The autoimmune thyroiditis of the thyroid gland, what is it? Symptoms and Treatment

Autoimmune thyroiditis is a pathology that affects mainly elderly women (45-60 years old). The pathology is characterized by the development of a strong inflammatory process in the thyroid gland.It arises because of serious malfunctions in the functioning of the immune system, as a result of which it begins to destroy thyroid cells.

Exposure pathology of older women is due to the X chromosomal abnormalities and the negative effect of estrogen hormones on the cells that form the lymphoid system. Sometimes the disease can develop, both in young people and in young children. In some cases, pathology is also found in pregnant women.

What can cause AIT, and can it be recognized on its own? Let's try to figure it out.

What it is?

Autoimmune thyroiditis is inflammation occurring in the tissues of the thyroid gland, the main cause of which is a serious malfunction in the immune system. On its background, the body begins to produce an abnormal large number of antibodies, which gradually destroy healthy thyroid cells. Pathology develops in women almost 8 times more often than in men.

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Causes of AIT development

Thyroiditis Hashimoto (pathology got its name after the doctor who first described her symptoms) develops for a number of reasons. The primary role in this issue is given by:

regular stressful situations;
emotional overstrain;
an overabundance of iodine in the body;
adverse heredity;
the presence of endocrine diseases;
uncontrolled intake of antiviral drugs;
The negative impact of the external environment (this may be bad ecology and many other similar factors);
malnutrition, etc.

However, one should not panic - autoimmune thyroiditis is a reversible pathological process, and the patient has all the chances to establish the thyroid gland. To do this, it is necessary to reduce the load on its cells, which will help reduce the level of antibodies in the patient's blood. For this reason, timely diagnosis of the disease is very important.

Classification

Autoimmune thyroiditis has its own classification, according to which it happens:

Bezbolevym, the reasons for the development of which until the end and have not been established.
Postpartum. During pregnancy, the woman's immunity is significantly weakened, and after the birth of the baby, on the contrary, it becomes more active. Moreover, its activation is sometimes abnormal, as it begins to produce excessive amounts of antibodies. Often the consequence of this is the destruction of the "native" cells of various organs and systems. If a woman has a genetic predisposition to AIT, she must be extremely careful, and carefully monitor her health after delivery.
Chronic. In this case, it is a genetic predisposition to the development of the disease. It is preceded by a decrease in the production of hormones of organisms. This condition is called primary hypothyroidism.
Cytokine-induced. Such thyroiditis is a consequence of taking medications based on interferon, used in the treatment of hematogenous diseases and hepatitis C.

All types of AIT, except for the first, manifest the same symptoms. The initial stage of the development of the disease is characterized by the appearance of thyrotoxicosis, which, if untimely diagnosis and treatment, can go into hypothyroidism.

Stages of development

If the disease has not been identified in a timely manner, or for some reason has not been treated, this may be the reason for its progression. The AIT stage depends on how long it has developed. Hashimoto's disease is divided into 4 stages.

Euterioid phase. Each patient has its own duration. Sometimes it may take several months for the disease to pass to the second stage of development, in other cases, it may take several years between phases. During this period, the patient does not notice any significant changes in his state of health, and does not consult a doctor. Secretory function is not violated.
At the second, subclinical, stage, T-lymphocytes begin to actively attack follicular cells, leading to their destruction. As a result, the body begins to produce a much smaller amount of the hormone St. T4. Euteriosis persists due to a sharp increase in the level of TSH.
The third phase is thyrotoxic. It is characterized by a strong jump in hormones T3 and T4, which is explained by their release from the destroyed follicular cells. Their entry into the blood becomes a powerful stress for the body, as a result of which the immune system begins to rapidly produce antibodies. When the level of functioning cells falls, hypothyroidism develops.
The fourth stage is hypothyroid. Functions shchitovidki can be restored themselves, however not in all cases. It depends on the form of the disease. For example, chronic hypothyroidism can take a long time, passing into the active stage, which replaces the phase of remission.

The disease can be in one phase or pass through all the above-described stages. It is extremely difficult to predict how exactly pathology will proceed.

Symptoms of autoimmune thyroiditis

Each of the forms of the disease has its own characteristics of manifestation. Since AIT does not pose a serious threat to the body, and its final phase is characterized by the development of hypothyroidism, neither the first nor the second stage has any clinical signs. That is, the symptomatology of pathology, in fact, is combined from those anomalies that are characteristic of hypothyroidism.

