Autoimmune thyroiditis of the thyroid gland. Autoimmune thyroiditis. The worst. What to expect? Signs and symptoms Medications for thyroiditis

What is autoimmune thyroiditis? We will analyze the causes of occurrence, diagnosis and treatment methods in the article of Dr. A. A. Sivov, an endocrinologist with an experience of 9 years.

Definition of illness. Causes of the disease

Chronic autoimmune (lymphomatous) thyroiditis (CHAIT)- a chronic disease of the thyroid gland of autoimmune origin, was described by H. Hashimoto in 1912. The disease is more often observed in women and is most often diagnosed among the known pathologies of the thyroid gland. Autoimmune thyroiditis occurs in one in 10-30 adult women.

The disease in question is of an autoimmune nature, and the presence of antibodies is mandatory for it. They first published data on the detection of antibodies to thyroid tissue in the serum of patients with autoimmune thyroiditis in 1956. Subsequently, it turned out that autoimmune thyroiditis implies the presence of antibodies to thyroglobulin, the second colloidal antigen and thyroperoxidase (microsomal antigen).

Symptoms of autoimmune thyroiditis

Initially, for some time, patients do not express any complaints. Gradually, over time, a slow development of the clinical picture of a decrease in thyroid function is recorded, however, in some situations, a progressive decrease in the size of the gland or, conversely, its increase will be noted.

Clinical manifestations in chronic autoimmune thyroiditis begin to appear with dysfunction of the thyroid gland, but in some situations there may be no symptoms. All symptoms are nonspecific, that is, they can be with a variety of diseases. But despite this, we still denote the clinical manifestations, having which you should contact an endocrinologist for examination.

The pathogenesis of autoimmune thyroiditis

The endogenous (internal) criterion for the inheritance of autoimmune diseases is interconnected with T-lymphocyte clones. In order for a chronic disease to develop, taking into account the existing hereditary predisposition, it is necessary to influence exogenous factors (viral and any other infections, pharmaceuticals) that contribute to the activation of T-lymphocytes, which subsequently activate B-lymphocytes, starting a chain reaction. Further, T-cells, cooperating with antithyroid antibodies, act on the epithelial cells of the follicles, contributing to their destruction, as a result of which the number of properly functioning structural units of the thyroid gland decreases.

The amount of antithyroid antibodies in this disease directly reflects the severity of the autoimmune process and sometimes tends to decrease as the duration of the disease increases. Only the presence of antithyroid antibodies is not enough to injure the structural elements of the thyroid gland. To realize the toxic properties of the available antibodies, it is necessary to interact with T-lymphocytes that are sensitive to thyroid antigens in CAI, which does not happen in the presence of a normal goiter or if the pathology of the thyroid gland is not detected. Normally, all cells have immunological insensitivity to other cells of their own body, which is acquired during fetal development (before birth), during the interaction of mature lymphocytes with their antigens. Any disturbances in this interaction and the synthesis of special clones of T-lymphocytes that interact with their own antigens can become the reason that leads to a violation of immunological insensitivity and subsequently leads to the formation of any autoimmune pathologies, including CAI.

Classification and stages of development of autoimmune thyroiditis

Forms of HAIT, taking into account the volume of the gland and clinic data:

Hypertrophic (Hashimoto's thyroiditis). The most common. The thyroid gland differs in density, increased to II or III degree. The function of the gland is often not changed, however, in most situations, thyrotoxicosis or hypothyroidism is recorded. It occurs in 15-20% of patients.
Atrophic. The thyroid gland is normal or slightly enlarged, and at the time of examination it may even be reduced. Functionally - hypothyroidism. Occurs in 80-85% of patients.

Another classification of autoimmune thyroiditis:

Phases of HAIT, taking into account the clinical picture of the disease:

Euthyroid. Asymptomatic prolonged (sometimes lifelong) course, without changes in thyroid function.
subclinical. If the disease progresses, as the destruction of thyroid cells occurs and the level of thyroid hormones decreases, the synthesis of thyroid stimulating hormone (TSH) increases, which in turn overstimulates the thyroid gland, due to which the body maintains normal T4 secretion.
Thyrotoxicosis phase. As the disease continues to develop, the available thyroid hormones are released into the blood and thyrotoxicosis is formed. In addition, destroyed parts of the internal structures of follicular cells enter the bloodstream, resulting in the formation of antibodies to thyroid cells. When, with progressive destruction of the thyroid gland, the concentration of hormone-producing cells decreases below the permissible limit, the concentration in the blood of T4 rapidly decreases, and the stage of overt hypothyroidism develops.
Hypothyroidism phase. It lasts for about a year, most often after that the restoration of thyroid function occurs. Sometimes the hypothyroid phase lasts a lifetime.

HAIT predominantly occurs with only one phase of the disease.

Complications of autoimmune thyroiditis

HAIT is a conditionally safe disease that does not lead to complications only if the necessary concentration of hormones in the blood is maintained, i.e., the euthyroid state. And, accordingly, then no complications develop. But when hypothyroidism occurs, complications can occur. If hypothyroidism is not treated, complications can occur: impaired reproductive function, severe memory loss, up to dementia, anemia, but the most formidable and severe complication of hypothyroidism - hypothyroid or mexidematous coma - occurs with a sharp insufficiency of thyroid hormones.

Diagnosis of autoimmune thyroiditis

Diagnosis of HAIT consists of several points. To determine this disease in a patient, at least one large criterion is required, if such criteria are not found, then the diagnosis is only probable.

Major diagnostic criteria:

primary hypothyroidism (moreover, both manifest and stable subclinical are possible);
the presence of antibodies to thyroid tissue;
ultrasound criteria for autoimmune pathology.

Particular attention should be paid to the fact that it is impossible to establish the diagnosis of autoimmune thyroiditis solely on the basis of the results of palpation of the thyroid gland, although it can be increased or decreased. These changes only allow one to suspect a pathology and send the patient for additional examination in order to make a diagnosis and prescribe special treatment.

It should be noted that when manifest or stable subclinical hypothyroidism is detected in a patient, the diagnosis of autoimmune thyroiditis is important for establishing the cause of the decrease in gland function, but despite this, the diagnosis does not change the therapeutic methods in any way. Treatment consists in the use of hormone replacement therapy with thyroid hormone preparations.

The use of needle biopsy of the thyroid gland is not indicated for the establishment of chronic autoimmune thyroiditis. It should be performed only if there are thyroid nodules larger than 1 cm in diameter.

It is important to note that there is no need to monitor the amount of thyroid antibodies present during the course of the disease, because this procedure has no diagnostic role in analyzing the progression of autoimmune thyroiditis.

Treatment of autoimmune thyroiditis

Therapy for autoimmune thyroiditis is nonspecific. When the phase of thyrotoxicosis is formed, it is sufficient to use symptomatic therapy. In the formation of hypothyroidism, the main option for drug therapy is the appointment of thyroid hormones. Now in the pharmacy network of the Russian Federation it is possible to purchase only tablets of Levothyroxine sodium (L-thyroxine and Euthyrox). The use of tablet preparations of thyroid hormones eliminates the clinic of hypothyroidism and, in the hypertrophic form of autoimmune thyroiditis, causes a decrease in the volume of the thyroid gland to acceptable values.

