Thyroid chronic thyroiditis on ultrasound. How to treat thyroiditis depending on the form of the course and protect yourself from the return of the disease. Causes and symptoms of euthyroidism

Doctors say you should just live with your autoimmune thyroiditis for the rest of your life because they simply don't know about natural treatments that help retrain the immune system to live in harmony with the thyroid gland. After all, they are not taught this in medical universities.

When considering treatment for this disease, it is important to evaluate all factors that may explain why the immune system is attacking the thyroid. To the main reasons autoimmune thyroiditis relate: poor nutrition, chronic stress, inflammation, infection, leaky gut syndrome, liver dysfunction, indigestion, and exposure to toxins environment. In addition, when taking hormonal drugs, you will only mask the problem, but in no way solve it radically.

Get your diet in order so your immune system can rest

Through dietary changes, you can eliminate from your diet those foods that lead to inflammation and intestinal dysfunction, as well as imbalance nutrients. It's Important to Consider an Anti-Inflammatory Diet to Help Relieve Stress immune system, heal the intestines and thyroid gland. It is vital to eliminate all foods that contain gluten and cross-reactivity (you can find a list of foods that cause cross-reactivity here - The Autoimmune Thyroid Diet) as they inhibit proper functioning thyroid gland.

An anti-inflammatory diet will allow the body to normalize the production of thyroid hormones, as well as blood sugar levels, which will lead to increased energy levels, improved mental clarity and normal metabolic processes. An anti-inflammatory diet should consist of:

Non-starchy vegetables and fruits (asparagus, pumpkin, cucumbers, green pea, carrots, beets, zucchini, turnips).
Protein foods (nuts and nut butters, legumes and organic meats and fish).
Enough healthy fats (cold-pressed olive oil, linseed oil, Coconut oil, avocado oil, avocado fruit, nuts and seeds, cold water and red fish).

Environmental factors can suppress thyroid function. Toxins that harm the thyroid gland include: heavy metals, pesticides, substances that make up plastic (dioxins, PCBs, etc.), and drugs (antibiotics, NSAIDs and anti-inflammatory drugs, diabetic drugs, statins, cholesterol-lowering drugs, etc.). The use of all these drugs should be almost completely stopped, and the impact of adverse factors at home, at work, and on the street should be minimized.

How to treat autoimmune thyroiditis natural means:

Diet
Taking food supplements
Reducing stress levels

Nutritional Supplements for the Thyroid and Immune System

If your thyroid levels are low, your doctor may prescribe synthetic thyroid hormones (see Drugs for Autoimmune Thyroiditis) so that your body is not deficient and you feel better. This can be done during the period of revealing the underlying causes that led to the development of autoimmune thyroiditis.

Autoimmune thyroiditis often results in impaired function of the digestive tract, resulting in insufficient absorption of nutrients. If you are nutritionally deficient, certain dietary and/or nutritional supplements are essential to ensure that you are receiving micro- and macronutrients, vitamins, and others. essential substances, among which: omega-3 fatty acids, vitamin D, iron, selenium, zinc, copper, vitamins A, B2, B3, B6, B12, C, E, iodine, amino acids and L-tyrosine. Fatty acids and cholesterol are involved in the formation and functioning of prohormones, so it is vital to saturate the body with healthy and natural fats. Learn more about healthy fats with autoimmune thyroiditis, you can on this page - Autoimmune thyroiditis: treatment with folk remedies.

Reducing stress levels

Summarize

Autoimmune thyroiditis is a disease caused by a malfunctioning immune system that mistakenly attacks thyroid tissue. Symptoms and signs of autoimmune thyroiditis include: fatigue, weight gain, puffy face, swelling, constipation, dry and thinning hair, and more. Your integrative medicine doctor can develop a holistic treatment approach that (1) calms the immune system, (2) lowers antibodies, and (3) makes you feel better on a permanent basis. When thyroid hormone production is restored, it will lead to positive physical and biochemical changes in energy levels, metabolic and cognitive functions and reproductive function. If your doctors tell you that there is no cure for your disease, then they simply do not know how to treat autoimmune thyroiditis.

The term "thyroiditis" refers to an extensive group of diseases that can be conditionally designated as inflammation of the thyroid gland. Lack of adequate and timely treatment entails the transition of pathology into a chronic form, which necessarily affects human health.

Description of the disease

Thyroid thyroiditis implies a disease inflammatory nature, manifested by a constant feeling of pressure and painful discomfort in the neck area, difficulty swallowing. The progression of the pathology inevitably entails diffuse changes and a violation of the usual functions of the organ. Thyroiditis may be based on various mechanisms and causes of development, however, this group of diseases is united by the presence of an inflammatory process in the thyroid tissue.

According to experts, today pathologies of this kind are the most common in the world after the well-known diabetes mellitus. Abnormal changes in the gland were first described in Ancient China. Previously, the main reason for their formation was considered to be a lack of iodine in the body. Later, E. Kocher operated on the gland and provided clear evidence of the effectiveness of iodine in the treatment of goiter. In 1909, this famous surgeon was awarded the Nobel Prize for his discovery. However, Kocher already at that time had patients in whom iodine therapy did not give the expected result.

In 1912, another scientist from Japan (the country richest in iodine) during an operation to remove the thyroid gland noticed the first inflammatory changes in this area. This made it possible to assume that the occurrence of goiter may be preceded by other causes. In 1956, N. Rose created an experimental animal model of the disease and successfully proved its autoimmune nature. Thyroiditis of the thyroid gland is still being actively studied by scientists around the world who are trying to find out real reasons development of the disease and offer in return adequate methods treatment.

Classification

AT medical practice this disease is classified on the basis of the features of the mechanism of development and clinical manifestations.

Acute thyroiditis can spread to the entire surface of the organ (diffuse thyroiditis of the thyroid gland) or to some part of it (focal variant of the disease). Myself inflammatory process may be purulent/non-purulent in nature. This form of the disease is extremely rare. It mainly develops against the background various infections(for example, pneumonia, tonsillitis) or after iodine treatment of the so-called diffuse toxic goiter.
Subacute thyroiditis in practice occurs only in three clinical forms: lymphocytic, granulomatous, pneumocystis. As a rule, the disease is diagnosed in the fair sex at the age of 30-35 years.
The chronic form is represented by autoimmune Hashimoto's thyroiditis, fibrous-invasive goiter of Riedel and specific diseases tuberculosis / syphilitic etiology.

