Chronic autoimmune thyroiditis. Ultrasound signs of AIT of the thyroid gland: how the disease is visualized on examination Chronic AIT what

The thyroid gland is one of the most susceptible organs to aggressive environmental influences. In addition, the internal processes of the body sometimes have a not very favorable effect on the thyroid gland. In this regard, thyroid diseases are often encountered, which can pose a direct threat to human life. These diseases include AIT of the thyroid gland (autoimmune thyroiditis).

AIT

Autoimmune thyroiditis is a disease in which the thyroid gland is covered by an inflammatory process. The occurrence of this pathology is affected by failures in the immune system, the result of which is that the body's own immunity begins to destroy thyroid cells.

AIT is a fairly common pathology. It most often occurs:

• in women 45-60 years old - this is due to the harmful effect of estrogen on the cells of the lymphoid system and X-chromosomal abnormalities;
• much rarer cases of detection;
• after artificial termination of pregnancy and natural childbirth;
• in women during menopause;
• in adolescence.

In cases where the lesion of the gland is not too large, the disease can be asymptomatic for a long time. If the body gives a powerful immune response, then the destruction of the follicles begins and everything becomes obvious. The organ is growing rapidly, this is due to the sedimentation of lymphocytes at the site of damaged structures of the gland. This entails malfunctions in the thyroid gland: hormonal disorders appear.

The reasons

The onset and development of the disease is influenced by a number of factors, including:

• frequent stay in a state of stress and general emotional overstrain;
• excessive concentration of iodine in the body, or, conversely, a deficiency of this element;
• the presence of any diseases of the endocrine system;
• unauthorized and incorrect intake of antiviral drugs;
• the harmful effects of an unfavorable environment;
• lack of proper nutrition;
• susceptibility to radiation exposure;
• severe infectious or viral diseases;
• hereditary predisposition. This factor has an impact in 25-30% of all cases.

From this we can conclude that the development of AIT can provoke any damage to the thyroid gland, due to which thyroid antigens enter the bloodstream.

Classification

1. Chronic AIT - the occurrence of this form is just affected by heredity. The development of this form of the disease is always preceded by a decrease in hormone production - hypothyroidism.
2. Postpartum autoimmune thyroiditis is often found due to a decrease in the immunity of a woman during the period of bearing a child and its sharp activation after childbirth. During this increased functioning of the immune system, antibodies can be produced in excess. Because of this, the destruction of organ cells will occur. Especially careful after childbirth, you need to be a woman who has poor heredity in this regard.
3. Cytokine-induced AIT develops as a result of taking medications based on interferon, as well as drugs used in the treatment of hepatitis C and diseases of the hematopoietic system.
4. Painless autoimmune thyroiditis still has no established cause.

In addition to the main classification, this disease has forms:

1. The hypertrophic form of thyroiditis is characterized by a significant increase in the size of the thyroid gland. The clinical picture at the same time has a certain similarity with the symptoms of hyperthyroidism.
2. The atrophic form is a decrease in the synthesis of thyroid hormones. The size of the gland in this case will not correspond to the norm - there is a gradual decrease in it.

However, despite the form, severity and nature of thyroiditis, the thyroid gland continues to perform its functions. Her work can be classified as follows:

1. Hypothyroid type of work, when the production of hormones in the body is significantly reduced.
2. The euthyroid type is characterized by a stable hormonal background.
3. Hyperthyroid - this type is characterized by increased production of hormones.

Symptoms

The initial stage of the disease can be completely asymptomatic. For this reason, it is very difficult to diagnose in the early stages.

It is easier to determine AIT after the thyrotoxic phase, which can last from three months to six months. Therefore, towards the end of this period, the patient feels the following changes:

• a steady increase in body temperature, not exceeding 37.5 degrees. A higher increase indicates the rapid development of the disease;
• frequent mood swings;
• excessively strong heart contractions;
• trembling in the body;
• severe sweating;
• soreness in the joints and insomnia - the result of these manifestations is general weakness.

During the progression of autoimmune thyroiditis, the symptoms worsen and become even more pronounced:

• severe swelling of the face, yellowness of the skin;
• clouding of consciousness, poor concentration of attention, periodic or constant depression, inhibition of reactions, mimic disorders;
• dryness and peeling of the skin, deterioration in the quality of nails and hair;
• deterioration or complete loss of appetite;
• weight gain - either a sharp jump or a gradual stable increase;
• painful menstruation, decreased libido, infertility. Many patients are concerned about the question - is it possible to get pregnant with autoimmune thyroiditis. In the event that the disease has gone too far and infertility has developed, conception becomes impossible;
• decreased heart rate, risk of developing heart failure;
• decrease in body temperature, chills;
• hoarseness of voice, hearing disorders;
• increase or decrease in the size of the thyroid gland;
• discomfort in the neck, especially during a night's sleep.