If overt hypothyroidism is detected in a patient (an increase in the level of thyroid-stimulating hormone and a decrease in the concentration of free T4), it is necessary to use levothyroxine sodium in the treatment at an average dose of 1.6-1.8 μg / kg of the patient's body weight. An indicator of the correctness of the prescribed treatment will be a confident retention of thyroid-stimulating hormone in the patient's blood within the reference values.

When a patient is diagnosed with subclinical hypothyroidism (increased concentration of TSH in combination with an unchanged concentration of free T4), it is necessary:

After 3-6 months, conduct a second hormonal examination to confirm the presence of a change in thyroid function;
When during pregnancy the patient is found to have an increase in the level of thyroid-stimulating hormone, even with a preserved concentration of free T4, give levothyroxine sodium at the full calculated replacement dose immediately;
Treatment with levothyroxine sodium is necessary for persistent subclinical hypothyroidism (an increase in the concentration of thyroid-stimulating hormone in the blood over 10 mU / l, and even in situations where the concentration of thyroid-stimulating hormone is determined at least twice between 5-10 mU / l), but if these patients are over 55 years old and have they have cardiovascular pathologies, treatment with levothyroxine sodium is prescribed only with excellent tolerance to the drug and in the absence of information about the decompensation of these diseases while taking thyroxine;
The indicator of the sufficiency of treatment of subclinical hypothyroidism is a stable retention of the level of TSH within the reference values in the blood.

If women have antibodies to thyroid tissue and / or ultrasound signs of autoimmune thyroiditis before pregnancy planning, it is necessary to determine the hormonal function of the thyroid gland (thyroid-stimulating hormone concentration and free T4 concentration) and it is imperative to determine the level of hormones in each trimester of pregnancy.

If autoimmune thyroiditis is diagnosed, but no changes in the functioning of the thyroid gland are detected, the use of levothyroxine sodium preparations is not indicated. It is sometimes possible in exceptional situations of an impressive increase in the volume of the thyroid gland, provoked by autoimmune thyroiditis, while the decision is made for each patient individually.

The physiological amount of potassium iodite (approximately 200 mcg / day) cannot provoke the formation of hypothyroidism and does not adversely affect thyroid function in previously developed hypothyroidism caused by autoimmune thyroiditis.

Forecast. Prevention

Chronic autoimmune thyroiditis usually progresses very slowly, with the development of a hypothyroid state after several years. In some situations, the condition and ability to work remain for 15-18 years, even taking into account short exacerbations. In the phase of exacerbation of thyroiditis, symptoms of unexpressed either hypothyroidism or thyrotoxicosis are recorded.

Today, methods for the prevention of chronic autoimmune thyroiditis have not been found.

Bibliography

1. Differential diagnosis and treatment of endocrine diseases: Manual / Balabolkin M.I., Klebanova E.M., Kreminskaya V.M. - Moscow: LLC "Medical Information Agency", 2008.- 752p.
2. Laykok, D.F. Fundamentals of endocrinology / D.F. Leykok, P.G. Weiss.-Moscow: "Medicine", 2001 - 504p.
3. Practical endocrinology / ed. G.A.Melnichenko. Moscow: Practical Medicine, 2009. - 352p.
4. Clinical guidelines of the Russian Association of Endocrinologists for the treatment of autoimmune thyroiditis in adults. Comp. Dedov I.I., Melnichenko G.A., Gerasimov G.A., Fadeev V.V., Petunina N.A., Aleksandrova G.F., Troshina E.A., Kuznetsov N.S., Vanushko V. E.
5. Endocrine regulation. Biochemical and physiological aspects: textbook / Ed. V.A. Tkachuk - M. : GEOTAR-Media, 2009
6. Sandra M. McLachlan, Basil Rapoport. Breaking Tolerance to Thyroid Antigens: Changing Concepts in Thyroid Autoimmunity. Endocr Rev. February 2014; 35(1): 59–105
7. Anthony P Weetman. The Immunopathogenesis of Chronic Autoimmune Thyroiditis One Century after Hashimoto. Eur Thyroid J. 2013 Jan; 1(4): 243–250
8. Patrizio Caturegli, Alessandra De Remigis, Kelly Chuang, Marieme Dembele, Akiko Iwama, Shintaro Iwama. Hashimoto's Thyroiditis: Celebrating the Centennial Through the Lens of the Johns Hopkins Hospital Surgical Pathology Records. Thyroid. 2013 Feb; 23(2): 142–150
9. Susan Hutfless, Peter Matos, Monica V. Talor, Patrizio Caturegli, Noel R. Rose. Significance of Prediagnostic Thyroid Antibodies in Women with Autoimmune Thyroid Disease. J Clin Endocrinol Metab. 2011 Sep; 96(9): E1466–E1471
10. Noel R. Rose. The Genetics of Autoimmune Thyroiditis: the first decade. J Autoimmun. 2011 Sep; 37(2): 88–94

What is AIT with thyroid damage and how dangerous is this disease? This is an inflammatory process that has. This disease has another name - thyroiditis or Hashimoto's goiter. This pathology accounts for 30% of all diagnosed disorders occurring in the thyroid gland. This disease occurs in approximately 3-4% of the total population. Only 1% have pronounced symptoms. This type of pathology is more often diagnosed in women than in men (approximately 4-8 times). Also, AIT of the thyroid gland develops with a much greater frequency in people who are over 60 years old. The number of sick children is insignificant - less than 1%.

Autoimmune thyroid disease develops against a background of a genetic defect, which is most often inherited from parents to children, and leads to improper functioning of the immune system.

In a healthy person, it is fully capable of distinguishing foreign cells from its own. The protective function of the body is based on the destruction of pathogenic microorganisms. With AIT and other diseases of an autoimmune nature, a person's immunity begins to fight with its own cells, producing special antibodies. Against the background of such a negative process, the thyroid gland is damaged with its partial destruction. This provokes, which is accompanied by a lack of certain hormones.

Despite the genetic predisposition, the rapid development of this disease is observed after exposure to certain factors:

stress, severe emotional stress, chronic fatigue;
the use of hormone replacement therapy for gynecological diseases, during the IVF procedure and in other cases;
lack of iodine or excess of the recommended dosage when consuming it. When using iodine-containing drugs in any form (tablets, antiseptic solutions, and others), accumulation of the main active substance in the thyroid gland is observed. Iodine is thyroglobulin. If there is too much of it, the processes of irritation of the immune system take place more actively, which secretes antibodies in response;

uncontrolled use of antiviral drugs (amiksin, interferon and others). They are prescribed with great care in the presence of hepatitis, multiple sclerosis, and chemotherapy. The use of these drugs for prophylactic purposes can lead to the launch of an autoimmune process;
the transfer of acute viral diseases, the presence of chronic foci of infection in the body (in the sinuses, tonsils, carious teeth, and others);
unfavorable ecological situation;
the use of water and food products that contain a large amount of fluorine, chlorine and other substances;
radiation exposure.