In addition, autoimmune thyroiditis is divided into the following forms:

Latent. The gland is slightly enlarged in size, there are no violations of its functions.
Hypertrophic. This form of the disease is accompanied by an increase in goiter. In this case, the gland itself can be both uniformly enlarged throughout the volume, and due to the formation of nodes (nodular thyroiditis). As the organ becomes depleted, hypothyroidism develops and corresponding symptoms appear. All changes are very easily diagnosed by ultrasound.
Atrophic. With this form of the disease, iron practically does not increase in size, remains normal or even decreases. Some patients have clinical manifestations hypothyroidism, since the gland still produces less hormones.

The main causes of thyroiditis

The acute form of the disease most often occurs due to various mechanical injuries, previous radiation therapy or after hemorrhage in the gland. Pathology develops against the background of acute or chronic infections. If you manage to cure them in a timely manner, you may not know about such a serious disease.

The main factor in the development of the subacute form is recognized as an infection of a viral nature.

Autoimmune thyroiditis of the thyroid gland is characterized by hereditary predisposition. In the chronic form of the disease, which develops gradually and does not manifest itself as obvious clinical signs, people begin to sound the alarm only after the appearance of goiter. It interferes with the usual way of life and causes discomfort. The chronic form of the disease begins to progress after suffering viral pathologies, medicines or radiation exposure, with caries.

How does thyroiditis manifest itself? Symptoms

Clinical signs of the disease depend solely on its form. The acute purulent variant is manifested by discomfort and pain in the neck, which radiates to the back of the head, becoming more and more intense each time with head movements or normal swallowing. Regional lymph nodes are usually enlarged. There is a persistent increase in temperature, chills, deterioration of the general condition. All these symptoms make the patient seek medical help without delay.

Signs of thyroiditis of acute non-purulent form are less pronounced. At the onset of the disease, patients report excessive sweating, palpitations, hand tremors, and marked weight loss. During the examination, it is revealed increased rates thyroid hormones. In the case of a long course of this form of the disease, there is a slow replacement of the previously destroyed cells of the glandular region of the organ directly. connective tissue, and the inflammation itself is already being replaced by fibrosis. Patients become lethargic and drowsy for no apparent reason. Their face swells, the skin becomes dry. The gland increases in size, painful discomfort occurs when touched.

Symptoms of the subacute form have their own distinctive features. As a rule, there is an increase in the size of the gland itself, appear severe pain in the anterior region of the neck. The skin in this area has a reddish tint due to a sharp increase in blood flow and an increase in temperature, which is also felt when touched. Lymph nodes do not change in size.

Chronic thyroiditis of the thyroid gland may not show symptoms for a long time. Most early sign The disease is considered the appearance of a sensation of a lump in the throat and difficulty swallowing. In the advanced stage of the pathology, a violation of the respiratory process, hoarseness of the voice develops. On palpation, the specialist determines an uneven increase in the organ, the presence of seals. The defeat is most often diffuse character. Compression of neighboring structures of the neck can provoke a compression syndrome, which manifests itself in the form of a headache, tinnitus, visual impairment, and pulsation of the cervical vessels.

Establishing diagnosis

Before the appearance of obvious violations in the work of the thyroid gland, it is practically impossible to confirm the disease with thyroiditis. Only thanks to laboratory tests it is possible to establish the presence or, conversely, the absence of pathology. If close relatives in the family have a history of any autoimmune disorders, it is recommended that you periodically undergo full examination. It may include the following activities:

Complete blood count (shows the quantitative content of lymphocytes).
Determination of the level of TSH (thyroid-stimulating hormone) in the blood.
Immunogram.
Ultrasound of the thyroid gland to determine its size, possible changes in the structure.
Fine needle biopsy.

After a complete diagnostic examination, a specialist can confirm the presence of the disease and prescribe an individual treatment. Note that you should not try to get rid of the pathology yourself, because the consequences may not be the most pleasant. Incorrectly selected therapy can adversely affect the overall state of health, and the disease, meanwhile, will continue to progress.

What should be the treatment?

After a diagnostic examination, the doctor prescribes the appropriate therapy depending on the form of the disease. Various drugs are used to treat the autoimmune variant of the pathology. Unfortunately, today experts cannot offer specific methods specific treatment. If the function of the gland is increased, thyrostatics are prescribed (drugs "Merkazolil", "Tiamazol") and the so-called beta-blockers.

Through the use of non-steroidal anti-inflammatory drugs, the production of antibodies is reduced. In this case, patients are recommended "Metindol", "Indomethacin", "Voltaren". All of the above means can overcome autoimmune thyroiditis of the thyroid gland. The treatment of this disease must be necessarily complex. This means that patients can additionally be prescribed vitamin complexes, adaptogens, drugs to correct the state of immunity.

In the case of a subacute variant of the disease, glucocorticoids are prescribed. They reduce the manifestations of the inflammatory process, reduce pain discomfort and swelling. Also, steroid drugs ("Prednisolone") are used for treatment. The duration of the course of therapy in each specific situation is determined by the doctor. Non-steroidal anti-inflammatory drugs usually positive effect only in the case of a mild form of the disease. At right approach and following all the recommendations of a specialist, it is possible to completely overcome the disease in just a few days. However, there are cases when the disease lasted longer, manifested by relapses.

Treatment of thyroiditis in the thyroid gland acute form does not allow surgical intervention or radiotherapy. In this case, the fact that the disease very often begins spontaneously must be taken into account. Treatment is carried out exclusively through the beta-adrenergic blockade "Propranolol".

In some cases (combination of autoimmune thyroiditis with the so-called neoplastic process, enlarged goiter, lack of proper effect from conservative option therapy), a decision is made to perform an operation called a thyroidectomy.

