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Hashimoto's Disease

Donald Aulds, M.D.

Hashimoto’s disease is a chromic inflammation of the thyroid gland that occurs when antibodies, which are produced by your immune system, attack your thyroid gland. The thyroid hormones produced by the thyroid gland (T3 and T4) help control metabolism, brain development and function, heart rate, breathing, skin moisture, weight, cholesterol levels, body temperature, muscle strength and the menstrual cycle. When the thyroid is attacked by the antibodies, a chronic inflammation occurs which will decrease the ability of the thyroid to produce the hormones leading to low production or hypothyroidism. Hashimoto’s disease is seven times more common in women than men and usually appears in the 40- to 60-year-old range, but sometimes can be seen as early as the teenage years. It sometimes appears to run in families, but no genetic pattern has yet been identified.

What are the symptoms of Hashimoto’s disease?
Most people may not show symptoms in the early stages of the disease, but as the disease advances, the symptoms will begin to gradually show up and the thyroid gland may become enlarged, causing the front of the neck to appear swollen. Enlargement of the gland (usually referred to as a goiter) is usually not painful but may lead to a feeling of fullness in the throat and a difficulty swallowing. Other symptoms vary from mild to severe and may include:

  • Weight gain
  • Fatigue and sluggishness
  • Joint and muscle pain, muscle weakness, swelling of the joints
  • Cold intolerance
  • Constipation
  • Depression
  • Slow heart rate
  • Heavy, irregular menstrual periods
  • Infertility
  • Pale, dry skin
  • Swelling of the face
  • Hoarse voice

Are there any identifiable risk factors for developing the disease?
Research has shown that certain factors may help lead to autoimmune diseases such as Hashimoto’s disease. These factors may include environmental toxins, excess iodine consumption, drugs, viral infections, fungal infections, diabetes and vitamin deficiencies.

What are the complications of Hashimoto’s disease?
Whenever this disease is undetected or undertreated it may lead to health changes:

  • Goiter – may affect the appearance and cause difficulty swallowing or breathing
  • Mental health issues – including depression, decrease in libido, slow mental function
  • Heart problems – elevated cholesterol leading to atherosclerosis, decreased heart rate and function, enlarged heart and heart failure
  • Myxedema – a rare life-threatening disorder that can cause intense cold intolerance, drowsiness, lethargy and even unconsciousness. It can sometimes lead to a coma that may be triggered by sedatives, infections or stress.
  • Birth defects – in severe, untreated cases it may cause mental and developmental problems. Birth defects may include cleft palate, heart problems, poor brain development, and kidney disorders.
  • How is Hashimoto’s disease diagnosed?
    The diagnosis is made by combining the symptoms reported to the physician, physical exam and laboratory test. The tests should include T3, T4, TSH and TPO (a blood test for an antibody against thyroid tissue).

    Whenever Hashimoto’s disease is diagnosed, it can be monitored with frequent testing for the thyroid hormones, as long as the symptoms are minimal, or it can be treated with thyroid hormone replacement. This will need to be discussed with your physician. If you have any or several of the symptoms, talk to your physician about getting full testing of the thyroid.

    More about Dr. Aulds

    Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.

    Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.

    Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.