Let's list the symptoms characteristic of autoimmune thyroiditis of the thyroid gland:

periodic or permanent depressive condition (purely individual sign);
memory impairment;
problems with concentration of attention;
apathy;
persistent drowsiness or tiredness;
a sharp jump in weight, or a gradual increase in body weight;
impairment or total loss of appetite;
slowing of the pulse;
chilliness of hands and feet;
a decline in strength even with adequate nutrition;
difficulties with the performance of ordinary physical work;
the inhibition of reaction in response to the action of various external stimuli;
hair tarnishing, their fragility;
dryness, irritation and peeling of the epidermis;
constipation;
a decrease in sexual desire, or a complete loss of it;
violation of the menstrual cycle (development of intermenstrual bleeding, or complete discontinuation of menstrual bleeding);
swelling of the face;
yellowness of the skin;
problems with facial expressions, etc.

Postpartum, mute (asymptomatic) and cytokine-induced AIT are characterized by alternating phases of the inflammatory process. In the thyrotoxic stage of the disease, the manifestation of the clinical picture is due to:

sharp weight loss;
sensations of heat;
increased sweating intensity;
Poor health in stuffy or small rooms;
trembling in fingers of hands;
sharp changes in the psychoemotional state of the patient;
increased heart rate;
bouts of hypertension;
impairment of attention and memory;
loss or decrease of libido;
rapid fatigue;
general weakness, get rid of which does not help even a good rest;
sudden attacks of increased activity;
problems with the menstrual cycle.

Hypothyroid stage is accompanied by the same symptoms as chronic. Postpartum AIT is characterized by the manifestation of symptoms of thyrotoxicosis in the middle of 4 months, and the detection of symptoms of hypothyroidism at the end of 5 - at the beginning of the 6th month of the postpartum period.

With no-pain and cytokine-induced AIT, no special clinical signs are observed. If the indisposition, nevertheless, is manifested, they have an extremely low degree of severity. When asymptomatic, they are detected only during a preventive examination in a medical institution.

How does an autoimmune thyroiditis look like:

The photo below shows how the disease manifests in women:

Diagnostics

Before the emergence of the first alarming signs of pathology, it is practically impossible to detect its presence. In the absence of ailments the patient does not consider it advisable to go to the hospital, but even if he does this, it will be practically impossible to identify pathology with the help of analyzes. However, when the first unfavorable changes in the thyroid gland activity begin, a clinical study of the biological sample will immediately reveal them.

If other family members suffer or have previously suffered from such disorders, this means that you are at risk. In this case, you should visit the doctor and take preventive examinations as often as possible.

Laboratory tests for suspected AIT include:

a general blood test, which is used to determine the level of lymphocytes;
a test for hormones, necessary for measuring TSH in the blood serum;
immunogram, which establishes the presence and antibodies to AT-TG, thyroid peroxidase, as well as thyroid hormones thyroid;
fine needle biopsy, necessary for establishing the size of lymphocytes or other cells (their increase suggests the presence of autoimmune thyroiditis);
Ultrasound diagnosis of the thyroid gland helps to establish its increase or decrease in size; with AIT there is a change in the structure of the thyroid gland, which can also be detected in the course of ultrasound.

If the results of ultrasound indicate AIT, but clinical tests disprove its development, then the diagnosis is considered doubtful, and the patient's medical history does not fit.

What happens if I do not heal?

Thyroiditis can have unpleasant consequences, which vary for each stage of the disease. For example, in the hyperthyroid stage, the patient may have a cardiac rhythm (arrhythmia) heart failure, and this is fraught with the development of such a dangerous pathology as myocardial infarction.

Hypothyroidism can lead to the following complications:

dementia;
atherosclerosis;
infertility;
premature termination of pregnancy;
inability to bear fruit;
congenital hypothyroidism in children;
deep and protracted depression;
myxedeme.

With miksedem, a person becomes hypersensitive to any changes in temperature in the lower side. Even banal flu, or other infectious disease, suffered in this pathological condition, can cause a hypothyroid coma.

However, it is not necessary to experience much - such a deviation is a reversible process, and it is easy to treat. If you correctly choose the dosage of the drug (it is prescribed depending on the level of hormones and AT-TPO), then the disease for a long period of time may not remind you.

