12 August

Autoimmune thyroiditis : Treatment , Symptoms, Causes

Contents:

  • Deciphering names
  • Statistics
  • disease Classification
  • reasons pathology
  • Stages and symptoms
    • euthyroid stage
    • subclinical stage
    • thyrotoxicosis
    • Hypothyroidism
    • Postpartumthyroiditis
    • painless thyroiditis
    • cytokine-induced thyroiditis
  • autoimmune thyroiditis and fertile functions
  • What you need to
  • diagnosis Complications
  • diet in patients with autoimmune thyroiditis
  • Treatment
  • forecast
  • disease prevention

thyroid gland - the body endocrine, one of the most important regulators of metabolic processes occurring in the human body.He is very sensitive to external and internal shocks.Violation of his work immediately affects the state of covering tissue, weight, heart activity, the ability to become pregnant and bear a child;it can be seen "from afar", looking at behavioral change and speed of thinking.

20-30% of all diseases of thyroid disease is called "autoimmune thyroiditis".Autoimmune thyroiditis thyroid gland - an acute or chronic inflammation of the bo

dy tissue associated with the destruction of its own cells as the immune system.The disease is more common in women;It takes a long time without any visible symptoms, so that the suspect can only be planned when passing ultrasound and determination of antibodies in the blood to the gland peroxidase.Treatment picks endocrinologist, focusing on the current stage of the process.Autoimmune thyroiditis can be treated as a whole or to control its activity using a continuous use of drugs: it all depends on the type of disease.The disease has a benign course.

Deciphering names

word "autoimmune" means a situation where the inflammation causes the immune system of its own, making an attack on the body (in this case, on the thyroid).Why is this happening?

All cells - and microbial, and "native" to organism must "introduce".To do this, on the surface they expose "identification mark" in the form of special, specific proteins.These proteins have decided to call "antigens", and produced by the immune system to eliminate these other proteins - "antibodies."Immune cells in the blood vessels, every second approach to every cell and test it on the danger to the organism is in such autoantigens, comparing them with your "list."Once the immune system is no longer do this properly (due to violation of the quality of the lymphocytes, or reduce the amount of its "army"), there are tumor, as in the fission process in any tissue appear "wrong" (atypical) cells.But the question now is not about that.

Even before the period of the birth of human lymphocytes undergo specific training, which resulted in getting "list" antigens of their cells, they pass and do not produce antibodies.But not all of our bodies (or departments) in the norm are "allowed" antigens.In this case, the body is surrounded by a barrier of specialized cells, which do not allow lymphocytes to approach and check the "markings".Thus surrounded by a barrier: the thyroid gland, lens, male genitalia;such protection is built around a child growing uterine cavity.

When breaking - temporarily or permanently - a barrier around the thyroid and autoimmune thyroiditis occurs.Blame the genes that tell the lymphocytes increased aggression.More common in women as estrogens, unlike male hormones, affect the immune system.

Statistics

Embracing nearly a third of all thyroid disease, autoimmune thyroiditis occurs in 3-4% of all people on Earth.Thus, for the above reasons, the disease is more common in women and the incidence rate increases with age.Thus, the pathology can be found in every 6-10 minutes sixty ladies, while the children are sick from 1-12 to 1000.

Classification

diseases in the category of "autoimmune thyroiditis" includes several diseases.It:

  1. chronic autoimmune thyroiditis or Hashimoto's disease .That it is often referred to simply as "autoimmune thyroiditis" and just look at it and we as a disease with the classic stages.It is a disease that has a genetic basis in reason.Its over - a chronic but benign.To maintain a normal quality of life will always have to take hormone replacement therapy drugs.

Hashimoto's disease is also called lymphomatous goiter as iron increases due to swelling resulting from a massive attack its tissues lymphocytes.Often there is a combination of this disease with other autoimmune diseases, if not the man, in the family.Thus, Hashimoto's thyroiditis, often combined with type I diabetes mellitus, rheumatoid arthritis, gastric parietal cell lesions, autoimmune liver inflammation, vitiligo.

