving the central nervous system, neurologists are typically well-equipped to diagnose the disorder and oversee treatment. But waiting for an appointment with a neurologist isn’t your only option. Many physicians work in collaboration with several doctors dedicated to other specialties.
Other specialists who could have experience diagnosing or treating this rare condition include rheumatologists, immunologists, neuropsychiatrists, family physicians, and pediatricians.
Hashimoto’s Vs Graves’ Disease
There are actually two autoimmune thyroid diseases that can show elevated TPO antibodies: Hashimoto’s and Graves’ disease. So whatâs the difference?
While Hashimoto’s causes hypothyroidism or an underactive thyroid gland, Graves’ disease causes hyperthyroidism, or an overactive thyroid gland. Some common Gravesâ symptoms are nearly opposite to Hashimotoâs, and include weight loss, frequent bowel movements, goiter and heat sensitivity.â·
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Hashimotos Disease And Blood Tests
It frequently happens that Hashimotos disease is missed because of undue reliance on blood tests. Usually, the T4 is low, although it may not be out of range. So too, maybe the T3. This will suggest poor thyroid hormone output. While in the normal course of events the TSH normally rises in this situation, it may actually be normal, or even low.
The reason for this is a down-grading of the hypothalamic/pituitary Pituitary “of or relating to the pituitary gland” axis due to the state of hypo-metabolism Metabolism “the chemical processes within the human body” that the low thyroid function induces.
The hypothalamus responds poorly to the low thyroid blood levels, and may not produce a normal level of Thyrotrophin Releasing Hormone . In addition, the pituitary, also affected adversely by the state of hypo-metabolism, may not properly respond to the TRH, and not, therefore, produce a normal level of TSH.
The thyroid itself, being damaged by the white cell infiltration and with damaged TSH receptors Receptors “a specialised cell or group of nerve endings that responds to things such as hormones” , may well be less responsive to TSH anyway. So there is a chain reaction of failure, beginning with the hypothalamus and extending to the pituitary. The antibody test is usually pretty conclusive and any level of thyroid antibodies will suggest an autoimmune process at work although as noted above, as the damage becomes chronic the levels may lessen.
Autoimmune Polyendocrine Syndrome Type Ii
This rare autoimmune disorder, once known as Schmidt syndrome, occurs when you have both Addison’s disease and Hashimoto’s disease, but it often occurs with Graves’ disease , celiac disease, and/or type 1 diabetes as well. Because hypothyroidism is common in this disorder, your TSH levels may be elevated.
There aren’t any special tests to diagnose autoimmune polyendocrine syndrome, but your healthcare provider can look for adrenal antibodies in your blood. Since around 50 percent of people with this condition have inherited it, if you have adrenal antibodies, relatives with the disorder, and you also have thyroid disease and/or diabetes but you don’t have adrenal insufficiency yet, you’re still considered to have autoimmune polyendocrine syndrome type II.
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Lab Testing Is A Cornerstone Of Clinical Diagnosis Because Hashimotos Disease Is The Most Common Cause Of Hypothyroidism Accurate Testing Is Key To Knowing If An Underperforming Thyroid Gland Causes Chronic Fatigue
Hashimotos disease is the most common autoimmune thyroid disorder. No one knows why this happens, but for various reasons, the immune system sets out to attack the thyroid gland. Over time, the thyroid gland is destroyed by your bodys lymphocytes, a type of immune blood cell. Lymphocytes produce inflammatory cytokines like Interleukin 17 that drive autoimmune activity in the thyroid gland. A tipping point occurs when thyroid cells can no longer produce enough hormones.
Well before that stage, however, your pituitary gland responds by making more thyroid-stimulating hormone . At the same time, your thyroid hormones become deficient. The pituitary is the master gland regulating hormone production in the body, including secreting TSH.
When main thyroid hormone levels of thyroxine and triiodothyronine decline, your anterior pituitary responds by secreting TSH to stimulate thyroid cells to produce more T4 and T3. You can check your TSH level with a simple blood test.
When TSH goes over 4.500 on a blood test, it means that the pituitary signaled your thyroid gland to produce more thyroid hormones. A high TSH is the hallmark of hypothyroidism. But damaged thyroid tissue caused by autoimmune activity associated with chronic inflammation cannot produce enough hormones. The pituitary responds and TSH rises. Some Hashimotos patients have TSH levels over 100!
Investigational Therapies And Clinical Trials
The medical community relies on investigative research and numerous clinical trials to help streamline diagnosis and identify the best treatments. Patient participation typically involves donating blood and tissue samples or volunteering to help evaluate the effects of a specific treatment.
Since there’s no way for participants to know if they’re getting a potentially effective medication or a placebo, patients are encouraged to consult a trusted medical provider before committing to a clinical trial.
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Costs Of Thyroid Testing
The cost of a thyroid test will vary by location and test type. Some clinics, usually community or nonprofit clinics, offer free or low-cost testing. Labs, clinics, and at-home testing companies may accept insurance to cover or lower your cost of testing. If you order you own thyroid lab tests, that could impact the cost of testing as well. As for how much blood work for thyroid costs without insurance, that depends on your testing facility.
A thyroid profile from Testing.com costs $54, while an expanded thyroid panel is $99. A more comprehensive thyroid panel is $189. Or if you prefer at-home testing, an at-home thyroid panel test kit is $189.
How Do Doctors Diagnose Hashimotos Disease
Doctors diagnose Hashimotos disease based on
- medical history and physical exam. Your doctor will start by taking a medical history and performing a physical exam. In addition to asking about symptoms, the doctor will check your neck for a goiter, which some people with Hashimotos disease can develop.
- blood tests. Your doctor will order one or more blood tests to check for hypothyroidism and its causes. Examples include tests for
- the thyroid hormones T4 and T3
- thyroid-stimulating hormone, or TSH
- thyroid peroxidase antibodies , a type of thyroid antibody that is present in most people with Hashimotos disease
You probably wont need other tests to confirm you have Hashimotos disease. However, if your doctor suspects Hashimotos disease but you dont have antithyroid antibodies in your blood, you may have an ultrasound of your thyroid. The ultrasound images can show the size of your thyroid and other features of Hashimotos disease. The ultrasound also can rule out other causes of an enlarged thyroid, such as thyroid nodulessmall lumps in the thyroid gland.
Working With Your Doctor
My sincere hope that your doctor is willing to order all of the labs listed above and then use the optimal reference ranges while working with you to restore your thyroid function.However, you may encounter some pushback or resistance. Thats why I included a letter from me to your doctor in my book, The Thyroid Connection, explaining why these tests and reference ranges are so important. I have heard from many people whose doctors were very receptive to running the labs after reading a letter from a fellow doctor, and who have even changed their treatment protocol after reading the book.Remember you are your own best advocate, and its your health you are fighting for, so dont be afraid to stand up for yourself!
Comparing High/low Tsh And T3/t4 Levels
- Normal TSH + normal T4 = normal thyroid function
- High TSH + normal T4 = you may have a higher risk of developing an underactive thyroid
- Low TSH + high T4 = overactive thyroid
- High TSH + low T4 = underactive thyroid
- Low TSH + low T4 = low thyroid function due to another problem, such as pituitary gland dysfunction
Looking at TSH alongside T3 test results can also help with diagnosis:
- Low T3 + high TSH = low thyroid function
- High T3 + low TSH = overactive thyroid
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Beat Hashimotos Symptoms For Good
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