Forms of the disease

Aitis of the thyroid gland - what is it, what forms of this disease can develop in humans? This pathological condition is usually divided into several varieties:

or lymphomatous thyroiditis. It develops against the background of the production of antibodies and T-lymphocytes to the cells of the thyroid gland by the immune system. have genetic causes of occurrence, are often accompanied by diabetes mellitus;
postpartum thyroiditis. A fairly common autoimmune disease of the thyroid gland, which develops due to the enormous stress on the body of a woman during pregnancy and childbirth. Often also appears in the presence of a genetic predisposition;
painless or silent thyroiditis. The causes of this disease have not been fully identified;
cytokine-induced thyroiditis. It develops in patients with hepatitis who are treated with drugs containing interferon.

Classification of the disease according to the degree of damage to the thyroid gland

Autoimmune thyroiditis is divided into several forms depending on the degree of damage to the thyroid gland:

latent form. It is characterized by the absence of clinical manifestations, but there are certain immunological disorders. In most cases, the thyroid gland is normal or slightly enlarged. There are no formations or seals. The work of the thyroid gland and the amount of hormones produced are normal;
the hypertrophic form is accompanied by the development of goiter. During the diagnosis, there is an increase in the size of the thyroid gland, a violation of its functioning. Uneven growth of the body of the organ may occur. This condition is defined as the type of AIT. If present, they talk about the nodular form of the disease. There are also cases when one patient has a combination of several subspecies of the same disease;
atrophic form. The first sign is a sharp reduction in hormones produced. This form is most common in the elderly. At a young age, the development of this disease is possible only with radioactive radiation.

Symptoms

AIT of the thyroid gland is accompanied by the following symptoms:

drowsiness, fatigue, depressive states, impaired intellectual function;
development of negative changes in the thyroid gland. It has uncharacteristic dimensions, structure, etc.;
swelling;
disorders of the cardiovascular system;
active hair loss;
pain in the joints;
menstrual disorders in women.

The diagnosis of AIT is made on the basis of the following methods of examination of the human body:

general blood analysis. An increased number of lymphocytes indicates the development of the disease;
an immunogram is performed. It determines the presence of specific antibodies to thyroglobulin, thyroperoxidase and thyroid hormones;
. The level of common and free , Т4, ;
. The presence of pathologies of an autoimmune nature may be indicated by a decrease (diffuse), heterogeneous tissue structure, impaired blood circulation in the organ, the presence of and;
. This procedure will help identify an increase in the number of lymphocytes and other changes that are characteristic of thyroiditis.

Treatment

With an autoimmune lesion of the thyroid gland, treatment cannot be aimed at eliminating the underlying cause of this disease. Immune suppression will lead to a decrease in the production of antibodies against one's own cells, and will provoke a significant decrease in the protective functions of the body. As a result, a person will be susceptible to viral, infectious diseases, which is a serious danger.

Therefore, the treatment of thyroiditis involves the use of drugs that eliminate certain symptoms. With a shortage, they resort to replacement therapy. Preparations containing synthetic analogues of thyroxine are prescribed. With the right approach to treatment, any side effects from these medications are excluded. The only drawback is that synthetic thyroxine must be taken for life to maintain optimal hormonal levels.

Glucocorticoids are also often prescribed to eliminate the inflammatory process of the thyroid gland. If a patient has a sharp increase in the number of antibodies, drugs such as Metindol, Voltaren and others are prescribed. When the disorders are rapidly progressing and conservative treatment does not work, surgery is indicated. The thyroid gland is removed, and the person takes hormones for the rest of his life.

Prevention of the disease consists in a timely visit to the doctor in the presence of any disturbing symptoms. If the fact of the development of this pathology is recorded in the family, it is necessary to constantly examine blood relatives in order to identify possible disorders in their body. In the presence of thyroiditis, a person's normal state of health persists for 15 years, after which there is a significant deterioration. This disease cannot be completely cured.

Bibliography

Henry, M. Cronenberg Diseases of the thyroid gland / Henry M. Cronenberg et al. - M .: Reed Elsiver, 2010. - 392 p.
Grekova, T. Everything you didn't know about the thyroid gland / T. Grekova, N. Meshcheryakova. - M.: Tsentrpoligraf, 2014. - 254 p.
Danilova, N.A. Diseases of the thyroid gland. Effective methods of treatment and prevention / N.A. Danilova. - M.: Vector, 2012. - 160 p.
Dreval, A.V. Diseases of the thyroid gland and pregnancy / A.V. Dreval, T.P. Shestakova, O.A. Nechaev. - L.: Medicine, 2007. - 625 p.
Thyroid diseases in women of reproductive age. Guide for doctors. - M.: GEOTAR-Media, 2013. - 487 p.

⚕️ Olga Alexandrovna Melikhova - endocrinologist, 2 years of experience.

Deals with issues of prevention, diagnosis and treatment of diseases of the endocrine system: thyroid gland, pancreas, adrenal glands, pituitary gland, gonads, parathyroid glands, thymus gland, etc.

In medicine, there is a whole group of diseases, the occurrence of which is associated with a violation of the immune system. In this case, the body, for unknown reasons, begins to attack its own organs, damaging cells and tissues. These are autoimmune diseases. Treatment of autoimmune thyroiditis, like other autoimmune diseases, is based on immunosuppression and hormone therapy. Autoimmune thyroid disease, autoimmune thyroiditis (AIT), is one of the most common autoimmune diseases.

Symptoms of autoimmune thyroiditis can be different, sometimes it is manifested by a feeling of a lump in the throat, impaired swallowing, weakness, fatigue, dry skin. Diagnosis is generally easy. Ultrasound helps, the detection of abnormalities in the blood of thyroid hormones and the appearance of specific antibodies.

Treatment of autoimmune thyroiditis is the appointment of hormonal therapy. And no one - neither doctors nor psychologists - can explain the causes of the development of the disease. Why did the body suddenly take up arms against some type of cell? Why does the immune system, whose function is to resist harmful external factors, become a punisher for native organs? Specific cell-fighters - lymphocytes, created to suppress the infection and cleanse the organs of damaged cells, turn into aggressors, as if they were zombified and turned to the enemy side.

Postpartum. It occurs more often than other forms. It occurs against the background of excessive stress on the female body during the period of bearing a child. A provoking factor is also hereditary predisposition. Often the postpartum form progresses to a destructive one;
Painless or silent. This type of disease is characterized by a course similar to the previous one, but the exact causes of occurrence have not yet been established;
Cytokine-induced develops against the background of hepatitis C and blood diseases in the treatment with interferon;
Autoimmune thyroiditis of the thyroid gland (Hashimoto's disease, or lymphatic) develops against the background of a sudden increase in the level of T-lymphocytes and antibodies that destroy gland cells. As a result, the latter produces a smaller amount of hormones necessary for the normal functioning of the body. A drop in the level of thyroid hormones in medicine is called hypothyroidism. It should be noted that the violation has a pronounced genetic form. As a rule, close relatives have diabetes and varying degrees of thyroid damage.

Also in medicine, the disease is classified according to clinical manifestations and changes in the size of the organ of the endocrine system.