Features of nutrition in thyroiditis

The most common form of the disease is chronic thyroiditis thyroid gland. Treatment of this pathology involves not only taking medications, but also observing a special diet. The diet should not impose any severe calorie restrictions. daily diet. The same recommendations apply to other forms of the disease. If you reduce the calorie content to approximately 1200 kcal, you will notice how the disease progresses and worsens general state patient. Soy products, red clover and millet are considered the most dangerous for the thyroid gland. They are rich in isoflavones and other compounds that hinder the work of enzymes.

What nutrition is necessary for the diagnosis of "autoimmune thyroiditis" (diet)? With this form of the disease, experts strongly recommend sticking to a vegetarian diet whenever possible. The main diet should consist mainly of fresh herbs, nuts, vegetables and fruits, legumes, and various root crops. On the other hand, one should not neglect seafood and lean meats. Very useful buckwheat, grapes, persimmon.

In general, for all forms of the disease, it is recommended to maintain a balance in nutrition. It should be rational and as balanced as possible. You should eat every three hours, in small portions. It is recommended to diversify the diet with dishes from fresh vegetables, foods with fatty unsaturated acids(for example, fish). Also, the patient should eat daily carbohydrates derived from cereals.

Experts have found that hyperthyroidism is very often accompanied by osteoporosis. To prevent the development of this disease, you should enrich the diet with calcium. However, all fatty, smoked, spicy food. Of course, it would be better to give up pastries and sweets. Mayonnaise, ketchups, spicy adjika will also be required to be excluded from the daily diet. Semi-finished products, fast food, products with chemical dyes and all kinds of flavor enhancers are categorically contraindicated.

Thyroiditis of the thyroid gland is enough serious illness Therefore, you should not neglect the recommendations of a doctor on nutrition. Taking into account the fact that the problem of this organ directly affects the work of other body systems, the diet should be made taking into account the existing diseases.

Help of traditional medicine

Herbal treatment is an auxiliary measure that allows you to quickly overcome the disease. We should not use the recipes of our grandmothers as the only measure for the treatment of pathology. In addition, before using this or that method, it is recommended to consult a doctor in advance.

Herbalists offer the following folk remedies:

Thyroiditis and pine buds. In total, you will need two packs of funds. It can be purchased at almost every pharmacy. The kidneys must be crushed in a blender, poured into a 0.5 liter jar and poured with vodka. This medicine should be insisted in a warm place for 21 days. After this, it is necessary to strain the infusion and squeeze out the pine buds. The result should be a liquid Brown color. With this infusion, you need to wipe your neck three times a day in the area where it is located. thyroid.
Vegetable juice and thyroiditis. Symptoms of the disease pass very quickly (in acute form) if you drink juice from carrots and beets daily. To prepare it, you need to take three parts of carrots for one part of beets. Flaxseed oil can be added to the juice (no more than one tablespoon).
Elecampane tincture. In mid-July, it is necessary to collect the flowers of the plant and put them in a container, while their number should not occupy more than half the volume of the vessel. Then you should pour elecampane with vodka. Such a medicine must be infused for 14 days, then strain. The finished version is used for gargling daily (preferably at bedtime).
Green walnut tincture and chronic thyroiditis of the thyroid gland. Treatment in this case involves a fairly simple recipe. It will take 30 walnuts, a liter of vodka, a glass of honey. All ingredients should be mixed and left to infuse for 15 days. Then the tincture should be filtered and taken daily in the morning, one teaspoon.

Possible Complications

Inflammation of the thyroid gland of a purulent nature, which is mainly diagnosed in acute thyroiditis, is dangerous by opening the cavity into the surrounding tissues. The spread of such a pathological process to the tissues of the neck can lead to the development of phlegmon and sepsis, damage to blood vessels, further promotion of the infection directly to meninges(meningitis) and nearby parts of the brain (encephalitis).

Advanced thyroiditis of the thyroid gland in a subacute form can cause damage to a significant number of thyrocytes and the subsequent development of irreversible insufficiency of this organ.

Prognosis for thyroiditis

Timely treatment of the acute form of the disease ends, as a rule, with the recovery of the patient in about 1.5-2 months from the start of therapy. Very rarely, after a purulent variant of the disease, persistent hypothyroidism develops.

Adequate therapy of the subacute form allows to achieve a final cure in about three months. Advanced variants of this disease can last up to two years and often develop into chronic autoimmune thyroiditis of the thyroid gland.

The fibrous form of the disease is characterized by a long-term course and the subsequent development of hypothyroidism.

Prevention

The disease is easier to prevent than to treat. As for thyroiditis various forms, then in this case, doctors strongly advise to treat all ailments of an infectious nature in a timely manner. Special attention focus on a healthy lifestyle and proper nutrition. Periodic hardening in the fresh air can be useful.

Once the diagnosis of thyroiditis has been confirmed, treatment should be carried out exclusively under the supervision of a specialist and in medical institution. Any neglect of the recommendations is fraught with rather unpleasant consequences.

Conclusion

In this article, we talked in as much detail as possible about what constitutes a thyroid disease "thyroiditis", examined its causes, main forms and treatment options. Timely appeal for help to the doctor gives almost 100% guarantee that the disease will be defeated. Otherwise, the likelihood of developing rather unpleasant complications increases, which requires more serious therapy.

We hope that all the information provided on the topic will be really useful for you. Be healthy!

AT modern world cases of thyroid disease are on the rise. One of the problems that can befall the body is thyroiditis. This term covers all inflammatory processes in the thyroid gland. One of the options for inflammation is chronic thyroiditis, which, in turn, has several varieties.

Chronic thyroiditis is a long-term inflammatory process in the thyroid gland, which leads to a gradual decrease in its functionality. The disease is autoimmune in nature and is associated with impaired perception of the body's cells by the immune system. More often, chronic thyroiditis is diagnosed in women after 50 years. ICD 10 disease code - E06.2-E06.5.

Types and forms of the disease

Chronic thyroiditis includes different etiologies and pathogenesis, which require a differential approach to treatment.

The main forms of pathology:

autoimmune () or lymphocytic, Hashimoto's thyroiditis;
fibrous.

autoimmune

It was first described at the beginning of the last century by the surgeon Hashimoto. The main factor in the development of inflammation is the failure of the immune system, leading to an aggressive attitude of lymphocytes to thyroid cells. Often Hashimoto's thyroiditis occurs simultaneously with other autoimmune disorders (rheumatoid arthritis, type 1.).