Diagnostics

For an accurate diagnosis and subsequent selection of treatment, it is very important to consult a doctor at the first disturbing symptoms.

He will collect the patient's family history, conduct a visual examination with palpation of the thyroid gland, prescribe additional research methods and indicate which tests to take. There are certain criteria that the doctor focuses on when making a diagnosis:

1. Increases in the size of the thyroid gland more than 18 mm and 25 mm in women and men, respectively.
2. The appearance of antibodies and their high titer to thyroid hormones.
3. Finding the level of hormones T3 and T4 outside the normal range (moreover, both below the normal range and above).

What tests to take if you suspect a disease

Diagnostic measures to identify AIT include:

1. A complete blood count is performed to determine the level of lymphocytes.
2. Immunogram - to detect the presence of antibodies to thyroid hormones.
3. Blood test for T3, T4, TSH. According to their concentration and ratio, the doctor determines the degree and stage of the disease.
4. one of the most important diagnostic methods, with its help you can determine the size of the organ and how far the changes in its structure have gone.
5. A fine-needle biopsy can accurately determine the presence of lymphocytes. As a rule, this study is indicated in cases of suspected degeneration of benign nodular formations into malignant ones. The most dangerous thing is when tumors form in the tissues.
6. Scintigraphy is a highly informative method that allows you to obtain a two-dimensional image of the affected organ by introducing radioactive isotopes into the body.

Based on the totality of the data, the doctor will determine the echo structure of the gland, its shape and size, the ratio of the shares of the thyroid gland and the shape of its isthmus.

Treatment

Measures for the treatment of autoimmune thyroiditis are possible only with the onset of hypothyroidism - the last stage of the disease. The most used drugs are preparations based on levothyroxine. Their distinguishing feature is that they contain an active ingredient that is as close as possible in composition to the T4 hormone.

The main advantages of such drugs are that they have no contraindications even during pregnancy, breastfeeding, have no side effects and do not contribute to weight gain.

These funds should not be taken in conjunction with other medicines., they are always taken exclusively on an empty stomach 30 minutes before meals and washed down with plenty of water. All other drugs can be taken no earlier than 4 hours after taking levothyroxine.

The best means of this group are Euthyrox and L-thyroxine. Despite the existing analogues, these two drugs will be the best option. Their action will be the longest. Switching to analogues will require consultation with a doctor to adjust the dosage and take blood tests every 2-3 months for TSH levels.

Nutrition for AIT

Proper nutrition is the key to a quick and successful recovery. The menu for the week should be designed in such a way that it must include:

• a sufficient amount of fermented milk products, this is very important for the normalization of the intestines;
• Coconut oil;
• a large number of fresh vegetables and fruits;
• lean meat and broths from it;
• any fish, seafood, seaweed;
• germinated cereals.

All of the above products have a positive effect on both the thyroid gland itself and the functioning of the immune system as a whole.

The following products should be banned: fast food, sweets (especially chocolate), flour products and bread, cereals.

If there is an excess of iodine in the body, foods with a high content of it are excluded from the diet.

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

1. 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.
2. 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.
3. Painless form- The etiology is not clear. Pathogenesis is similar to postpartum. There are also signs of mild hyperthyroidism; symptoms are attributed to overwork.
4. 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:

1. The latent form is the work of the thyroid gland in N, but the volume can be slightly increased.
2. Hypertrophic variant - an increase in the size of the thyroid gland occurs due to several nodes or diffusely. Then thyroiditis with nodulation is diagnosed.
3. 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

1. In the KLA - leukopenia and an increase in lymphocytes. The hormonal profile varies depending on the stage of the pathology.
2. 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.
3. With FAB - fine needle aspiration biopsy - an increased number of lymphocytes and cells characteristic of AIT are detected.
4. Rarely, lymphomas can occur.
5. AIT is most often a benign process. Periodically, it gives exacerbations that can be kept under control by a doctor.
6. 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.

Autoimmune thyroiditis (AIT)- chronic inflammation of the thyroid tissue, which has an autoimmune genesis and is associated with damage and destruction of the follicles and follicular cells of the gland. In typical cases, autoimmune thyroiditis has an asymptomatic course, only occasionally accompanied by an enlarged thyroid gland. Diagnosis of autoimmune thyroiditis is carried out taking into account the results of clinical tests, ultrasound of the thyroid gland, data from histological examination of the material obtained as a result of a fine needle biopsy. Treatment of autoimmune thyroiditis is carried out by endocrinologists. It consists in correcting the hormone-producing function of the thyroid gland and suppressing autoimmune processes.

ICD-10

E06.3

General information

Autoimmune thyroiditis (AIT)- chronic inflammation of the thyroid tissue, which has an autoimmune genesis and is associated with damage and destruction of the follicles and follicular cells of the gland. Autoimmune thyroiditis accounts for 20-30% of all thyroid diseases. Among women, AIT occurs 15-20 times more often than among men, which is associated with a violation of the X chromosome and with the effect of estrogens on the lymphoid system. Patients with autoimmune thyroiditis are usually in their 40s and 50s, although more recently the disease has been seen in young adults and children.

