Jasmyn's Diagnosis ~ Hashimoto's Disease

Jasmyn saw the endocrinologist yesterday and was diagnosed with Hashimoto's disease. The doctor thinks that she got it from her dad, seeing as he has diabetes type I. He estimated that about two thirds of her thyroid is gone. He said if you have to pick an auto immune disease this is the "best" & easiest one to treat. She'll have to be on meds for the rest of her life & have blood tests every 3 months.

She hasn't had her period since October and if it doesn't start in 6 months (after thyroid meds have had a chance to work) then we'll have to figure that one out too.


Definition
By Mayo Clinic staff
Hashimoto's disease is a disorder that affects your thyroid, a small gland at the base of your neck, below your Adam's apple. The thyroid gland is part of your endocrine system, which produces hormones that coordinate many of your body's activities.

In Hashimoto's disease, also known as chronic lymphocytic thyroiditis, your immune system attacks your thyroid gland. The resulting inflammation often leads to an underactive thyroid gland (hypothyroidism). Hashimoto's disease is the most common cause of hypothyroidism in the United States. It primarily affects middle-aged women, but also can occur in men and women of any age and in children.

Doctors test your thyroid function to help detect Hashimoto's disease. Treatment of Hashimoto's disease with thyroid hormone replacement usually is simple and effective.

Symptoms

By Mayo Clinic staff

Hashimoto's disease does not have unique signs and symptoms. The disease typically progresses slowly over a number of years and causes chronic thyroid damage, leading to a drop in thyroid hormone levels in your blood. The signs and symptoms are mainly those of an underactive thyroid gland (hypothyroidism).

The signs and symptoms of hypothyroidism vary widely, depending on the severity of hormone deficiency. At first, you may barely notice any symptoms, such as fatigue and sluggishness, or you may simply attribute them to getting older. But as the disease progresses, you may develop more-obvious signs and symptoms. Signs and symptoms of hypothyroidism include:

·         Fatigue and sluggishness, Increased sensitivity to cold, Constipation, Pale, dry skin, A puffy face, Hoarse voice, An elevated blood cholesterol level, Unexplained weight gain — occurring infrequently and rarely exceeding 10 to 20 pounds, most of which is fluid, Muscle aches, tenderness and stiffness, especially in your shoulders and hips, Pain and stiffness in your joints and swelling in your knees or the small joints in your hands and feet, Muscle weakness, especially in your lower extremities, Depression

Without treatment, signs and symptoms gradually become more severe and your thyroid gland may become enlarged (goiter). In addition, you may become more forgetful, your thought processes may slow or you may feel depressed.

Causes

Hashimoto's disease is an autoimmune disorder in which your immune system creates antibodies that damage your thyroid gland. Doctors don't know what causes your immune system to attack your thyroid gland. Some scientists think a virus or bacterium might trigger the response, while others believe a genetic flaw may be involved.

A combination of factors, including heredity, sex and age, may determine your likelihood of developing the disorder. Hashimoto's disease is most common in middle-aged women and tends to run in families.

Tests and diagnosis

By Mayo Clinic staff

In general, your doctor may test for Hashimoto's disease if you're feeling increasingly tired or sluggish, have dry skin, constipation and a hoarse voice, or have had previous thyroid problems or goiter.

Diagnosis of Hashimoto's disease is based on your signs and symptoms and the results of blood tests that measure levels of thyroid hormone and thyroid-stimulating hormone (TSH). These may include:

A hormone test. Blood tests can determine the amount of hormones produced by your thyroid and pituitary glands. If your thyroid is underactive, the level of thyroid hormone is low. At the same time, the level of TSH is elevated because your pituitary gland tries to stimulate your thyroid gland to produce more thyroid hormone.

·         An antibody test. Because Hashimoto's disease is an autoimmune disorder, the cause involves production of abnormal antibodies. A blood test may confirm the presence of antibodies against thyroid peroxidase, an enzyme normally found in the thyroid gland that plays an important role in the production of thyroid hormones.

In the past, doctors weren't able to detect underactive thyroid (hypothyroidism), the main indicator of Hashimoto's disease, until symptoms were fairly advanced. But by using the sensitive TSH test, doctors can diagnose thyroid disorders much earlier, often before you experience symptoms. Because the TSH test is the best screening test, your doctor will likely check TSH first and follow with a thyroid hormone test if needed. TSH tests also play an important role in managing hypothyroidism. These tests also help your doctor determine the right dosage of medication, both initially and over time.

Treatments and drugs

By Mayo Clinic staff

Treatment for Hashimoto's disease may include observation and use of medications. If there's no evidence of hormone deficiency and your thyroid is functioning normally, your doctor may suggest a wait-and-see approach. If you do need medication, chances are you'll need it for the rest of your life.

Synthetic hormones
If Hashimoto's disease causes thyroid hormone deficiency, you may need replacement therapy with thyroid hormone. This usually involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Levoxyl, Synthroid). Synthetic levothyroxine is identical to thyroxine, the natural version of this hormone made by your thyroid gland. The oral medication restores adequate hormone levels and reverses all the symptoms of hypothyroidism.

Soon after starting treatment, you'll notice that you're feeling less fatigued. The medication also gradually lowers cholesterol levels elevated by the disease and may reverse any weight gain. Treatment with levothyroxine is usually lifelong, but because the dosage you need may change, your doctor is likely to check your TSH level every six to 12 months.

Monitoring the dosage
To determine the right dosage of levothyroxine initially, your doctor generally checks your level of TSH after a few weeks of treatment. Excessive amounts of the hormone can accelerate bone loss, which may make osteoporosis worse or add to your risk of this disease. Overtreatment with levothyroxine also can cause heart rhythm disorders (arrhythmias).

If you have coronary artery disease or severe hypothyroidism, your doctor may start treatment with a smaller amount of medication and gradually increase the dosage. Progressive hormone replacement allows your heart to adjust to the increase in metabolism.

Levothyroxine causes virtually no side effects when used in the appropriate dose and is relatively inexpensive. If you change brands, let your doctor know to ensure you're still receiving the right dosage. Also, don't skip doses or stop taking the drug because you're feeling better. If you do, signs and symptoms will gradually return.

Effects of other substances
Certain medications, supplements and even some foods may affect your ability to absorb levothyroxine. Talk to your doctor if you eat large amounts of soy products or a high-fiber diet, or if you take any of the following:

·         Iron supplements, including multivitamins that contain iron
·         Cholestyramine (Questran), a medication used to lower blood cholesterol levels
·         Aluminum hydroxide, which is found in some antacids
·         Sodium polystyrene sulfonate (Kayexalate), used to prevent high blood potassium levels
·         Sucralfate, an ulcer medication
·         Calcium supplements