There are three forms of it:

Atrophic - the size of the thyroid gland is normal or slightly reduced, the amount of hormones produced is greatly reduced. A similar clinical picture is typical for elderly patients, as well as for young people in the case of radioactive exposure;
Hypertrophic - the functions of the organ are impaired, the dimensions are increased to such an extent that a goiter is formed. When the increase in the size of the thyroid is equal throughout the volume, a diffuse form is noted. If nodes form in the body of the gland (uneven increase), the nodal form is diagnosed, respectively. Sometimes both of these forms occur at once;
Latent - the complete absence of clinical symptoms, but immunological signs are observed. The organ has a standard size or is slightly enlarged. No seals are observed, all functions are preserved.

Causes

The list of causes of autoimmune thyroiditis almost completely coincides with the lists of causes of other benign thyroid diseases. According to the etiology (causes of development and course), autoimmune thyroiditis varies from an asymptomatic form to manifested in the form of hypothyroidism with a decrease in the volume of the thyroid gland - hypotrophy and hypoplasia (in some cases, the detection of antibodies to gland tissue is an accidental finding, in others it is a mandatory and expected laboratory sign ).

Asymptomatic (transient, painless) thyroiditis, misunderstood by specialists, draws attention. This is a phenomenon of unknown etiology. In addition to the unknown causes of such thyroiditis, the mechanism of its origin, course and completion is also unknown - recovery with the disappearance of the main sign of autoimmune inflammation in the blood - antibodies. What does this phenomenon indicate? First of all, the absence of aggression in a chronic autoimmune process and the temporary beneficial participation of the immune system? On reversibility and a real possibility of recovery? Or the deep secrets of nature, which still hides from inquisitive specialists the mechanism of transition to chronic autoimmune thyroiditis?

Pregnancy and childbirth can also cause autoimmune activity with an increase in the blood titer of AT-TPO and AT-TG. It is known that the postpartum period often ends with a decrease and disappearance of the excess of such antibodies.

Causal factors and conditions include any excessive load on the body. Among them are mental stress, smoking, adaptive and re-adaptive loads, cold, malnutrition, radiation effects, etc.

In an autoimmune process in the thyroid gland, the body requires a physiological amount of iodine corresponding to the magnitude of the gland's compensatory tension. The notion of iodine saturation or satiety as the cause of autoimmune thyroiditis is erroneous.

Autoimmune thyroiditis: symptoms

The symptoms of thyroiditis are most often quite blurred, and their set itself is associated with the specifics of the development of the disease.

So, it is customary to distinguish several types of thyroiditis with autoimmune etiology:

hyperplastic: characterized by increased size of the gland and the formation of goiter;
atrophic: on the contrary, it involves a strong decrease in the size of the gland and inhibition of its functions;
focal: inflammation is local in nature, can affect only one lobe of the gland, nodes are formed;
postpartum: autoimmune thyroiditis can occur during pregnancy and a few months after childbirth due to hormonal changes occurring in the body of a woman;
pain: at the heart of the clinical picture of pain in the thyroid gland, which in general is not characteristic of this disease.

The development of autoimmune thyroiditis suggests at its various stages the presence of manifestations that arise as a result of both an excess of thyroid hormones - thyrotoxicosis, and their deficiency - hypothyroidism.

Thyrotoxicosis, or excessive levels of hormones, is observed in the early stages of the disease due to the fact that thyroid cells are destroyed and thyroid hormones enter the patient's bloodstream, as well as due to the compensatory activity of the pituitary gland, which provokes the gland to produce more hormones.

Symptoms of thyrotoxicosis are symptoms from a variety of body systems:

cardiovascular: manifested in a rapid heart rate (even with slight physical exertion), shortness of breath, heart rhythm failures (arrhythmias), often during sleep, with a certain body position; there may also be a feeling of heat ("blush" in the face and neck), sweating, skin moisture;
nervous system: for example, trembling and cramps of the fingers and eyelids can be observed; deviations in the patient's behavior (irritability, tearfulness, mood swings, panic attacks, insomnia);
disruption of metabolic processes caused by an increase in the amount of thyroid hormones, which tend to speed up the metabolic process, so there may be an increased feeling of hunger, weight loss with good appetite;
increased fragility of nails and hair (hair can also split and fall out);
frequent unformed stools are possible, in women - menstrual cycle failures;
vision: decreased vision is possible, as well as protrusion of the eyeballs (bulging eyes), which is characteristic of an excess of thyroid hormones.

In the case of hyperplasia of the thyroid gland, it is possible to increase it to the point that it will be noticeable to the naked eye.

The further development of thyroiditis involves the gradual destruction of the tissues of the thyroid gland and, as a result, a decrease in its function and hormone deficiency - a condition that is commonly called hypothyroidism. Many symptoms of hypothyroidism are caused by a slowdown in metabolic processes in the body.

The relatively specific manifestations of hypothyroidism include:

weight gain against the background of a decreased metabolism;
specific swelling and puffiness of the face;
decreased elasticity of joints and tendons;
cold intolerance, constant chilliness;
hoarseness of voice;
dryness and pallor of the skin, the skin on the palms and elbows may become rougher;
apathy, forgetfulness, distraction.

It should be borne in mind that the described symptoms themselves are nonspecific and may not be an indicator of the presence of thyroiditis, which can only be established with the help of special diagnostics.

Diagnostics

Before the onset of hypothyroidism, it is quite difficult to diagnose AIT. Endocrinologists establish the diagnosis of autoimmune thyroiditis according to the clinical picture, laboratory data. The presence of autoimmune disorders in other family members confirms the likelihood of autoimmune thyroiditis.

Laboratory studies for autoimmune thyroiditis include:

complete blood count - an increase in the number of lymphocytes is determined
immunogram - characterized by the presence of antibodies to thyroglobulin, thyroperoxidase, the second colloid antigen, antibodies to thyroid hormones of the thyroid gland
determination of T3 and T4 (total and free), serum TSH levels. An increase in the level of TSH with a normal content of T4 indicates subclinical hypothyroidism, an elevated level of TSH with a reduced concentration of T4 indicates clinical hypothyroidism
Ultrasound of the thyroid gland - shows an increase or decrease in the size of the gland, a change in structure. The results of this study complement the clinical picture and other laboratory findings.
fine-needle biopsy of the thyroid gland - allows you to identify a large number of lymphocytes and other cells characteristic of autoimmune thyroiditis. It is used in the presence of evidence of a possible malignant degeneration of a nodular formation of the thyroid gland.

Criteria for the diagnosis of autoimmune thyroiditis are:

increased levels of circulating antibodies to the thyroid gland (AT-TPO);
ultrasound detection of hypoechogenicity of the thyroid gland;
signs of primary hypothyroidism.

In the absence of at least one of these criteria, the diagnosis of autoimmune thyroiditis is only probabilistic. Since an increase in the level of AT-TPO, or a hypoechoic thyroid gland, by itself does not yet prove autoimmune thyroiditis, this does not allow an accurate diagnosis. Treatment is indicated for the patient only in the hypothyroid phase, so there is usually no urgent need for a diagnosis in the euthyroid phase.