The cells of the gland are damaged, which leads to a gradual decrease in its function to synthesize hormones and development.

Phases of AIT development:

Euthyroid- clinical and laboratory signs there is no disease. But lymphocytes have already begun the process of infiltration of thyroid tissues. This period can last for years.
- changes in hormone levels. Increases TSH, thyroxine remains within the normal range.
Clinical hypothyroidism- more damaged, non-functioning thyroid cells appear. A blood test shows an increased level and a significant decrease in and.

It is believed that Hashimoto's thyroiditis is hereditary. For implementation to take place genetic predisposition, as the causes of the inflammatory process, it is necessary to influence certain exogenous factors. It can be viral diseases ENT organs, chronic infections and other pathologies.

Fibrous

The thyroid gland is difficult to repair. If during the inflammatory process some of the follicular cells die and are replaced fibrous tissue, we can talk about the fibrous form of thyroiditis. The reasons for its occurrence are not fully understood. According to one version, this is the result of an autoimmune process, according to another, exposure to viral agents becomes its cause.

Varieties of fibrous thyroiditis:

strum (goiter) Riedel;
fibrous-invasive;
woody.

Chronic thyroiditis can occur in several forms:

latent (hidden);
hypertrophic (appear, there is a diffuse increase in the organ);
atrophic (the organ decreases in size, the synthesis of hormones decreases).

Causes and development factors

Predisposing factors for a chronic inflammatory process can be:

heredity;
gland injury;
carrying out operations on the body;
ionizing radiation;
the presence of foci of infection (otitis media, tonsillitis, cystitis, pyelonephritis);
allergic diseases in history;
abuse of alcohol and cigarettes;
prolonged stress;
iodine deficiency.

On a note! The exact causes of chronic inflammation of the thyroid gland have not been studied. Its development is based on an inadequate response of the immune system to the cells of the organ. As a result of the aggression of antibodies, iron begins to become inflamed and destroyed. There are fewer active thyrocytes, the process of hormone production decreases.

Signs and symptoms

Long time about having chronic person may not guess. The gradual loss of its functions by the thyroid gland is reflected in the work of the whole organism.

With fibrous thyroiditis, the general condition of the patient remains normal. There may be a feeling of difficulty when swallowing food. Sometimes there is a dry cough. If the disease progresses, then hoarseness or loss of voice may join the listed symptoms. If inflammation is involved in the process, hypoparathyroidism develops.

ATI is manifested by the following symptoms:

pain on palpation in the area of the gland;
lump in the throat;
joint pain;
dry skin;
violation of the emotional state;
apathy;
fast fatiguability.

On the early stages diseases of the thyroid gland can actively release hormones, which results in. Patients have increased blood pressure, disturbed heartbeat, appear excessive sweating. Over time, the thyroid gland loses its functions, which is expressed by persistent hypothyroidism.

As a rule, with chronic thyroiditis, an increase in the size of the gland is noted. The exception is atrophic AIT.

If the inflammation is not treated, then later thyroiditis can lead to:

thyroid coma;
atherosclerosis;
heart attack;
osteoporosis;
thyroid lymphoma (rare).

Diagnostics

Diagnosing chronic thyroiditis is difficult. In the early stages, it practically does not manifest itself in any way, proceeds in latent form. Laboratory tests may not reveal characteristic changes. Only with palpation can an increase in the volume of the thyroid gland be detected (if the autoimmune process is hypertrophic). Riedel's goiter is characterized by a dense fixed gland, which is soldered to the surrounding tissues.

An important role in the diagnosis of thyroiditis is played by research:

determination of markers of the autoimmune process in the blood;
fine needle biopsy (if cancer is suspected).

The main diagnostic criteria for chronic thyroiditis are:

the volume of the gland is more than 10 ml in women, and 25 ml in men;
hypothyroidism (detected during a blood test for hormones T3, T4, TSH);
hypogeneity of the parenchyma;
increase in antibody titer to TPO and thyroid tissues.

To surgical intervention in chronic thyroiditis resorted to only in case of severe hyperplasia thyroid gland, which compresses the nearest organs, and also if the inflammatory process occurs against the background of existing tumor formations.

Folk remedies and recipes

To the means traditional medicine can only be used as helper method treatment after consulting a doctor. The use of some folk recipes helps to stop the progression of the pathological process, to maintain normal hormone levels.

Proven Recipes:

grind greens walnuts(30 pieces). Pour them with 1 liter of vodka and add 200 ml of honey. Leave for 14 days in a dark place. Stir from time to time. Strain means. Take 1 scoop in the morning on an empty stomach.

Grind 1 tablespoon of dry seaweed. Mix with honeydew. Pour a glass of boiling water and leave for several hours. Use strained infusion of 80 ml before meals.

Good to drink daily fresh juices carrots and beets.

Nutrition Features

Nutrition plays an important role in the normalization of the thyroid gland. The main emphasis should be on fresh vegetables and fruits, as well as juices and fruit drinks (homemade). Eliminate from the diet spicy dishes, as well as products with artificial additives.

You need to eat in small portions, but often. This helps to avoid overloading the body and not experience constant feeling hunger. It is important to include in the diet foods with polyunsaturated fatty acids ( sea fish, linseed oil). From carbohydrate food it is better to stay on cereals and cereals. Useful products containing calcium to prevent the development of osteoporosis due to thyroiditis (cottage cheese, yogurt, milk).

Chronic thyroiditis is a long-term, lifelong disease that requires constant monitoring and control of the state of the thyroid gland. In order to stop the progression of the pathological process as much as possible and avoid complications, it is necessary to eat a balanced diet, properly organize the mode of work and rest, and avoid emotional and physical overload. If you follow all the recommendations, you can achieve a stable remission of thyroiditis and lead a full life.

Is it possible to cure chronic autoimmune thyroiditis? Find out the answer in the following video:

The thyroid gland is an organ of internal secretion, one of the most important regulators of metabolic processes occurring in the human body. He is very sensitive to external and internal influences. Violation of its work immediately affects the state of integumentary tissues, weight, cardiac activity, the ability to become pregnant and bear a child; it can be seen "from afar", looking at the change in behavioral reactions and speed of thinking.