The reasons

Even with a hereditary predisposition, the development of autoimmune thyroiditis requires additional adverse provoking factors:

• transferred acute respiratory viral diseases;
• foci of chronic infection (on the palatine tonsils, in the sinuses of the nose, carious teeth);
• ecology, excess of iodine, chlorine and fluorine compounds in the environment, food and water (affects the activity of lymphocytes);
• prolonged uncontrolled use of drugs (iodine-containing drugs, hormonal drugs);
• radiation exposure, prolonged exposure to the sun;
• traumatic situations (illness or death of loved ones, job loss, resentment and disappointment).

Classification

Autoimmune thyroiditis includes a group of diseases that have the same nature.

• Chronic autoimmune thyroiditis(lymphomatous, lymphocytic thyroiditis, obsolete - Hashimoto's goiter) develops as a result of progressive infiltration of T-lymphocytes into the parenchyma of the gland, an increase in the number of antibodies to the cells and leads to the gradual destruction of the thyroid gland. As a result of a violation of the structure and function of the thyroid gland, the development of primary hypothyroidism (decrease in the level of thyroid hormones) is possible. Chronic AIT has a genetic nature, can manifest itself in the form of family forms, be combined with other autoimmune disorders.
• Postpartum thyroiditis most common and most studied. Its cause is excessive reactivation of the body's immune system after its natural suppression during pregnancy. With the existing predisposition, this can lead to the development of destructive autoimmune thyroiditis.
• Painless thyroiditis is an analogue of postpartum, but its occurrence is not associated with pregnancy, its causes are unknown.
• Cytokine-induced thyroiditis may occur during treatment with interferon drugs in patients with hepatitis C and blood diseases.

Such variants of autoimmune thyroiditis, such as postpartum, painless and cytokine-induced, are similar in the phase of the processes occurring in the thyroid gland. At the initial stage, destructive thyrotoxicosis develops, subsequently turning into transient hypothyroidism, in most cases ending in the restoration of thyroid function.

In all autoimmune thyroiditis, the following phases can be distinguished:

• Euthyroid phase diseases (without dysfunction of the thyroid gland). It can last for years, decades, or a lifetime.
• Subclinical phase. In the case of disease progression, mass aggression of T-lymphocytes leads to the destruction of thyroid cells and a decrease in the amount of thyroid hormones. By increasing the production of thyroid-stimulating hormone (TSH), which overstimulates the thyroid gland, the body manages to maintain normal production of T4.
• thyrotoxic phase. As a result of an increase in T-lymphocyte aggression and damage to thyroid cells, the available thyroid hormones are released into the blood and thyrotoxicosis develops. In addition, destroyed parts of the internal structures of follicular cells enter the bloodstream, which provoke further production of antibodies to thyroid cells. When, with further destruction of the thyroid gland, the number of hormone-producing cells falls below a critical level, the content of T4 in the blood decreases sharply, and the phase of apparent hypothyroidism begins.
• hypothyroid phase. It lasts about a year, after which the restoration of thyroid function usually occurs. Sometimes hypothyroidism remains persistent.

Autoimmune thyroiditis can be monophasic (have only thyrotoxic or only hypothyroid phase).

According to clinical manifestations and changes in the size of the thyroid gland, autoimmune thyroiditis is divided into forms:

• Latent(there are only immunological signs, there are no clinical symptoms). The gland is of normal size or slightly enlarged (1-2 degrees), without seals, the functions of the gland are not impaired, moderate symptoms of thyrotoxicosis or hypothyroidism can sometimes be observed.
• Hypertrophic(accompanied by an increase in the size of the thyroid gland (goiter), frequent moderate manifestations of hypothyroidism or thyrotoxicosis). There may be a uniform increase in the thyroid gland throughout the volume (diffuse form), or the formation of nodes (nodular form), sometimes a combination of diffuse and nodular forms, can be observed. The hypertrophic form of autoimmune thyroiditis may be accompanied by thyrotoxicosis in the initial stage of the disease, but usually the function of the thyroid gland is preserved or reduced. As the autoimmune process in the thyroid tissue progresses, the condition worsens, thyroid function decreases, and hypothyroidism develops.
• atrophic(the size of the thyroid gland is normal or reduced, according to clinical symptoms - hypothyroidism). It is more often observed in the elderly, and in young people - in the case of exposure to radioactive irradiation. The most severe form of autoimmune thyroiditis, due to the massive destruction of thyrocytes, the function of the thyroid gland is sharply reduced.