Autoimmune thyroiditis - treatment

We have to admit that there is no single protocol for the treatment of autoimmune thyroiditis in conventional medicine. The generally accepted strategy for managing a patient is considered to be careful monitoring of well-being, regular laboratory tests and ultrasound of the thyroid gland. In addition, depending on the patient's condition, the doctor may choose one of the following strategies:

At the initial stage of the disease (when the thyroid gland is still hyperactive), hormone replacement therapy is possible. Unfortunately, it is very likely that the patient will be forced to take them for life. Naturally, this cannot but affect the state of the body as a whole, since long-term use of any hormones is accompanied by numerous side effects. In addition, such treatment is exclusively symptomatic: it normalizes the functioning of the damaged thyroid gland, but does not affect the activity of the immune system in any way - that is, it does not affect the cause of the disease.

A milder version of the drug treatment of autoimmune thyroiditis is phytotherapy. Often it is prescribed simultaneously with hormonal. Also, depending on the nature of the disease, additional medications may be prescribed: glucocorticoids, beta-blockers, anti-inflammatory, vitamins.

In the later stages of Hashimoto's disease, surgery is sometimes used - namely, the thyroid gland is removed. But this method is used only when the thyroid gland is greatly enlarged due to illness. As with hormone replacement therapy, this treatment does not have a positive effect on the immune system. On the contrary: after the operation, the autoimmune process usually becomes even more active. In addition, it is worth noting that the removal of the thyroid gland leads to a lifelong deficiency of thyroid hormones - that is, the patient is likely to suffer from hypothyroidism all his life.

As a replacement for the radical methods of treating Hashimoto's disease described above, alternative methods, such as reflexology, can also be used. It can be traditional acupuncture, acupuncture, modern computer reflexology (impact with ultra-low currents). In principle, such treatment can be indicated at any stage of the disease. But, probably, few doctors will take the responsibility to advise a patient with severe negative symptoms to abandon classical methods of treatment in favor of an alternative one. In addition, reflexology sessions can be unpleasant (particularly for children).

Folk remedies for the treatment of autoimmune thyroiditis

Home remedies to eliminate the disease are very effective and, if used in a timely manner, can completely solve the problem. In order to achieve the desired result, it is necessary to strictly follow the recommendations for the use of the drug and not change its dosage and duration of therapy.

A tincture made from the roots of white cinquefoil is an excellent remedy for restoring thyroid health. To obtain a medicinal product, you need to take 40 grams of a well-chopped root and pour 2 glasses of very high-quality vodka. After that, the dishes with the drug must be placed in the dark for infusion for 14 days. During this period, the medicine is shaken every other day. After the infusion time has passed, the composition is filtered and taken 30 drops, diluted in 2 tablespoons of milk, 3 times a day 20 minutes before meals. The course of such treatment lasts 30 days, after which a break of 1 week is required and the course is repeated. After 2 months of treatment, the symptoms of the disease completely disappear.

Wearing raw amber beads that fit snugly around the neck, according to traditional healers, can help cope with autoimmune thyroiditis. There is no medical evidence of the effectiveness of this therapy, but it certainly will not cause harm.

Walnut tincture with honey also helps restore thyroid health. In order to cope with the disease, you need to take 30 green nuts and, cut into 4 parts, fall asleep in a glass jar. After that, they are poured with 1 liter of vodka and added to the composition of 200 g of very high quality flower honey. Having mixed the medicine well, it is closed with a tight lid and set to infuse for half a month in the dark. After this time, the drug is filtered and taken in the morning, 1 tablespoon 30 minutes before breakfast. One serving of the drug is designed for 1 course of treatment. For healing, you should take at least 3 courses with a break of 10 days.

Lemongrass allows you to restore the normal functioning of the immune system and eliminate autoimmune thyroiditis. To get the medicine, you need to take 2 tablespoons of heavily crushed leaves of the plant and pour them with 100 ml of alcohol with a strength of 70%. Infuse the remedy for 2 weeks in a dark place, shaking 4 times a day. After straining, the composition is taken 1 hour before breakfast and lunch, 25 drops dissolved in a small amount of water. The duration of therapy, depending on the severity of the disease, can take from 1 week to 1 month. Do not use the drug in the afternoon, as this can lead to insomnia.

Cocklebur is also a natural remedy for thyroid diseases. To obtain an effective remedy, you need to take 1 tablespoon of herbs and pour 500 ml of boiling water. After that, the medicine is put on fire and, bringing to a boil, boil for 5 minutes. Immediately after removing from heat, the composition is poured into a thermos and insisted for 4 hours. Then the medicine is filtered and drunk during the day, divided into several portions. The duration of treatment is selected for each patient individually.

Ginger perfectly supports the thyroid gland and restores its health. In order to achieve the desired result, you should eat 1 teaspoon of ginger powder in the morning and evening and drink 1 glass of milk. The duration of treatment is 1 month. A second course can be taken in six months.

Juices from vegetables are also great help in the fight against thyroiditis. In order to prepare a medicinal cocktail, you need to mix 150 ml of only squeezed carrot juice with 50 ml of celery juice and 50 ml of beetroot juice. After that, 25 ml of linseed oil is added to the drink. Take the medicine 1 glass 2 times a day for 2 months. The therapy can be repeated after a break of 14 days.

Cabbage and lemon juice also help well. In order to carry out such a treatment, it is necessary to combine 120 ml of only squeezed cabbage juice with 2 teaspoons of lemon juice. This medicine is taken in the morning and evening for 3 months. If necessary, you can repeat the course after a 30-day break.

Prevention methods

When identifying high risks of developing autoimmune thyroiditis, it is worth taking a significant place in life for the prevention of this disease. First of all, people who are at risk need constant monitoring of the endocrinological profile. Patients with a predisposition or identified initial form should undergo an annual examination. It is recommended to conduct an ultrasound of the thyroid gland, donate blood for the presence of special markers. A more detailed course of prevention can be prescribed by the attending physician.

It is believed that with this disease and a predisposition to the development of such an ailment, a special diet can be effective. Although, it is worth emphasizing that in these cases, it is rather not a diet that is considered, but a special principle of nutrition. Most importantly, a vitamin and mineral balance is needed. It is important to provide the body with a sufficient content of vitamins A, D, E, B. Particular attention should be paid to the consumption of iodine-containing foods and food components that include magnesium. In this case, the iodine rate must be agreed with the attending endocrinologist. In some situations, iodine intake should be kept to a minimum. It is believed that the occurrence of goiter can provoke soy products and millet. To select a basic diet, you should consult a dietitian.

Prognosis, possible complications

If the treatment of autoimmune thyroiditis is started in a timely manner, the prognosis is considered favorable. Both drug therapy and surgical methods of treatment can restore the functionality of the thyroid gland, normalize the hormonal background.

Even in the most advanced cases, it is possible to extend the remission period up to 10-15 years. However, during this period, all doctor's prescriptions must be strictly observed, since there is a risk of exacerbations. To do this, you need to periodically take hormonal drugs, eat right and lead a healthy lifestyle. Otherwise, complications develop.

The greatest likelihood of recurrence of autoimmune thyroiditis exists in the postpartum form of the disease. In almost 60-70% of all cases, the pathology occurs again with the onset of another pregnancy.