20-30% of all diseases of the thyroid gland is a disease called "autoimmune thyroiditis". Autoimmune thyroiditis of the thyroid gland is an acute or chronic inflammation tissue of an organ associated with the destruction of its cells by its own immune system. The disease is more common in women; long time goes by without visible symptoms, so it can be suspected only with a planned ultrasound scan and the determination of antibodies to gland peroxidase in the blood. Treatment is selected by an endocrinologist, focusing on the stage of the process. Autoimmune thyroiditis can be cured both completely and its activity can be controlled with the help of permanent reception drugs: it all depends on the type of disease. The disease has a benign course.

Name decoding

The word “autoimmune” refers to a situation where inflammation is caused by the own immune system, attacking an organ (in this case, the thyroid gland). Why is this happening?

All cells - both microbial and "native" to the body must "introduce themselves". To do this, on their surface, they expose an "identification mark" in the form of special, specific proteins. They decided to call such proteins "antigens", and other proteins produced by the immune system to eliminate them - "antibodies". The immune cells in blood vessels, every second they approach each cell and check it for danger to the body precisely for such autoantigens, comparing them with their “list”. As soon as the immune system ceases to do this normally (due to a violation of the quality of lymphocytes or a decrease in the number of its “army”), tumors appear, because in the process of division, “wrong” (atypical) cells appear in any tissue. But it's not about that now.

Even before the birth of a person, lymphocytes undergo specific preparation, as a result of which they receive a “list” of antigens of their cells, by which they pass and do not produce antibodies. But not all of our organs (or their departments) normally have “permitted” antigens. In this case, the body surrounds them with a barrier of special cells that prevent lymphocytes from approaching and checking. identification marks". Such a barrier is surrounded by: the thyroid gland, the lens, the male genital organs; such protection is built around a child growing in the uterine cavity.

With the destruction - temporary or permanent - of the barrier around the thyroid gland, autoimmune thyroiditis occurs. Genes are to blame for this, which tell lymphocytes increased aggressiveness. Women are more likely to get sick, since estrogens, unlike male hormones, affect the immune system.

Statistics

Covering almost a third of all thyroid diseases, autoimmune thyroiditis occurs in 3-4% of all inhabitants of the Earth. At the same time, for the above reasons, the disease is more common in women, and the incidence rate increases with age. So, pathology can be detected in every 6-10th sixty-year-old lady, while 1-12 out of 1000 children are sick.

Disease classification

Chronic autoimmune thyroiditis or Hashimoto's disease. It is this that is often referred to simply as “autoimmune thyroiditis” and it is precisely this that we will consider as a disease with classical stages. This is a disease based genetic cause. Its course is chronic, but benign. To maintain a normal quality of life, you will have to constantly take hormone replacement therapy.

Hashimoto's disease is also called lymphomatous goiter, as the gland enlarges due to edema resulting from a massive attack of its tissue by lymphocytes. Often there is a combination of this pathology with other autoimmune diseases If not this person, then this family. So, Hashimoto's thyroiditis is often combined with diabetes Type I, rheumatoid arthritis, damage to the lining cells of the stomach, autoimmune inflammation of the liver, vitiligo.

Postpartum thyroiditis: inflammation of the thyroid gland develops approximately 14 weeks after birth. It is associated with a special reaction of the immune system: during pregnancy, it has to be suppressed so as not to destroy the child (the fetus is inherently alien), and after childbirth, it can be excessively reactivated.
Painless form of autoimmune thyroiditis. This is a disease with an unknown cause, but the mechanism of development is identical to postpartum.
Cytokine-induced form. It develops when the thyroid gland is “bombarded” with cytokine substances that appear in the body in large quantities when long-term treatment with interferon preparations is carried out - injectable “Laferon”, “Viferon” (this is usually treated viral hepatitis C to outcome in, some blood diseases).

Depending on the degree of enlargement of the gland, there is another classification of autoimmune thyroiditis. Based on this, the disease can be:

Latent: the thyroid gland may be slightly enlarged or be normal. The level of hormones and, accordingly, the function of the gland are not changed.
Hypertrophic: the size of the organ is increased or completely ( diffuse form), or in one/several places (nodular thyroiditis).
Atrophic: the size is reduced, the amount of hormones produced is reduced. This is with autoimmune thyroiditis.

Causes of pathology

In order for any of the autoimmune thyroiditis to develop, only a defect in the genes encoding the activity of the immune system is not enough. As a triggering factor, which a person considers the cause of his illness, can be:

transferred, less often - other respiratory viral diseases, as well as;
taking large amounts of iodine;
chronic infection in the body:, untreated caries,;
living in poor environmental conditions, when a lot of chlorine or fluorine enters the body;
selenium deficiency in the soil in the region of residence
ionizing radiation;
psychoemotional stress.

Stages and symptoms

Hashimoto's thyroiditis is divided into several stages. One smoothly flows into the other.

Euthyroid stage

Hashimoto's disease begins with the fact that immune cells begin to "see" thyroid cells, thyrocytes. These are foreign structures for them, so they decide to attack thyrocytes and, with the help of chemical substances, dissolved in the blood, call for this purpose to their fellows. They attack thyrocytes, producing antibodies against them. The latter may vary in number. If there are few of them, few cells of the gland die, it is supported euthyroid phase diseases, the levels of all hormones are not changed, there are symptoms only due to an increase in the gland:

the thyroid gland becomes visible;
it can be probed, while it is determined;
it becomes difficult (like a “lump in the throat”) to swallow, especially solid food;
a person gets tired when doing less work than before.

subclinical stage

The same symptoms of autoimmune thyroiditis are observed in subclinical phase diseases. At this time, the number of cells in the gland decreases, but those that should be at rest are included in the work. This happens due to thyroid-stimulating hormone (TSH).

Thyrotoxicosis

If there are too many thyroid-stimulated antibodies, it develops thyrotoxic phase. Its signs are as follows:

fast fatiguability;
irritability, tearfulness, anger;
weakness;
hot flushes;
sweating;
a perceived increase in heart rate;
tendency to diarrhea;
decrease in sexual desire;
difficult to be in a hot climate;
violation of the menstrual cycle.