  1. Postpartum thyroiditis : inflammation of the thyroid gland develops in about 14 weeks after childbirth.It is connected with a particular reaction of the immune system: during pregnancy, she has to be suppressed so as not to destroy the baby (fetus is foreign in nature), and after the birth, it can be reactivated excessively.
  2. Painless form of autoimmune thyroiditis .It is a disease with unknown cause, but the mechanism is identical to the post-natal development.
  3. cytokine-induced form .It develops in the "bombardment" of thyroid substances, cytokines that occur in the body in large amounts when held long-term treatment interferon drugs - injectable "Laferon", "with interferon" (as is usually treated with hepatitis C to the outcome of cirrhosis, certain blood diseases).

Depending on the degree of increase in cancer there is another classification of autoimmune thyroiditis.On this basis, the disease may be:

  • latent: thyroid can be significantly increased or be normal.Hormone levels and therefore gland function is not changed.
  • hypertrophic: Body sizes increased or completely (diffuse form), or one / several places (nodular thyroiditis).
  • atrophic: reduced size, reduced the amount of hormones produced.It - hypothyroidism in patients with autoimmune thyroiditis.

reasons pathology

In order to develop any of autoimmune thyroiditis, only one defect in the genes encoding the activity of the immune system, is not enough.As a start-up factor that people consider the cause of their illness, can act:

  • transferred flu, at least - other respiratory viral diseases, as well as mumps and measles;
  • receiving large amounts of iodine;
  • chronic infection in the body: chronic tonsillitis, untreated caries, chronic sinusitis;
  • living in poor environmental conditions, when the body gets a lot of chlorine or fluorine;
  • selenium deficiency in the soil in areas inhabited
  • ionizing radiation;
  • psycho-emotional stress.

Stages and symptoms of Hashimoto's thyroiditis

is divided into several stages.Smoothly into one another.

euthyroid stage

Hashimoto's disease begins with the fact that the immune cells begin to "see" the cells of the thyroid gland, thyrocytes.It is for them - a foreign structure, so they decide to attack thyrocytes and using chemicals dissolved in the blood, calling to this end, to him their brothers.They attack thyrocytes by producing antibodies against them.The latter may be a different number.If they are a little bit killed cancer cells maintained euthyroid phase of the disease, the levels of all hormones are not changed, the symptoms are only due to the increase in cancer:

  • thyroid becomes visible;
  • it can be felt, with her determined;
  • becomes difficult (as a "lump in the throat") to swallow, especially solid food;
  • people get tired when making less work than before.

subclinical stage

such as autoimmune thyroiditis symptoms observed in phase subclinical disease.The gland cell number is reduced at this time, but the work included those that should be at rest.This happens due to thyroid stimulating hormone (TSH).

thyrotoxicosis

tireoidstimulirovannyh If too many antibodies, developing thyrotoxic phase.Signs her following:


  • fatigue;
  • irritability, tearfulness, anger;
  • weakness;
  • «tides" heat;
  • sweating;
  • perceived palpitations;
  • tendency to diarrhea;
  • decreased sex drive;
  • difficult to be in hot climates;
  • menstrual disorders.

If the disease occurs in a child at this stage most noteworthy is that it becomes very thin and not gaining weight, despite increased appetite.

Hypothyroidism

With the destruction of a large amount of antibodies working gland zone begins last phase of autoimmune thyroiditis - hypothyroidism.Its symptoms are:

  • weakness;
  • depression, apathy;
  • slowing of speech and reactions;
  • weight gain with poor appetite;
  • skin becomes pale, edematous, yellowish and dense (not going to fold);
  • puffy face;
  • constipation;
  • man quickly freezes;
  • hair strongly drop out;
  • voice hoarse;
  • menstruation rare and scarce;
  • brittle nails;
  • joint pain.

The child manifested hypothyroidism weight gain, memory impairment, it becomes more phlegmatic, worse memory material.If the disease develops at an early age, mental development lags behind due.

Postpartum thyroiditis

In this case, at 14 weeks postpartum symptoms of lung hyperthyroidism:

  • fatigue;
  • weight reduction;
  • weakness.

They can be amplified up to the appearance of feeling hot, feeling of palpitations, insomnia, rapid mood shifts, limbs shake.By the end of 4 months after childbirth (about 5 weeks after the first signs) appear symptoms of hypothyroidism, which are often written off as postpartum depression.

painless thyroiditis

It is characterized by hyperthyroidism is mild: slight irritability, sweating, increased heart rate.It is attributed to fatigue.

cytokine-induced thyroiditis

Against injecting "Alverona", "Viferon" or other interferons may occur symptoms such as increased and reduced thyroid function.Usually they expressed slightly.