Possible complications:

arrhythmia and tachycardia;
heart failure;
strokes and myocardial infarction;
infertility;
inability to bear a child;
atherosclerosis and dementia;
chronic depression;
cold intolerance;
drowsiness in a chronic form;
hypothyroid coma and crisis.

For the full functioning of the organs of the cardiovascular, reproductive and nervous systems, hormones produced by the thyroid gland are necessary. But due to circumstances, the immune system, designed to carry the protective function of the body, begins to destroy its cells, reacting as if they were foreign formations. The tissues are oversaturated with leukocytes, the inflammatory process begins -.

The reasons

Autoimmune thyroiditis is a very common disease in endocrinology. The duplicate name of AIT is, by the name of the scientist who first described its symptoms.

If autoimmune diseases of the thyroid gland are not detected in a timely manner and measures are not taken to eliminate the causes, necrosis begins in the affected cells. Dead cells cannot produce hormones and their level drops sharply. The body reacts to a level that does not meet physiological standards, a violation of the reproductive system, arrhythmia, hormonal renal failure.

Autoimmune thyroiditis is classified as a chronic disease. Women who have reached the age of forty are more susceptible to it. In men, according to the type of AIT, they are less common. Scientists in this field have come to the consensus that there is no human fault in the development of thyroid pathology. The disease can develop due to a number of factors:

Due to the genetic predisposition of a person.
If there are chronic foci of infection in the body, the process of autoimmune thyroiditis can trigger otitis media, tonsillitis, and pharyngitis. Viral infections such as influenza or coxsackievirus.
The cause may be caries.
The impetus for the manifestation of AIT will be prolonged or sudden stress.
The level of intake of iodine or fluorine in the body is exceeded or, conversely, insufficient.
Individual intolerance to glutin or casein.
Intestinal disorders can lead to autoimmune malfunction of the thyroid gland.

The reason for the appearance of autoimmune thyroiditis in the thyroid gland can be the poor ecology of the place where the patient lives, a long stay under the influence of ultraviolet radiation. Increased background radiation. And also the uncontrolled intake of hormonal and antiviral drugs can contribute to the emergence of AIT.

Disease classification

Depending on the course of the disease, several groups of AIT are distinguished, they are characterized by types, phases and forms.

Kinds

Autoimmune thyroid diseases are divided into several types:

postpartum thyroiditis manifests itself in the postpartum period, the process of bearing a fetus weakens the immune system, and after childbirth its activity increases several times. If the body has factors predisposing to the disease, AIT will certainly make itself felt;
painless thyroiditis manifests itself, as well as postpartum, the causes of occurrence are not fully understood;
cytokine-induced thyroiditis is caused by taking an interferon drug that has been used to treat hepatitis C or blood disorders;

The most common type is chronic. develop gradually. At the initial stage of AIT, primary hypothyroidism develops, it is characterized by a decrease in hormone production, then it becomes chronic and refers to genetic pathologies.

Phases

Using the example of the phases of the course of the disease, let's consider what AIT of the thyroid gland is and how it affects its size:

In the first phase of the course of the disease, it does not change and retains its normal functions. The time course of the first stage can last for years, without showing itself as pathological disorders.
The next phase is characterized by a decrease in the production of thyroid hormone and the destruction of the cells of the organ of the thyroid gland itself.
In the third phase of AIT, the hormone from the dying tissue enters the bloodstream, provoking the onset of thyrotoxicosis.
The last fourth phase, due to an insufficient amount of the hormone, is characterized by the development of hypothyroidism. With qualified treatment, tissues are restored, and hormone production is normalized.

The definitions of the phases of autoimmune thyroiditis are conditional, in each individual case the duration and sequence of the course of the disease will be different.

Forms

For the diagnosis and subsequent treatment of AIT, endocrinologists take into account the shape of the thyroid gland itself:

The latent form in autoimmune thyroiditis is practically not manifested. The thyroid gland is normal, the function of hormone production is not impaired. The patient may experience mild manifestations of hypothyroidism or thyrotoxicosis.

The hypertrophic form of AIT is characterized by an increase in the size of the organ itself (diffuse) and the formation of nodular formations on the gland (nodular). In frequent cases, a mixed form of AIT is diagnosed. At the initial stage of this form, signs of hypothyroidism or thyrotoxicosis are characteristic.

The atrophic form is characteristic of the elderly. Due to the general change in the hormonal background, the production of thyroid hormone is reduced. In this form of AIT, signs of hypothyroidism predominate.

Symptoms and diagnosis of the disease

The manifestation of AIT in the early stages can be diagnosed by a number of symptoms. The patient may complain of discomfort during the act of swallowing. . On palpation in the thyroid gland, the presence of pain.

Common symptoms that require specialist advice:

increased sweating against the background of general weakness;
pallor of the skin in the face, swelling on the eyelids;
slow movements, due to swelling of the tongue, “pulling” speech in the patient, shortness of breath;
high blood pressure;
hair loss has been reported.

Patients diagnosed with AIT often complained of dry mouth, the skin was covered with cracks localized on the elbows and knees due to a violation of the water balance. Against the background of the development of AIT in women, the menstrual cycle was disturbed, and men complained about the lack of sexual desire. In severe forms of AIT, the onset of erectile dysfunction is not excluded.

Knowing the symptoms of AIT of the thyroid gland, treatment is prescribed according to the results of the diagnosis, carried out in the following way:

A blood test for the presence of an elevated level of lymphocytes and the presence of the hormone TSH in the serum.
An immunogram is performed to determine antibodies in AIT.
For a complete clinical picture, the method makes it possible to see a change in the organ for an increase or decrease in size and a change in the structure of the tissue.
Fragments of thyroid tissue are taken for conduction in order to exclude the presence.

If, based on the results of the diagnostics, at least one of the indicators does not confirm the presence of AIT, the diagnostics continues. If the diagnosis is confirmed by all indicators, he prescribes individual treatment for each individual patient.

Treatment Methods

After examining the patient, complex treatment is prescribed if a hypofunctional state of the thyroid gland is noted. In the first stages of AIT, when the level of thyroid hormone slightly deviated from the norm, drugs are not prescribed. Patients are advised to comply.

Treatment of AIT includes two methods, it is surgical intervention and drug treatment.

Therapeutic treatment

With a low level of the hormone due to AIT, hormone replacement therapy is prescribed. It includes the drug L-thyroxine, a synthetic analogue of T4. The course of treatment is individual for each case, but on average lasts about a year.

Throughout the course of treatment, the doctor prescribes an ultrasound scan and looks at the results of a blood test. Tracking the dynamics is necessary to observe changes in the thyroid gland for the diagnosis of AIT. And the level of the hormone is monitored so that there is no overdose.

As a rule, taking a synthetic substitute for L-thyroxine solves the problem of hormone deficiency, but if the desired result is not achieved, the doctor prescribes treatment of the pathology with glucocorticoids. Specialists are reluctant to resort to this therapy, due to side pathological effects on the body.

With an increased level of T4, drugs are prescribed that inhibit its production. These include Tyrozol, Propicil and Levothyroxine. The course of treatment is carried out throughout the year, with the constant supervision of a doctor.