If the disease occurs in a child, at this stage, attention is most often drawn to the fact that he becomes very thin and does not gain weight, despite increased appetite.

Hypothyroidism

When antibodies destroy a large volume of the working area of the gland, the last phase of autoimmune thyroiditis occurs - hypothyroidism. Its signs are:

weakness;
depression, apathy;
slowing down speech and reaction;
weight gain with poor appetite;
the skin becomes pale, edematous, yellowish in color and dense (does not fold);
puffy face;
constipation;
a person freezes quickly;
hair falls out more;
hoarse voice;
menstruation rare and scanty;
brittle nails;
joint pain.

In a child, hypothyroidism is manifested by weight gain, memory impairment, he becomes more phlegmatic, remembers material worse. If the disease develops at an early age, mental development is significantly behind the due.

Postpartum thyroiditis

In this case, at 14 weeks after birth, lung symptoms hyperthyroidism:

fatigue;
weight loss;
weakness.

They can intensify up to the appearance of a feeling of heat, a feeling of a strong heartbeat, insomnia, rapid mood swings, trembling of the limbs. By the end of 4 months after birth (about 5 weeks after the onset of the first signs), symptoms of hypothyroidism appear, which are often attributed to postpartum depression.

Painless thyroiditis

It is characterized by hyperthyroidism mild form: slight irritability, sweating, increased frequency heart rate. All this is attributed to overwork.

Cytokine-induced thyroiditis

Against the background of the injection of "Alveron", "Viferon" or other interferons, symptoms of both increased and reduced thyroid function may occur. Usually they are expressed slightly.

Autoimmune thyroiditis and fertility

Autoimmune thyroiditis at the subclinical, euthyroid and thyrotoxic stages does not interfere with conception, which cannot be said about the stage of hypothyroidism, because thyroid hormones affect ovarian function. If adequate treatment with synthetic hormones is carried out at this stage, then pregnancy will occur. At the same time, there is a danger of miscarriage, since antibodies to the gland, the production of which does not depend on the amount of L-thyroxine (or Euthyrox) taken, negatively affects the ovarian tissue. But the situation is corrected if replacement therapy progesterone to keep the pregnancy going.

A woman with thyroiditis should be observed by an endocrinologist during the entire gestation period. In a hypothyroid state during this period, he should increase the dose of thyroxin (the need for thyroid hormones of two organisms - mother and child - increases by 40%). Otherwise, if a small amount of thyroid hormones remains in the mother's body during pregnancy, the fetus may develop severe pathologies, sometimes incompatible with life. Or will he be born congenital hypothyroidism, which is equivalent to heavy mental retardation and metabolic disorders.

What is needed for a diagnosis

If autoimmune thyroiditis is suspected, such a diagnosis is carried out. A blood test for hormones is performed:

T3 - common and free,
T4 - common and free,

If TSH is elevated, and T4 is normal, this is a subclinical stage, but if elevated TSH the level of T4 decreases - means that the first symptoms should already appear.

The diagnosis is established on the basis of a combination of such data:

Increased level of antibodies to the thyroid enzyme - thyroid peroxidase (AT-TPO) in the analysis of venous blood.
On ultrasound of the thyroid gland, its hypoechogenicity is determined.
Decreased concentrations of T3, T4, elevated TSH levels.

Only one indicator does not allow making such a diagnosis. Even an increase in AT-TPO only indicates that a person has a predisposition to autoimmune damage to the gland.

If the thyroiditis is nodular, each node is biopsied to visualize signs of thyroiditis and to rule out cancer.

Complications

At different stages thyroiditis - various complications. So, the hyperthyroid stage can be complicated by arrhythmia, heart failure, and even provoke myocardial infarction.

Hypothyroidism can cause:

habitual miscarriage;
congenital hypothyroidism in a newborn child;
dementia;
depression
myxedema, which looks like intolerance to the slightest cold, constant drowsiness. If in this state enter sedatives, get severe stress or get sick with an infectious disease, you can provoke a hypothyroid coma.

Luckily, given state responds well to treatment and, if you take drugs in a dose matched to the level of hormones and AT-TPO, you can long time not feel the presence of the disease.

Diet for autoimmune thyroiditis

The diet should be normal in terms of calories ( energy value not less than 1500 kcal), but it is better if you calculate it according to Mary Chaumont: (weight * 25) minus 200 kcal.

The amount of protein should be increased to 3 g per kg of body weight, and saturated fat and easily digestible carbohydrates - limit. You need to eat every 3 hours.

What you can eat:

vegetable dishes;
red fish in a baked form;
fish fat;
liver: cod, pork, beef;
pasta;
dairy;
legumes;
eggs;
butter;
cereals;
bread.

Salty, fried, spicy and smoked foods, alcohol and seasonings are excluded. Water - no more than 1.5 l / day.

We need unloading - once a week or 10 days - days on juices and fruits.

Treatment

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

in the euthyroid stage treatment is not carried out.

How to treat the stage of thyrotoxicosis the doctor decides. Usually thyreostatics, such as Mercazolil, are not prescribed. The treatment is carried out symptomatically: for tachycardia, beta-blockers are prescribed: Atenolol, Nebivolol, Anaprilin, with severe psycho-emotional excitability - sedatives. If a thyrotoxic crisis occurs, therapy is carried out in a hospital with the help of injectable glucocorticoid hormones (Dexamethasone, Prednisolone). The same drugs are administered if autoimmune thyroiditis is combined with subacute thyroiditis, but the treatment is carried out at home.

In the stage of hypothyroidism synthetic T4 (thyroxine) called "L-thyroxine" or "Eutiroks" is prescribed and, if there is a shortage of triiodothyronine, its analogues created in the laboratory. The dosage of thyroxin for adults is 1.4-1.7 mcg / kg of weight, in children - up to 4 mcg / kg.

Thyroxine is prescribed for children if there is an increase in TSH and normal or reduced level T4, if the gland is enlarged by 30 percent or more of the age norm. If it is enlarged, its structure is heterogeneous, while AT-TPO is absent, iodine is prescribed in the form of potassium iodide at a dosage of 200 mcg / day.