Treatment of autoimmune thyroiditis

Treatment of AIT is carried out only at the last stage of its development - with hypothyroidism. However, in this case certain nuances are taken into account.

So, the therapy is carried out exclusively with manifest hypothyroidism, when the level of TTG is less than 10 MED / L, and St.V. T4 is lowered. If the patient suffers from a subclinical form of the pathology with TTG at 4-10 MED / 1 L and with normal indices of St. T4, then in this case, treatment is carried out only in the presence of symptoms of hypothyroidism, as well as during pregnancy.

Today, the most effective in the treatment of hypothyroidism are drugs based on levothyroxine. The peculiarity of such drugs is that their active substance is as close as possible to the human hormone T4. Such drugs are absolutely harmless, therefore they are allowed to be taken even during pregnancy and GV. Preparations practically do not cause side effects, and, despite the fact that they are based on a hormonal element, they do not lead to an increase in body weight.

Drugs based on levothyroxine should be taken "isolated" from other medications, because they are extremely sensitive to any "foreign" substances. The reception is carried out on an empty stomach (half an hour before a meal or using other drugs) with the use of an abundant amount of liquid.

Calcium preparations, multivitamins, iron-containing drugs, sucralfate, etc. should be taken no earlier than 4 hours after taking levothyroxine. The most effective means on its basis are L-thyroxine and Eutiroks.

Today, there are many analogues of these drugs, but it is better to give preference to the originals. The fact is that they have the most positive effect on the patient's body, while the analogs can only bring temporary improvement in the patient's health.

If from time to time you switch from the originals to generics, then you should remember that in this case you need to adjust the dosage of the active substance - levothyroxine. For this reason, every 2-3 months, it is necessary to take a blood test to determine the level of TSH.

Nutrition with AIT

Treatment of the disease (or a significant slowdown in its progression) will give better results if the patient will avoid food that harms the thyroid gland. In this case, it is necessary to minimize the frequency of consumption of products containing gluten. Under the ban fall:

cereals;
flour dishes;
bakery products;
chocolate;
sweets;
fast food, etc.

Thus it is necessary to try to use products enriched with iodine. They are particularly useful in the fight against the hypothyroid form of autoimmune thyroiditis.

At AIT it is necessary to concern with the maximal seriousness to a question of protection of an organism from penetration of pathogenic microflora. Also, you should try to clear it of the pathogens that are already in it. First of all, you need to take care of cleansing the intestine, because it is in it is the active multiplication of harmful microorganisms. For this, the patient's diet should include:

fermented milk products;
Coconut oil;
fresh fruits and vegetables;
Low-fat meat and broths;
different types of fish;
sea kale and other algae;
germinated grains.

All products from the above list help strengthen the immune system, enrich the body with vitamins and minerals, which, in turn, improves the functioning of the thyroid and intestines.

Important! If there is a hyperthyroid form of AIT, it is necessary to completely exclude from the diet all products containing iodine, since this element stimulates the production of hormones T3 and T4.

With AIT, it is important to give preference to the following substances:

selenium, which is important for hypothyroidism, as it improves the secretion of hormones T3 and T4;
vitamins of group B, contributing to the improvement of metabolic processes, and helping to maintain the body in tone;
probiotics, important for maintaining intestinal microflora and preventing dysbacteriosis;
plant adaptogenov, stimulating the production of hormones T3 and T4 with hypothyroidism (rhodiola rosea, Reishi mushroom, root and ginseng fruit).

Prognosis of treatment

What's the worst thing you can expect? The prognosis of AIT treatment, in general, is quite favorable. If there is persistent hypothyroidism, the patient will have to take levothyroxine-based medications before the end of life.

It is very important to monitor the level of hormones in the patient's body, therefore every six months it is necessary to take a clinical analysis of blood and ultrasound. If during the ultrasound examination a nodular compaction in the thyroid gland region is seen, this should be a good reason for consulting the endocrinologist.

If during the ultrasound examination an increase in nodules was observed, or their intensive growth was observed, the patient was prescribed a puncture biopsy. The resulting tissue sample is examined in the laboratory in order to confirm or disprove the presence of a carcinogenic process. In this case, ultrasound is recommended to be performed every six months. If the site does not tend to increase, ultrasound can be performed once a year.