Surgical intervention with a diagnosis of thyroiditis is used in rare cases. If there are vital indications, an enlarged thyroid gland makes it difficult to swallow or presses on the trachea.

Knowing what it is AIT of the thyroid gland and with timely diagnosis, you can easily get rid of the disease without consequences.

Chronic autoimmune thyroiditis (CHAIT, AIT, lymphomatous thyroiditis, obsolete - Hashimoto's disease) - all these are the names of one pathology, namely: chronic inflammation of the thyroid gland, which is based on autoimmune processes.

With it, antibodies to the cells of one's own thyroid gland begin to circulate in the blood and damage them. Immunity fails and he begins to take his proteins for foreign ones.

Among thyroid pathologies, chronic autoimmune thyroiditis occupies a leading position among thyroid pathologies - 35%; and the thyroid lesions themselves come in terms of prevalence immediately after SD.

AIT of the thyroid gland is present in 3-4% of the world's population. In general, endocrine pathologies are in the 2nd place in terms of frequency of occurrence after CVD.

AIT of the thyroid gland occurs more in women - 10-20 times. The peak of cases falls on the age of 40-50 years. When thyroiditis appears in babies, the intellect definitely suffers - it begins to lag behind. In recent years, there has been a trend towards rejuvenation of this pathology.

Causes of AIT

Chronic autoimmune thyroiditis (lymphomatous thyroiditis) always has only a hereditary nature. Often it is accompanied by additional autoimmune pathologies: diabetes, lupus erythematosus, rheumatism, DTG, myasthenia gravis, Sjögren's syndrome, vitiligo, collagenoses, etc. But to get sick, one heredity is not enough; it needs to work. Then provoking factors, which are called triggers, come to the rescue.

The most significant of them is chronic infections of the upper respiratory tract. Next come carious teeth; infections (flu, mumps, measles); uncontrolled intake of iodine-containing drugs, hormones; the effect of radiation, dangerous in any doses; poor ecology with excess fluorine and chlorine in the environment; lack of selenium and zinc; insolation; psychotrauma and stress.

With poor genetics, such patients have a tendency to acquire thyroiditis from birth. They have a defect in the genes encoding the activity of the immune system. This is bad because it complicates the treatment; facilitates the task of prevention.

Bad ecology - gives increased access to the body of various toxins, pesticides, and the thyroid gland becomes the first on their way. Therefore, in any hazardous production, do not forget about the protection and observance of safety regulations.

Negative effects of drugs. These include recently interferons, iodine, lithium, hormones, estrogens.

When treated with interferons, cytokines enter the blood massively, which literally bombard the thyroid gland, disrupting its work and causing inflammation with a picture of chronic thyroiditis.

Pathogenesis

The process of development of autoimmunization is very complex and multifaceted. For a general idea, it happens like this: any cells of the body - both microbial and "native" - are always obliged to "introduce themselves".

To do this, something like a signal flag is put on their surface - this is a special specific protein. This protein or protein has been called "antigens", to eliminate which, if foreign, the immune system produces antibodies that destroy them.

The ENT organs, together with the thyroid gland, have one common drain - the lymphatic system, which takes in all the toxins and pathogens. Lymphatic vessels permeate the entire gland, as well as blood vessels, and when the incoming pathogens merge into the lymph, they constantly mark the thyroid gland as infected. And immune cells approach any cell every second and check it for danger by their antigens. They receive a “list” of antigens during the period of gestation by the mother.

Interestingly, some organs do not normally have such permitted antigens. Such organs are surrounded by a cellular barrier that does not allow lymphocytes to pass through for inspection.

SCZ is just one of those. When this barrier is broken due to markings, chronic autoimmune thyroiditis appears. Moreover, in such patients, a violation of genes occurs in terms of setting increased aggressiveness to lymphocytes. Those. lymphocytes are of poor quality. Therefore, the immune system fails and zealously rushes to protect the body from, as it believes, impostor glands, and sends its killers to it. And they are already destroying all the cells in a row - their own and others. From damaged cells, all their contents enter the blood: organelles are the destroyed parts of internal components, hormones. This leads to an even greater creation of antibodies to thyrocytes. There is a vicious circle, the process becomes cyclical. This is how autoimmune processes occur.

Why does it happen more in women? Their estrogens directly affect the immune system, but testosterone does not.

Disease classification

HAIT or Hashimoto's disease. It is often referred to simply as AIT, as a classic example of thyroiditis; his course is good. Chronic autoimmune thyroiditis (Hashimoto's disease or thyroiditis) is also called lymphomatous goiter, because it causes swelling of the gland due to its inflammation.
Postpartum thyroiditis- develops 1.5 months after childbirth, when the thyroid gland becomes inflamed due to increased reactivity of the immune system. This is because during gestation, the thyroid gland was suppressed in order to preserve the fetus, which, in fact, is foreign to the body of the pregnant woman. At the end of childbirth, the thyroid gland may overreact - this is individual. The clinic consists of manifestations of a slight hyperthyroidism: weight loss, asthenia. Sometimes there may be a feeling of heat, tachycardia, mood swings, insomnia, hand tremors. But gradually, over 4 months, these signs are replaced by hypothyroidism. It can be mistaken for postpartum depression.
Painless form- The etiology is not clear. Pathogenesis is similar to postpartum. There are also signs of mild hyperthyroidism; symptoms are attributed to overwork.
Cytokine-induced form- appears in the treatment of any pathologies with interferons. Most often this occurs during the treatment of hepatitis C to prevent its transition to cirrhosis.

Symptoms of thyroiditis of the thyroid gland can be both in the direction of hyperthyroidism and in the direction of hypofunction, but the manifestations are usually minor.

Downstream division:

The latent form is the work of the thyroid gland in N, but the volume can be slightly increased.
Hypertrophic variant - an increase in the size of the thyroid gland occurs due to several nodes or diffusely. Then thyroiditis with nodulation is diagnosed.
Atrophic appearance: hormones are less than normal, sizes are also reduced. This is hypofunction of the thyroid gland.

Stages and symptoms of AIT

All available stages smoothly pass into each other.

Euthyroid stage - lymphocytes see enemies in thyroid cells, decide to attack them. The production of antibodies begins. Thyrocytes are destroyed. If a small number of cells die, euthyroidism is maintained.

Symptoms may be disturbing due to an increase in the volume of the thyroid gland, when it can be palpated. There may be difficulty in swallowing, performance decreases when the patient quickly gets tired even of the usual activities.

Subclinical stage - symptoms may be the same. The number of destroyed cells continues to grow, but for the time being, those thyrocytes, which normally should be at rest, are included in the work. Stimulates them to this TTG.

Thyrotoxicosis - occurs with a large number of antibodies. Symptoms:

irritability, anger, fussiness;
increase in fatigue;
weakness;
tearfulness;
heat intolerance;
hyperhidrosis;
tachycardia;
diarrhea;
decreased libido;
MC violations.

Hypothyroidism - most of the cells are destroyed, the gland is reduced and the last stage of AIT begins.