Symptoms of autoimmune thyroiditis

Most cases of chronic autoimmune thyroiditis (in the euthyroid phase and the phase of subclinical hypothyroidism) are asymptomatic for a long time. The thyroid gland is not enlarged, painless on palpation, the function of the gland is normal. Very rarely, an increase in the size of the thyroid gland (goiter) can be determined, the patient complains of discomfort in the thyroid gland (feeling of pressure, coma in the throat), easy fatigue, weakness, joint pain.

The clinical picture of thyrotoxicosis in autoimmune thyroiditis is usually observed in the first years of the development of the disease, is transient, and as the functioning thyroid tissue atrophies, it passes for some time into the euthyroid phase, and then into hypothyroidism.

Postpartum thyroiditis usually presents with mild thyrotoxicosis at 14 weeks postpartum. In most cases, there is fatigue, general weakness, weight loss. Sometimes thyrotoxicosis is significantly pronounced (tachycardia, a feeling of heat, excessive sweating, tremor of the limbs, emotional lability, insomnia). The hypothyroid phase of autoimmune thyroiditis appears on the 19th week after childbirth. In some cases, it is combined with postpartum depression.

Painless (silent) thyroiditis is expressed by mild, often subclinical thyrotoxicosis. Cytokine-induced thyroiditis is also usually not accompanied by severe thyrotoxicosis or hypothyroidism.

Diagnosis of autoimmune thyroiditis

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:

• general blood analysis- 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(general 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
• Thyroid ultrasound- 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.

Treatment of autoimmune thyroiditis

Specific therapy for autoimmune thyroiditis has not been developed. Despite modern advances in medicine, endocrinology does not yet have effective and safe methods for correcting autoimmune thyroid pathology, in which the process would not progress to hypothyroidism.

In the case of the thyrotoxic phase of autoimmune thyroiditis, the appointment of drugs that suppress the function of the thyroid gland - thyrostatics (thiamazole, carbimazole, propylthiouracil) is not recommended, since there is no hyperfunction of the thyroid gland in this process. With severe symptoms of cardiovascular disorders, beta-blockers are used.

With manifestations of hypothyroidism, replacement therapy with thyroid hormone preparations of thyroid hormones - levothyroxine (L-thyroxine) is individually prescribed. It is carried out under the control of the clinical picture and the content of TSH in the blood serum.

Glucocorticoids (prednisolone) are indicated only with the simultaneous course of autoimmune thyroiditis with subacute thyroiditis, which is often observed in the autumn-winter period. To reduce the titer of autoantibodies, non-steroidal anti-inflammatory drugs are used: indomethacin, diclofenac. They also use drugs for the correction of immunity, vitamins, adaptogens. With hypertrophy of the thyroid gland and severe compression of the mediastinal organs by it, surgical treatment is performed.

Forecast

The prognosis for the development of autoimmune thyroiditis is satisfactory. With timely treatment, the process of destruction and decrease in thyroid function can be significantly slowed down and a long-term remission of the disease can be achieved. Satisfactory health and normal performance of patients in some cases persist for more than 15 years, despite the occurrence of short-term exacerbations of AIT.

Autoimmune thyroiditis and elevated titer of antibodies to thyroperoxidase (AT-TPO) should be considered as risk factors for future hypothyroidism. In the case of postpartum thyroiditis, the probability of its recurrence after the next pregnancy in women is 70%. About 25-30% of women with postpartum thyroiditis later have chronic autoimmune thyroiditis with a transition to persistent hypothyroidism.

Prevention

If autoimmune thyroiditis is detected without impaired thyroid function, it is necessary to monitor the patient in order to detect and promptly compensate for manifestations of hypothyroidism as soon as possible.

Women who are carriers of AT-TPO without changes in thyroid function are at risk of developing hypothyroidism in the event of pregnancy. Therefore, it is necessary to monitor the condition and function of the thyroid gland both in early pregnancy and after childbirth.

How is this pathology classified?

The classification of the disease is associated with the need to distinguish one or another of its varieties.

1. Chronic autoimmune thyroiditis (Hashimoto's goiter) is a disease of the thyroid gland that develops as a result of prolonged infiltration of T-lymphocytes into the tissue of the organ. A person may develop autoimmune thyroiditis.
2. Postpartum thyroiditis is diagnosed very often and therefore well studied. The cause of this type of thyroiditis is the increased reactivity of the woman's immune system due to the fact that she was depressed during pregnancy.
3. Painless thyroiditis is an analogue of postpartum, but the causes of this type of pathology have not been studied.
4. Patients with type C hepatitis may develop cytokine-induced AIT of the thyroid gland. It occurs against the background of patients taking interferon.

All types of thyroiditis have such phases of development.