When the diagnosis of autoimmune thyroiditis is established to a person living in an area with iodine deficiency, physiological doses of iodine are used: 100-200 mcg / day.

Pregnant women are prescribed L-thyroxine if TSH is more than 4 mU / l. If they have only AT-TPO and TSH is less than 2 mU/L, thyroxine is not used, but TSH levels are monitored every trimester. In the presence of AT-TPO and TSH 2-4 mU/l, L-thyroxine is needed in prophylactic doses.

If thyroiditis is nodular, in which it cannot be excluded, or if the thyroid gland compresses the organs of the neck, significantly complicating breathing, surgical treatment is performed.

Forecast

If treatment is started on time, before the death of more than 40% of the thyroid cell mass, the process can be controlled and the prognosis is favorable.

If a woman has already developed thyroiditis after childbirth, the likelihood of its occurrence after next birth – 70%.

One third of cases of postpartum thyroiditis transforms into a chronic form with the development of persistent hypothyroidism.

Disease prevention

It is impossible to prevent the transmission of a defective gene. But it is worth monitoring the function of your own thyroid gland, on a planned basis (especially if there is a tendency to gain weight or, conversely, to thinness), once a year, by donating blood for T4 and TSH. It is also optimal to undergo an ultrasound of the gland every 1-2 years.

A routine examination for T4, AT-TPO and TSH is especially needed in the event of pregnancy. These tests are not included in the list of mandatory studies, so you need to ask for a referral yourself, from an endocrinologist.

Thyroiditis, otherwise known as lymphatic/autoimmune thyroiditis, is a general definition of inflammatory processes in the tissues of the thyroid gland, which have a different origin. In the case of a uniform distribution of inflammation, the disease is called "strumitis".

Thyroiditis affects almost a third of all sufferers endocrine diseases. If a earlier diagnosis were given to elderly people, then at present the disease has become much “younger”, occurring even in children.

The symptomatic picture of thyroiditis is mainly manifested after respiratory infection acute current.

It's important to know! The most widespread thyroiditis is autoimmune (Hashimoto's goiter) and subacute (de Quervain's goiter) types.

Classification of thyroiditis

The pathology of the thyroid gland differs in several types that have a common onset of development, but each of which is manifested by its own course and cause:

Chronic view characterized by diseases that have a sluggish inflammatory response. This may apply to postpartum, autoimmune (Hashimoto's goiter), painless, fibrous (Riedel), specific (fungal, syphilitic, tuberculous types), cytokine-induced thyroiditis:

with lymphomatous thyroiditis, or Hashimoto's goiter, the pathology manifests itself as a reaction to a significant number of T-lymphocytes and antibodies that destroy cell structures glands. As a result, hormone production is reduced, called hypothyroidism. There is a hereditary predisposition to this disease;
with postpartum thyroiditis - one of the most recorded forms - the process of inflammation occurs due to unbalanced psycho-emotional state women and physical overload during childbearing. The postpartum form of the disease has a short course, disappearing on average after 2-3 months. With hereditary predisposition, this form of the disease changes, acquiring the form of autoimmune destructive thyroiditis;
with a silent / painless variant, the signs of inflammation are the same as in the postpartum one, but the causes of the appearance have not yet been described in medicine;
with fibro-invasive (Riedel's goiter) - a rare disease - there is a "stone" hardness of glandular tissues. Pathology is often detected in females who have reached the age of 50 years and older. The cause of the occurrence is unknown to medicine. The result of the pathology is hypothyroidism;
with specific thyroiditis, the function of the thyroid gland is impaired due to tuberculosis, syphilis, and fungal infections. Signs of the disease do not make themselves felt for a long time, but then appear according to the characteristics of the course of pathologies;
with cytokine-induced thyroiditis, the inflammatory process develops against the background of hepatitis C, diseases circulatory system and, in turn, according to the symptoms is divided into several types, among which:

latent (the patient does not notice painful manifestations, "thyroid gland" is not enlarged, there are no seals);
hypertrophic (the gland is enlarged as in goiter, functionality is impaired, nodes may form);
atrophic (the size of the thyroid gland is either normal or slightly less than normal, hormones are produced in small quantities).

Hashimoto's goiter in chronic thyroiditis

Autoimmune thyroiditis belongs to the leading position among the pathologies of the "thyroid gland". They mostly affect women. The entire tissue of the gland is affected for a currently unknown reason. For some reason, the cells of the immune system begin to destroy the elements of the "thyroid gland" structure. Perhaps this disease occurs due to a genetic predisposition. The connection of autoimmune processes with infections has also been determined. chronic nature in the respiratory tract urinary organs, teeth with carious pathology, etc. Hypothyroidism occurs as a complication of the disease.

Subacute thyroiditis(de Quervain's granular goiter) 2-6 weeks are preceded by viral diseases, for example, mumps, measles, influenza and other pathologies of adenovirus infection. Women suffer from this variant of thyroiditis more often than men (four times), mostly at the age of 35-45 years. Viruses destroy the glandular tissue, a large amount of the follicular contents of the organ (colloidal), consisting of hormones, “breaks through” into the blood. Once in the bloodstream, these hormones cause intense symptoms (including pain) of thyrotoxicosis, which first affects one lobe of the "thyroid gland", and then the other.

It's important to know! Pain in the subacute form of the disease is not as intense as in the acute form. The skin over the gland does not change its structure and color. An indicator can help diagnose a subacute type of pathology increased speed erythrocyte sedimentation, determined during a blood test. The indicator above the norm remains as such for a long time.

Acute type of disease correspond to purulent and non-purulent processes. The first type is provoked by coccal bacteria. Currently, such a pathology is a rare phenomenon in medicine, since antibiotics are widely used. But acute purulent diseases, chronic infections of the throat, ear, nose. The patient is concerned about significant pain sensations of a pulsating nature in the "thyroid gland", sometimes extending to the jaw or ear. At the same time, the neck swells, turns red, and responds with pain during palpation examination. It is possible to open an abscess on its own, which significantly aggravates the course of the disease. This variant of the disease requires surgical assistance.