Symptoms:

apathy and a tendency to lower mood;
inhibition of speech, movements and thinking;
loss of appetite and weight gain;
the skin thickens due to constant swelling, acquires a yellowish or waxy hue; it is so dense that it is impossible to fold it;
the face is pasty, inexpressive;
chronic constipation due to slow peristalsis;
chilliness;
hair loss;
fragility of nails;
hoarseness of voice;
oligomenorrhea;
arthralgia.

Impact of AIT on fertility

All stages, except for the state of hypothyroidism, do not particularly affect conception, it can occur. The exception is hypothyroidism. Infertility may develop and conception becomes impossible.

The fact is that thyroid hormones are directly related to the ovaries. When there are few thyroid hormones, the ovaries do not work well, the proper processes in the form of ovulation and maturation of the follicles do not occur.

If a woman takes this into account and is registered with an endocrinologist to receive replacement hormones, pregnancy occurs. But due to the autoimmunity of the process, antibodies will not allow the fetus to endure.

Moreover, the dose of Euthyrox in such cases does not solve anything. Doctors in such cases may prescribe Progesterone.

The control of the doctor throughout the gestation is necessary in any case. Usually the dose of thyroxine is increased by 40%, because there is a need for 2 organisms in it - the mother and the fetus.

Otherwise, the child in the womb may die or be born with congenital hypothyroidism. And this is tantamount not only to impaired metabolism, but also to congenital dementia.

Symptoms of AIT in general

Despite the variety of forms and stages of AIT, they all have one common manifestation - the presence of an inflammatory process in the thyroid gland. It always requires treatment. The onset of pathology in 90% of cases is asymptomatic.

Such a gland functions normally for a long time. The period of such a course lasts up to 2-3 years or more. Then the first calls come in.

Its early signs are unpleasant sensations in the neck, a feeling of squeezing in the throat, a lump in it; this is especially felt when wearing high collars, sweaters, etc.

Sometimes there is a slight weakness and soreness of the joints fleetingly. All symptoms are combined into 3 large groups: asthenic; hormone-forming; behavioral.

Asthenic are manifested in rapid fatigue, general weakness; lethargy appears; muscle tone is reduced. Frequent headaches and dizziness; sleep disorders. Asthenia is aggravated by increased production of hormones. There may be weight loss. Then such manifestations as palpitations, body tremors join; increased appetite.

In men, impotence develops, in women, the MC goes astray. The gland is enlarged at this time, it changes the size of the neck, which becomes thick and deformed.

Characteristic signs of behavioral disorders: the patient is often anxious, tearful, constantly fussing. In conversation, he often loses the topic of conversation, becoming verbose, but empty of content.

Chronic autoimmune thyroiditis is also different in that it does not manifest itself for a very long time. In the later stages of AIT, the clinic is similar to hypothyroidism. Symptoms are due to the inhibition of all processes in the body, from where most of the symptoms occur.

The mood often gives off a depressive tinge;

memory decreases;
difficulty concentrating and concentrating;
the patient is lethargic, drowsy or complains of fatigue;
weight is gaining steadily, at different speeds against the background of reduced appetite;
bradycardia and decrease in blood pressure;
chilliness;
weakness, despite a good fortified diet;
unable to perform the usual amount of work;
inhibited in reactions, thoughts, movements, speech;
skin lifelessly dry, yellowish, dry;
peeling of the skin; pastosity of the face;
inexpressive facial expressions; hair loss and brittle nails;
loss of libido;
chronic constipation;
oligomenorrhea or intermenstrual bleeding.

Diagnostics

In the KLA - leukopenia and an increase in lymphocytes. The hormonal profile varies depending on the stage of the pathology.
Ultrasound of the thyroid gland - a change in the size of the gland, also depends on the stage. In the presence of nodes - uneven increase.
With FAB - fine needle aspiration biopsy - an increased number of lymphocytes and cells characteristic of AIT are detected.
Rarely, lymphomas can occur.
AIT is most often a benign process. Periodically, it gives exacerbations that can be kept under control by a doctor.
HRT becomes mandatory. With age, the risk of developing AIT increases.

Patients retain their working capacity for many more years - up to 15-20 years.

Complications

Consequences occur with improper or no treatment. Among them: the appearance of goiter - occurs because inflammation constantly irritates the tissues of the gland, causing swelling of its tissues. It begins to produce hormones in an increased amount and increases in volume.

With its large size, compression syndrome may occur. Deterioration of the heart - with thyroiditis, metabolism is disturbed and LDL increases.

What is LDL? These are low density lipoproteins, i.e. bad cholesterol, which always increases the load on the myocardium and affects the walls of blood vessels, which cannot but affect cardiac activity.

Deterioration in mental health. The decrease in sexual desire is the same for both sexes.

Myxedematous coma - may appear with a long course of the disease against the background of improper treatment or its sudden cancellation. This is acute thyroiditis, which requires the most urgent measures. Predispose to coma hypothermia, stress, taking sedatives.

There is an exacerbation of all symptoms of hypothyroidism under the influence of a number of factors. There is lethargy, drowsiness and weakness up to loss of consciousness. Urgent assistance and an ambulance call are required.

Congenital defects in the fetus - they usually occur in mothers with AIT with no treatment. In such children, as a rule, there is a lag in mental development, physical deformities, and congenital pathologies of the kidneys.

Therefore, when planning a child, mom should check. First of all, the state of your thyroid gland. Today, it is impossible to cure completely chronic thyroiditis of the thyroid gland, but it can be corrected with hormone replacement therapy for many years.

Treatment of HAIT

Chronic autoimmune thyroiditis (Hashimoto's thyroiditis) and its treatment does not involve special specific therapy. In the phase of thyrotoxicosis, treatment is symptomatic and thyreostatics. Mercazolil, Thiamazole, beta-blockers are prescribed.

With hypothyroidism - treatment with L-thyroxine. In the presence of coronary artery disease in elderly patients, the dose at the beginning is minimal. Hormone levels and treatment are monitored every 2 months. In the cold season (autumn and winter), AIT can worsen and turn into subacute thyroiditis, then glucocorticosteroids (most often Prednisolone) are prescribed. There are frequent cases when a potential mother suffered from euthyroidism before and during pregnancy, and with the completion of childbirth, the thyroid gland began to reduce its functions before the onset of hypothyroidism.

In any case, to influence the inflammatory process, NSAIDs are prescribed - Voltaren, Metindol, Indomethacin, Ibuprofen, Nimesil, etc. They also reduce the production of antibodies. The treatment is supplemented with vitamins, adaptogens. Reduced immunity is treated with immunocorrectors. The presence of CVD requires the appointment of adreno-blockers.

When a goiter develops as a result of hyperthyroidism and if this causes a compression syndrome, treatment is usually surgical.

Forecast

The progression of the disease is very gradual. With adequate HRT, long-term remission is achieved.

At the same time, patients retain their normal life activity for more than 15-18 years, even taking into account exacerbations. They are usually short-term, may be associated with hypothermia in the cold season against the background of provoking moments.

Prevention

There is no special prophylaxis, but mass iodine prophylaxis is carried out in endemic areas with iodine deficiency. In addition, timely prescription of therapy for chronic infections of the nasopharynx is required, sanitation of the oral cavity and hardening of the body are carried out.