1. Euthyroid. The functions of the organ in euthyroidism of the thyroid gland are not violated. It can last for years, sometimes even for a lifetime.
2. Subclinical. It appears in a person as a result of the progression of HAIT. At the same time, a significant amount of T-lymphocytes enters the blood. Cells are progressively destroyed as a result.
3. Thyrotoxic. A person develops signs of thyrotoxicosis, destroyed parts of internal cell fragments. They provoke active processes of antibody production. The number of cells capable of producing hormones decreases below an acceptable level, causing the patient to develop hypothyroidism.
4. Hypothyroid. It can last about a year, after which the normal function of the organ is restored. Sometimes a patient may develop persistent hypothyroidism, which can only be stopped by taking thyroid hormone preparations.

In addition, there are:

• acute thyroiditis;
• subacute thyroiditis;
• primary disease;
• fibrous thyroiditis;
• de Quervain's thyroiditis (giant cell form of pathology)

Causes of pathologies

The exact causes of autoimmune thyroiditis are still poorly understood. For the appearance of signs of the pathology under consideration, the influence of such factors is necessary:

• acute viral respiratory infections;
• permanent sites of infection on the tonsils, sinuses, carious teeth;
• unfavorable natural environment, an excess of iodine, fluorine and chlorine salts;
• long-term use without proper control of iodine-containing drugs and hormonal drugs;
• prolonged exposure to direct sunlight;
• the influence of radiation;
• psychological trauma.

General signs

Most cases of this disease, if it occurs in the euthyroid or subclinical phase, do not manifest. The patient has normal dimensions of the thyroid gland on palpation. He does not feel any pain. Extremely rarely, a person may have an enlarged thyroid gland, a feeling of tightness and pressure in the throat.

Depending on the type of pathology, the patient may develop symptoms of autoimmune thyroiditis:

Features of hypothyroidism

Hypothyroidism in autoimmune thyroiditis can be latent, manifest, complicated. Common manifestations of this condition are:

Hyperthyroidism

Manifestations of hyperthyroidism in autoimmune thyroiditis may be temporary.

Pay attention to the presence of such symptoms:

Compression of other organs

When the thyroid gland changes in size, a person feels pain in the chest or neck. Often his temperature rises (to subfebrile values). Due to pressure on the vocal cords, the timbre of the voice decreases significantly in a person (this is especially noticeable in women).

Compression of the esophagus can be manifested by a constant feeling of a lump in the throat, impaired respiratory function, and other symptoms. With compression of the mediastinal organs, constant noise in the ears, visual disturbances and other signs may be felt.

Manifestations of inflammatory processes

With inflammation of the thyroid gland, patients experience such symptoms.

1. Phenomena of intoxication (that is, weakness and aches in the joints, head).
2. Temperature rise.
3. Enlarged lymph nodes.

Features of diagnostics

Diagnosis of the disease can be carried out only on the basis of a comprehensive examination of a person. He is prescribed the following laboratory tests:

• on TSH;
• on T3 and T4;
• for the presence of microsomal antibodies to thyroid peroxidase;
• for the presence of antibodies to thyroglobulin in the blood.

Blood for analysis is taken only from venous blood. An indispensable condition for the correctness and accuracy of the results of clinical examinations is taking the material on an empty stomach. If, under these conditions, AT TG is greatly increased, this indicates the possible development of the disease.

In addition, in order to make a correct diagnosis in Hashimoto's disease, it is necessary to diagnose the thyroid gland using instrumental methods. The most commonly used for this is ultrasound. Using ultrasound, you can determine the following signs of AIT on ultrasound of the thyroid gland:

• the size and location of the thyroid gland (signs of normovolumia);
• its structure and the presence in it of diffuse changes, pseudonodes;
• echo signs of damage to the parathyroid glands;
• condition of nearby lymph nodes;
• features of blood flow in the study area.

Puncture biopsy is performed only under ultrasound control. During this examination, a small piece of tissue is removed from the gland, which is then sent for cytological examination. Often, on the basis of the data of such an examination, a diagnosis of AIT is made.

The most complete and reliable picture of the ongoing processes in the thyroid gland is given by magnetic resonance or computed tomography. Moreover, MRI has more advantages due to the absence of radiation.

Methods of treatment

Therapeutic measures should be prescribed only on the basis of diagnostic examination data. They are aimed at eliminating one or another factor that contributes to the development of a characteristic clinical picture of the pathology.

1. Thyroid drugs. These are L-thyroxine, Triiodothyronine, Thyreoidin, Thyrodom.
2. Glucocorticosteroid drugs (which are analogues of the hormones of the adrenal glands). The drug of choice is Prednisolone.
3. Antibiotics are used for severe inflammation caused by bacteria. Patients are prescribed, Cefelim, Augmentin, Amoxiclav, drugs from fluoroquinolones, tetracyclines, aminoglycosides and other groups.
4. For pain and inflammatory processes of non-infectious origin, Indomethacin and its analogues are used. The use of Diclofenac ointment is also shown.
5. Beta blockers - Propranolol and others.
6. Levamisole and other immunomodulatory drugs are used to support the immune system.
7. With a tendency to allergies, Tavegil, Diazoli, Loratadin are used.
8. Endonorm and the treatment of autoimmune thyroiditis are closely related, since the use of this drug makes it possible to control the activity of the thyroid gland.
9. Iodine-containing preparations (Ioddicerin, Iodomarin).