Non-purulent process occurs as a result of injury, hemorrhage, treatment. Bacteria have no effect here. Modern endocrinology does not register cases of non-purulent thyroiditis associated with the use radioactive iodine in treatment, due to a significant improvement in the method.

It's important to know! Acute purulent thyroiditis does not affect the activity of the gland, hormonal background is not violated. Accordingly, there is no need to analyze the thyroid hormones in order to clarify the diagnosis. In the treatment, antibacterial agents are used, aimed at the destruction of the causative agent of the pathology, determined by the laboratory method.

Causes of thyroiditis

In addition to hereditary predisposition, other factors provoking the disease have been established:

transferred acute respiratory infections, ARVI;
unfavorable ecological situation, fluorine, chloride, iodide compounds in excess in water and food consumed by a person;
chronic infectious diseases in the nose, mouth;
stressful conditions;
prolonged exposure to sunlight, radioactive rays;
self-treatment with hormonal, iodine-containing agents.

Symptomatic picture

The disease has common symptoms associated with:

elevated temperature;
signs of chills, weakness;
profuse sweating;
headache;
irritability (especially with de Quervain's goiter);
unhealthy gleam in the eyes;
trembling fingers;
heating and moisturizing the skin.

The acute variant of the disease differs in addition to common symptoms the following signs:

sensations of pain in the neck, radiating to the occipital and jaw regions, as well as when turning the head and trying to make a swallowing movement;
an increase in lymph nodes in the neck;
when pressed, there is an increase and soreness of the inflamed part of the gland.

Subacute thyroiditis is characterized by an acute onset, additionally manifesting symptoms, expressed in:

severe pain felt in the anterior-posterior parts of the neck, spreading to the occipital region, both ears, mandibular region, when trying to turn the head to the right or left (the symptoms of pain in Riedel's goiter can last up to 20 days);
hyperemia, soreness, "hotness" of the skin in the area of the inflamed "thyroid gland";
the normal state of the lymph nodes in the neck, which do not increase with this disease (the pathology may be called lymphocytic thyroiditis).

The immune variant of thyroiditis is characterized by the following symptoms:

an increase in only that area of \u200b\u200bthe "thyroid gland" where the inflammatory process originates;
nodulation (when probing, the density and mobility of the gland are recorded);
compression in front of the neck (with significant progression and an increase in the "thyroid gland");
the appearance of hyperthyroid symptoms, then hypothyroidism;
weight loss, weakness, irritability, rapid heart rate, excessive sweating, feeling hot (due to excess hormones in the blood);
swallowing problems.

Rigel's thyroiditis (fibrous) with chronic type slow development is inherent, the disease does not “show” its symptoms for a long time.

One of the first signs is the appearance of a "lump" in the throat, then there are:

impaired functions of swallowing, breathing, there is a violation of speech;
enlarged, inflamed and tuberous "thyroid gland", which reacts with pain to touch (the sealing surface becomes "wooden" over time);
damage to all parts of the gland, impaired visual function;
compression syndrome.

Diagnostic measures

When diagnosing thyroiditis, the following research activities are carried out:

blood (general, for hormones, immunological tests);
ultrasound (tumors, nodes formed in the gland are detected);
scintigraphy (the area of the lesion, contour outlines, the transformed form of the "thyroid gland", etc. are estimated).

Treatment of thyroiditis

There are no uniform standards for the treatment of this pathology. Treatment requires individual approach to every patient.

The course of the disease in a mild form is under the control of an endocrinologist who prescribes non-steroidal anti-inflammatory drugs to eliminate pain and means for symptomatic therapy. The use of steroid hormones is required for severe diffuse inflammation.

Acute purulent thyroiditis is treated in a hospital, in the department of surgery. Used antibacterial, antihistamines, vitamins C, B, detoxification agents by intravenous administration. With an abscess in the gland, an operation with drainage is mandatory.

Chronic subacute thyroiditis requires taking drugs containing thyroid hormones, and a surgical method is indicated if there is a progression of the compression syndrome with squeezing signs.

The results of treatment of subacute thyroiditis are often positive, but nodular seals appear in the gland that do not require medical intervention.

The immune type of the disease is subject to immediate treatment. In order to normalize the activity of the immune system, a special diet is prescribed. With a significant increase in the gland, a thyroidectomy is performed - an operation to remove the "thyroid gland".

Thyroidectomy

The operation is carried out in cases of detection of malignant, nodular formations, diffuse goiter. In those situations where there is a clear deterioration in the state of the "thyroid gland" with an excessive amount of hormones produced, and conservative treatment and the diet did not show effectiveness, when squeezing the trachea and esophagus.

Surgical intervention is also prescribed in cases where the patient has completed a course of therapy, received radiation, resulting in nodular formations on the thyroid gland.

Treatment with alternative medicine

Traditional medicine has a number of recipes that help to effectively influence the symptoms of thyroiditis and are used at home. You should consult your doctor before choosing any method for use regarding the use of:

Compresses. Since pathologies of the "thyroid gland" are often complications colds, as a result of which there are nodular formations, and if the operation is contraindicated, then compresses with wormwood should be done daily. Two large spoons of dry herbs are mixed with melted over a fire. pork fat. The mixture is stirred until smooth and infused for half an hour. Before going to bed, it is applied to the places of inflammation. Contrasting compresses are also welcome. The alternation of cold and warm compresses always ends with the application of warm. From above, wrap the neck with a diaper, towel or scarf.
Decoctions. For example, willow leaves (fresh) are poured with four liters of water and boiled over low heat until a brown creamy liquid is formed. The decoction is cooled, then applied every night, applied to the neck, wrapping with a film and remaining until the morning.
An iodine mesh applied to the foot for 30 days, and an iodine strip - in the form of a bracelet at night.
Pig fat. It is cut into slices and applied to the neck, then wrapped in a film. The procedure takes 30 days.
Seaweed, apples. It is necessary to enrich the diet with vitamins, iodine, minerals, etc.
Vegetable cocktail. It can reduce pain. To prepare a cocktail, you will need potato, beetroot, carrot juice(equal parts). Drink half a liter a day.

Important to remember! Usage folk remedies acts as an auxiliary link in the treatment of a serious illness. Do not rely on them as basic and do not ask for medical care. Consequences and complications can threaten the health and life of people.