Autoimmune thyroiditis and fertile functions

Autoimmune thyroiditis on subclinical, euthyroid and thyrotoxic stage do not interfere with fertility, which is not the stage of hypothyroidism, since thyroid hormones affect ovarian function.If at this stage to carry out adequate treatment of synthetic hormones, the pregnancy occurs.At the same time there is a danger of her miscarriage as antibodies to the iron, production of which does not depend on the number received «L-thyroxine" (or "Eutiroksa") adversely affects the ovarian tissue.But the situation is corrected, provided progesterone replacement therapy, which will maintain the pregnancy.

thyroiditis patient woman should be seen by an endocrinologist during the entire period of gestation.In hypothyroid state in this period, it should increase the dose of thyroxine (thyroid hormones need for two organisms - mother and baby - increased by 40%).Otherwise, if the mother's body during pregnancy will remain a small amount of thyroid hormones, the fetus may develop severe disease, sometimes incompatible with life.Or he will be born with congenital hypothyroidism, which is tantamount to severe mental retardation and disorders of metabolism.

What you need to

diagnosis If you suspect an autoimmune thyroiditis held such diagnostics.Blood test for hormones:

  • T3 - total and free,
  • T4 - total and free,
  • TSH.

If elevated TSH and T4 is normal, it is - a subclinical stage, if at an elevated TSH level decreased T4 - means that already have the first symptoms appear.

Diagnosis is based on the totality of these data:

  • Increased levels of antibodies to the enzyme thyroid - thyroid peroxidase (TPO AT-) in the analysis of venous blood.
  • on thyroid ultrasound is determined by its hypoechogenicity.
  • Reduced concentrations of T3, T4, elevated TSH levels.

Only one component does not allow to put such a diagnosis.Even raising AT-TPO just says that a person has a predisposition to an autoimmune attack against cancer.If

thyroiditis - node, each node biopsy is performed to visualize thyroiditis signs, and to prevent cancer.

Complications

At different stages of thyroiditis - a variety of complications.Thus, the hyperthyroid phase can be complicated by arrhythmia, heart failure and even trigger a myocardial infarction.

Hypothyroidism can cause:

  • infertility;
  • habitual miscarriage;
  • congenital hypothyroidism in the unborn child;
  • dementia;
  • atherosclerosis;
  • depression;
  • miksedemu that looks like intolerance of the slightest cold, constant sleepiness.If in this state to enter sedatives, a pronounced stress or ill with an infectious disease, it is possible to provoke hypothyroid coma.

Fortunately, this condition responds well to treatment, and if you take drugs matched by the level of hormones and AT-TPO dose can be a long time do not feel the presence of the disease.

diet in patients with autoimmune thyroiditis

diet should be normal caloric (energy value of not less than 1500 kcal), and it is better if you will calculate it for Mary Chaumont (weight * 25) -200 kcal.

proteins intake should be increased to 3 g per kg of body weight, and saturated fats, and digestible carbohydrates - limit.There should be every 3 hours.

What You Can Eat:

  • vegetable dishes;
  • red fish in baked form;
  • fish oil;
  • liver, cod, pork, beef;
  • pasta;
  • dairy products;
  • cheese;
  • legumes;
  • eggs;
  • butter;
  • porridge;
  • bread.

excluded salty, fried, spicy and smoked food, alcohol and seasonings.Water - not more than 1.5 liters / day.

need handling - once a week or 10 days - days in the juices and fruits.

Treatment Treatment of autoimmune thyroiditis completely drug depends on the stage of the disease.It is assigned at any age and does not stop even during pregnancy, unless, of course, there are indications.His goal - to maintain the level of thyroid hormone at the physiological values ​​(their control is carried out once every 6 months, the first control - 1.5-2 months).

Under euthyrosis no treatment.

How to treat hyperthyroidism stage , solves a doctor.Usually tireostatiki such as "Merkazolil" is not appointed.Treatment symptomatic: when appointed tachycardia beta-blockers drugs "Atenolol", "Nebivolol," "Inderal" in severe psychological and emotional excitability - sedatives.If thyrotoxic crisis has occurred, the therapy is conducted in the hospital with the help of injection of glucocorticoid hormones ( "Dexamethasone", "Prednisolone").These drugs are administered if combined with autoimmune thyroiditis subacute thyroiditis, but the treatment is carried out at home.