Treatment with folk remedies should be considered only as an auxiliary method of therapy. A diet is shown (food enriched with iodine, selenium, vitamins).

Forecast and prevention

The prognosis of the course of such a disease is favorable. Early treatment can significantly slow down the destruction of thyroid tissue and degradation of the organ. A properly selected complex of drugs makes it possible to achieve remission. In the event of thyroiditis after childbirth, a woman significantly increases the risk of developing autoimmune lesions of the organ. Dangerous consequences of damage to the thyroid gland can be observed when the process is running.

Specific measures for the prevention of the disease have not been developed. Dispensary observation is recommended for women who are carriers of antibodies to thyroperoxidase.

Autoimmune forms of thyroiditis respond well to treatment and compensation with the help of modern medications. Early detection of such a pathology will help cure the disease, contribute to maintaining high performance and quality of life.

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The thyroid gland is a special human organ that provides all types of metabolism carried out in the body. Its anatomical difference is in a special protective property from the destructive action of a person's own immunity.

The body's defense system is able to recognize the presence of the gland and immunoglobulins - antibodies, performing their direct function, destroy the thyroid gland, mistaking it for a foreign body. Despite modern advances in the medical field, autoimmune thyroiditis of the thyroid gland is very popular in endocrinology, and therefore requires a very thorough study. In this article, we will tell you what autoimmune thyroiditis (AIT) is, its causes, symptoms, and treatment.

What is autoimmune thyroiditis

Autoimmune thyroiditis of the thyroid gland is an inflammatory lesion of the thyroid gland fibers in a chronic manifestation. It is characterized by the destruction of the vesicles (follicles) of the thyroid tissue, their cells and autoimmune origin. Usually the disease proceeds without any manifestation, only in rare cases there is an increase in the volume of this organ.

Detection of an autoimmune disease of the thyroid gland is carried out taking into account the results of laboratory tests, ultrasound of the organ, histological evidence of the biomaterial extracted as a result of fine needle sampling. Activities for the treatment of deviations are carried out by doctors - endocrinologists. The therapy consists of normalizing the hormone-synthesizing task of the thyroid gland and suppressing autoimmune processes.

An interesting circumstance - the disease was originally described in 1912 by a Japanese practicing surgeon and scientist Hashimoto. In the world, 0.1-1.2% of autoimmune thyroiditis is found in children, and in the Russian Federation - 3-5%. This deviation is subject to 1% of the world population, while 5-7 times more in women.

Other names for the disease:

• autoimmune Hashimoto's thyroiditis;
• autoimmune thyroid disease;
• lymphocytic thyroiditis;
• lymphomatous thyroiditis.

Causes of AIT

The thyroid gland is a very sensitive organ that is easily affected by all sorts of adverse factors. Taking into account the current state of the environment and a large number of pathogens, there is a reasonable concern for the thyroid gland.

Table 1: Causes of AIT:

Acquired	Internal
Viral (acute respiratory: influenza, parainfluenza, adeno- and rhinoviruses, measles, parotitis) or bacterial (gonorrhea, tuberculosis, scarlet fever) defeat.	An imbalance of hormones in any of the organs of the internal production system.
Injuries in the cervical region.	thyrotoxicosis.
Poisoning of the body with heavy metals (mercury, lead).	Decreased production of thyroid hormones - hypothyroidism.
Radiation background.	Insufficient functionality of the structural cells of the gland.
	Deviation of globulins (proteins) of immunity, which are hostile to thyroid tissue, provided by a congenital change.

Other factors in the development of the disease

• hereditary predisposition;
• the female sex is more in women than in the male population in the ratio of 1:20. This disease is common in women between the ages of 30 and 50;
• the presence of other autoimmune processes;
• factors such as stress, infection, etc. These causes cause the occurrence of autoimmune thyroid diseases in people with a hereditary predisposition.

Symptoms and signs

This disease can exist for quite a long period without any symptoms. This circumstance is often characteristic of the chronic condition of thyroid aitis:

• thyromegaly is not observed, the size of the organ does not increase, there are no painful manifestations and it works as usual;
• infrequently, goiter may occur (iron increases in volume, see photo above);
• discomfort, loss of strength and fatigue.

Sometimes there is an increase in the production of thyroid hormones in the thyroid gland and there are such signs of aitis:

• the patient is characterized by a rapid change in mood;
• shortness of breath occurs;
• there are signs of tachycardia.

