Autoimmune thyroiditis is a chronic inflammatory lesion of thyroid tissue caused by an immune attack of the body on its own thyroid gland, manifested by damage and subsequent destruction of follicular cells and follicles of the gland. Today, autoimmune thyroiditis is the most common disease, of all known thyroid diseases, accounting for about 30% of their total number. In women AIT is observed almost in Twenty times more often, which is directly related to the effect on the lymphoid system of estrogens and / or the violation of the X chromosome. The average age of people with diagnosed autoimmune thyroiditis usually ranges from forty to fifty years, although the disease can also occur in childhood / adolescence. Timely diagnosis of autoimmune thyroiditis is rather difficult, since during the first few years of the course, this disease does not manifest itself at all. Much more often autoimmune thyroiditis is affected by women who have previously been diagnosed with infertility and endometriosis. Studies have shown that AIT often leads to autoimmune damage to the ovaries and uterus, i.e. is actually the cause of infertility. It was also noted that the existing sufficiently long time without professional intervention endometriosis very often leads to the fact that a woman develops cervical cancer
Autoimmune thyroiditis - causes
The patient has no guilt in the occurrence of the disease, since after numerous studies, a hereditary predisposition was established (the genes causing the development of this disease were found) to the development of autoimmune thyroiditis. In addition, the development of this disease often contributes to the previous day's stress.
It was noted the direct dependence of the incidence of the disease on the sex and age of a person. So in men, AIT is almost ten times less common. The average age of patients varies from thirty to fifty years, although recently the incidence of the disease in adolescents and children has increased.
The trigger mechanism for the development of autoimmune thyroiditis can be viral and bacterial diseases, poor environmental conditions and pollution of the environment.
The immune system is the most important system of the human body. It is thanks to the immune system that foreign agents (microorganisms, viruses, etc.) are recognized in a timely manner and their penetration and subsequent development in the body is not allowed. In the case of an existing genetic predisposition, as a result of stress and a number of other reasons, the immune mechanism fails, and it begins to confuse the "stranger" and "one's own" by attacking "one's own". It is these diseases that are called autoimmune diseases. Lymphocytes (cells of the immune system) produce antibodies (proteins), the action of which in this case is directed against its own organ. In the case of AIT, antithyroid autoantibodies are produced to the cells of the thyroid gland, causing their destruction. As a consequence, a disease such as hypothyroidism may develop. Given the mechanism of development of this disease, the second name AIT - chronic lymphocytic thyroiditis
Autoimmune thyroiditis - symptoms
Most often, the symptoms of autoimmune thyroiditis at the initial stage (the first few years) of the course of the disease do not appear and the disease is detected only during the examination of the thyroid gland. In the initial period of the disease, and sometimes throughout life, the normal function of the thyroid gland may persist. This condition is called euthyroidism - a condition in which the thyroid gland produces a normal amount of hormones. This state in itself is the norm, but requires further periodic dynamic observation.
Over time, any degree of hypothyroidism develops, usually accompanied by signs of a decrease in the thyroid gland in size. During the first years of the course of the disease, as a rule, AIT is found with a clinical picture of thyrotoxicosis, after which the thyrotoxicosis replaces eutirosis and its hypothyroidism as the thyroid gland tissue deteriorates and decreases accordingly.
The main complaints of patients with autoimmune thyroiditis are associated with an enlarged thyroid gland: shortness of breath, difficulty in swallowing, and a minor soreness in the thyroid gland. The patient with AIT usually has slow motion; face puffy, pale, with a yellowish tinge; eyelids edematous, facial features coarse. Against the background of a pale face, on the tip of the nose and on the cheekbones distinctly stands out an unhealthy blush in the form of red spots. The hair is fragile and rare, often falling out, forming bald patches. There is also a loss of hair in the pubic region and / or in the underarm area.
In the process of conversation, facial mimicry practically does not change. The person speaks very slowly, taking words for a long time, remembering with great difficulty the name of objects and phenomena. This speech disorder occurs due to edema of the tongue.
In most cases, a patient with an autoimmune thyroiditis complains of poor performance and expressed fatigue, he has a constant desire to sleep, memory decreases and voice changes. Often there is an impossibility of an independent chair, as a result of which it is necessary to resort to enemas and laxatives.
Women often have a menstrual cycle, and there may be a delay in menstrual cycles for several weeks. By itself, menstruation is scarce. There may be uterine bleeding. Such menstrual irregularities often lead to the development of amenorrhea (complete cessation of menstruation) and eventually to infertility. In some patients from the nipples of the mammary gland appear different in intensity of excretion, possible mastopathy . Men significantly decrease their sexual desire and often develop impotence.
In children, the common symptom of autoimmune thyroiditis is pronounced dryness in the mouth in the morning, without signs of intense thirst. Usually, such children lag behind their peers in mental development and growth.
The diagnosis of autoimmune thyroiditis is established on the basis of laboratory data and a general clinical picture. In the case of confirmed presence of AIT in other family members, it is possible to talk about autoimmune thyroiditis with a high degree of probability. Laboratory tests determine the presence in the body of antibodies to various components (peroxidase, thyroglobulin, etc.) of the thyroid gland.
Laboratory tests include: an immunogram, a general blood test, a fine needle biopsy of the thyroid gland, a serum level determination of the TSH level, the determination of T3 and T4, ultrasound of the thyroid gland
Autoimmune thyroiditis - treatment
Unfortunately, there is no specific therapy aimed at treating autoimmune thyroiditis. The main goal of the treatment is to maintain the necessary amount of thyroid hormones in the blood.
In euthyroidism, treatment is not performed, however, a regular examination (once every six months), consisting of TSH control and hormonal examination of T3 st. and T4 St.
In the hypothyroid stage, the appointment of a thyroid hormone such as levothyroxine (Eutirox, L-thyroxine) is indicated. This drug is prescribed to replenish the amount of thyroid hormones deficient in the body. The scheme of taking the drug is selected individually by the attending physician-endocrinologist.
In the stage of thyrotoxicosis, hormone-reducing drugs (thyreostatics) are usually not prescribed. Their place is taken by symptomatic therapy, aimed at reducing symptoms (a decrease in the sensation of irregularities in the work of the heart, palpitations) of the disease. In each specific case, treatment is compulsorily selected individually.
Treatment of folk remedies for autoimmune thyroiditis is contraindicated. With this disease in general, you should refrain from any self-treatment. Adequate in this case, the treatment is able to appoint only an experienced doctor, and it should be conducted under mandatory systematic control of the tests. Immunomodulators and immunostimulants for autoimmune thyroiditis are not recommended. It is very important to observe some principles of proper healthy eating, namely: to eat more fruits and vegetables. During the illness, as well as during periods of stress, emotional and physical exertion, it is recommended to take the microelements and vitamins that are necessary for the body (vitamins such as Supradin, Centrum, Vitrum, etc.)
Prognosis for autoimmune thyroiditis
In general, the further forecast is quite favorable. People with developed persistent hypothyroidism are shown lifelong administration of Levothyroxine drugs. Once every six to twelve months, dynamic monitoring of hormonal performance is indicated. In the event that the ultrasound of the thyroid gland on the organ revealed nodal neoplasms, a compulsory consultation of an endocrinologist is indicated.
Normal working capacity and satisfactory state of health in autoimmune thyroiditis usually persist for more than fifteen years, even despite short-term periods of exacerbation.
In case a woman has been diagnosed with postpartum thyroiditis, the probability of its recurrence after a possible next pregnancy is about 70%. In 30% of women with postnatal thyroiditis, chronic autoimmune thyroiditis is subsequently observed, followed by its transition to persistent hypothyroidism.