All these symptoms of the thyroid gland are not so pronounced, and for this reason a person often does not attach due importance to this. Well, when one seeks medical help, the symptoms are eliminated, and not the disease itself. For example, patients with increased synthesis of steroids are often treated for a different disease by completely different specialists, since the patient complains about the work of the gastrointestinal tract.

Postpartum type often occurs after 14 days after delivery. In the patient:

• body weight decreases;
• bad feeling;
• fatigue sets in quickly.

Also, increased production of thyroid hormones or thyrotoxicosis in the thyroid gland is sometimes pronounced and manifests itself in the form of:

• rapid heartbeat;
• excessive sweating;
• tremor in the limbs;
• nervous breakdown;
• insomnia.

By the 19th or 20th week, the disease transforms into the hypothyroid stage.

For the painless and resulting use of drugs with the active component of interferon, which are used in the treatment of hematogenous pathologies and hepatitis C, slight thyrotoxicosis and euthyroidism are characteristic. Symptoms and treatment of the disease are interrelated.

Diagnostics

Before the manifestation of symptoms of hypothyroidism, it becomes very difficult to determine the presence of AIT of the thyroid gland. Doctors - endocrinologists compare all indications of laboratory examinations and clinical symptoms before announcing the diagnosis. When diagnosing a disease, one must understand that AIT is primarily a genetic disease. The existence of the diagnosis of AIT is also indicated by the direct relatives of the patient suffering from autoimmune pathologies.

Clinical detection of autoimmune thyroiditis implies:

• delivery of a general and detailed blood test - an increase in the number of lymphocytes is detected;
• immunogram - inherent in the presence of immunoglobulin to thyroglobulin, thyroperoxidase, the second colloidal immunoglobulin, immunoglobulin to hashimoto's thyroiditis;
• establishment of T3 and T4 (general and free), the degree of TSH in the blood plasma. An increase in the degree of TSH when T4 is normal confirms subclinical hypothyroidism, an increased degree of TSH with a low content of T4 confirms clinical autoimmune hypothyroidism;
• Ultrasound of the thyroid gland - reveals an increase or decrease in the volume of the organ, a modification of its structure. The results of AIT on ultrasound are used as an addition to the general clinical manifestations and other results of laboratory tests;
• fine-needle sampling of thyroid biomaterial - makes it possible to establish the presence of a large number of white blood cells and cells inherent in chronic autoimmune thyroiditis. The method is used to establish signs indicating a probable malignant transformation of the nodular structure of the thyroid gland.

The criteria for detecting autoimmune thyroiditis or thyromegaly are:

• an increase in the presence in the bloodstream of immunoglobulins to the thyroid gland ();
• detection by ultrasound of the thyroid gland of low-density tissue that transmits ultrasound;
• detection of symptoms of primary hypothyroidism.

We also want to note that an increase in the degree of AT-TPO, or an inhomogeneous structure of the thyroid gland that transmits ultrasound, does not yet diagnose autoimmune thyroiditis. Treatment of autoimmune thyroiditis in a patient is required exclusively in the hypothyroid phase, for this reason there is no need for diagnosis in the euthyroid stage.

Treatment of Hashimoto's thyroiditis

Treatment of autoimmune thyroiditis of the thyroid gland is a very complex process that uses drugs, surgery, and even alternative medicine methods.

All therapeutic actions of chronic autoimmune thyroiditis are based on all kinds of correction of the hormonal picture, the endocrinologist prescribes a scheme specific in each case. As a rule, they use L-thyroxine. This tool is a synonym for the hormone T4. When a positive effect is not observed, drug tactics are enhanced with glucocorticosteroids.

There is no permanent method for eliminating autoimmune thyroiditis in medicine. All therapeutic measures are aimed at getting rid of the symptoms of the thyroid gland regarding the phase of the course - thyrotoxic or hypothyroid. And consists of:

• hormone replacement treatment;
• therapeutic effect of depressing hormonal tasks of the thyroid gland;
• with a significant increase in the size of the thyroid gland - surgical operations.

In AIT with symptoms of hypothyroidism, conservative treatment with pharmacological drugs and medicines is used:

• "Levothyroxine";
• "Mercazolila";
• "Thiamazola";
• and medicines - adrenomimetics "Alpha-blockers", which has the functionality of normalizing the production of hormones.

In a situation where the disease is in an acute stage, glucocorticosteroid drugs are added - such as "Prednisolone". In order to reduce the activity of immunoglobulins to thyroid structures, NSAIDs (non-steroidal anti-inflammatory drugs) are prescribed:

• "Voltaren";
• "Indomethacin".

The scheme of drugs used in the treatment of symptoms of autoimmune thyroiditis includes and "Endonorm". This pharmacological product is used to reduce immune activity and supplement the macro and microelements of the thyroid gland structure. The homeopathic components present in the composition of the remedy contribute to the resumption of the activity of the adrenal glands and glands of the genital area, which has been disturbed due to a disorder in the balance of hormones. All drugs in the treatment of autoimmune thyroiditis are applicable, taking into account individual contraindications.

Surgery

With HAIT of the thyroid gland, surgical intervention becomes a necessary measure. Sometimes it becomes possible to eliminate the symptoms of autoimmune thyroiditis thanks to this method of treatment.

Treatment with folk remedies

The autoimmune thyroiditis of the thyroid gland, provided by heredity, requires only symptomatic treatment, i.e. with the help of medicinal herbs, suitable as an additional remedy for eliminating symptoms (alopecia, hardening of feces, soreness in the joints, increased cholesterol plaques, etc.). Here are some folk recipes that treat autoimmune thyroiditis ( Before starting therapy, consult your doctor!):

• You need to take freshly picked leaves of sweet clover, succession, cocklebur, kirkazon and celandine. Rinse the collection well, chop and pour vegetable oil in equal proportions. Insist therapeutic extract for a month. With the finished extract every evening before going to bed, rub the neck in the area of ​​​​the gland.
• To obtain an alcohol tincture, you need to take two pharmaceutical packages of pine buds, pour 0.5 liters of vodka and leave for 21 days in a dark place. Rub in the evening before going to bed until symptoms disappear.
• A similar tincture of celandine is used both as lotions and as an internal remedy.
• 50 g of bear bile is poured with a liter of vodka. Use the remedy before meals, three times a day, the dosage depends on the patient's body weight. With a mass of 50 kg, you need to drink a teaspoon, up to 80 kg - dessert, more than 100 kg - a tablespoon. After using for a month, an interval of 7 days is required and then a second course.

Exercises

If we talk about therapeutic exercises, then with aitis, the following become useful: simple gymnastics to ensure the tone of the back and limbs, and for the directed action of yoga classes - breathing exercises to tone the diaphragm and chest muscles and feasible exercises to strengthen the muscles in general.

Nutrition and supplements

With autoimmune thyroiditis, the most effective treatment is nutritional control. Due to the fact that the fundamental factor of HAIT is outside the scope of medicine, the development of a healthy menu is required, the diet should contain foods such as:

• meat - enhances the synthesis of triiodothyronine and thyroxine;
• carbohydrates - minimizes the risk of allergies, baldness;
• lipids and unsaturated acids included in fish oil, liver, sunflower oil, bone marrow;
• selenium, present in nuts, seafood, brown rice, mushrooms, asparagus, dietary meats;
• zinc, which is present in legumes, buckwheat, garlic, nuts, beef meat.

It is necessary to consume foods without hormones, such as soy.

Complications

The aggravation of the course of autoimmune thyroid diseases is an infrequent occurrence and is observed only in cases where treatment was not carried out at all. The following complications may occur with the disease:

• adult patients are exposed to mental illness, which are provoked by a depressive state. Mental retardation and delayed development may develop. There are cardiovascular diseases.
• autoimmune thyroiditis in children can lead to underdevelopment of the pelvic organs, slowing down intellectual and mental development, even to the point of idiocy.
• complications of autoimmune thyroiditis in women bearing a child may manifest as signs of preeclampsia, involuntary abortion.

Autoimmune thyroiditis cannot be fully cured. The patient is lifelong dependent on supportive care. A timely detected disease and an unmistakably chosen treatment regimen makes it possible to live a full life and exclude hypothetical complications. Reproductive ability and performance can be maintained by providing a stable and prolonged relief of symptoms for a fairly long time.

Prevention

Caution should be shown to people who have any hereditary disease, for example vitiligo, type 1 diabetes mellitus, rheumatoid arthritis or thyromegaly. In such people, autoimmune thyroiditis appears more often. When at the same time there are signs of steroid deficiency, it is required to immediately contact an endocrinologist, since severe consequences are likely to develop.

When planning pregnancy, women with a genetic predisposition need to check the degree of thyroxine, triiodothyronine and immunoglobulins to the thyroid gland in the bloodstream. It is necessary to start therapy of autoimmune hypothyroidism with levothyroxine in advance of pregnancy, since in the first trimesters the embryo does not produce its own thyroid hormones - it uses maternal hormones for growth and development without deviations. Replacement treatment and diet are necessary throughout the entire period of bearing a child.

Forecast

What to expect from autoimmune thyroiditis? AIT is a genetically transmitted anomaly. The most important thing is that it is impossible to recover completely and completely. This deviation is treated only partially, thanks to the correct scheme, coupled with a diet (Iodomarin - nutrition for the gland), it will help prevent deterioration of health.

The probability of death of a patient in the treatment of autoimmune thyroiditis is very small, Hashimoto's autoimmune thyroiditis does not affect the patient's life expectancy. Neglect of this deviation entails a disorder in the functions of the endocrine system. The most terrible consequence of Hashimoto's disease is a factor in the formation of oncological diseases - the degeneration of benign nodes into a malignant tumor.

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