Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Hashimoto's thyroiditis is the most common cause of hypothyroidism in the
United States. It is named after the first doctor who described this condition,
Dr. Hakaru Hashimoto, in 1912.
What causes Hashimoto's thyroiditis?
Hashimoto's thyroiditis is a condition caused by inflammation of the
thyroid gland. It is an
autoimmune disease, which means that the body inappropriately attacks the thyroid
gland--as if it was foreign tissue. The underlying cause of the autoimmune
process still is unknown. Hashimoto's thyroiditis tends to occur in families, and is
associated with a clustering of other autoimmune conditions such as Type 1
diabetes, and celiac disease. Hashimoto's
thyroiditis is 5-10 times more common in women
than in men and most often starts in adulthood. Blood drawn from patients with
Hashimoto's throiditis reveals an increased number of antibodies to the enzyme, thyroid
peroxidase an enzyme (protein) found within the thyroid gland. As result of the
antibodies' interaction with the enzyme, inflammation develops in the thyroid
gland, the thyroid gland is destroyed, and the patient ultimately is rendered
hypothyroid (too little thyroid hormone).
The symptoms of Hashimoto's thyroiditis are similar to those of hypothyroidism in general, which are often subtle. They are not specific (which means
they can mimic the symptoms of many other conditions) and are often attributed
to aging. Patients with mild hypothyroidism may have no signs or symptoms. The symptoms
generally become more obvious as the condition worsens and the majority of these complaints
are related to a metabolic slowing of the body. Common symptoms are listed below:
As hypothyroidism becomes more severe, there may be puffiness around the eyes, a slowing
of the heart rate, a drop in body temperature, and heart failure. In its most
profound form, severe hypothyroidism may lead to a life-threatening coma (myxedema coma). In a
severely hypothyroid individual, a myxedema coma tends to be triggered by severe illness,
surgery, stress, or traumatic injury. This condition requires hospitalization and immediate
treatment with thyroid hormones given by injection.
Properly diagnosed, hypothyroidism can be easily and completely treated with thyroid
hormone replacement. On the other hand, untreated hypothyroidism can lead to an
enlarged heart (cardiomyopathy), worsening heart failure, and an accumulation of fluid around
the lungs (pleural effusion).
There are a few patients with Hashimoto's thyroiditis who may undergo a hyperthyroid phase (too much thyroid
hormone), called hashitoxicosis, before eventually becoming hypothyroid. Other
symptoms and signs include:
Swelling of the thyroid gland (due to the inflammation), leading to a feeling
of tightness or fullness in the throat
A lump in the front of the neck, (the enlarged thyroid gland) called a
Difficultly swallowing solids and/or liquids due to the enlargement of the
thyroid gland with compression of the esophagus
Medical Author: Melissa Conrad St?ppler, MD
Medical Editor: William C. Shiel, Jr, MD, FACP, FACR
The thyroid glandis a
butterfly-shaped organ situated on the front of the neck that secretes two hormones, thyroxine(also known as T4) and
triiodothyronine(called T3), that are important in the control of metabolism.
Hypothyroidism is a condition in which the thyroid gland does not produce
adequate levels of these critical hormones.
Hypothyroidism is very common and is estimated to affect
3%-5% of the adult population. It is more common in women
than in men, and the risk of developing hypothyroidism increases with advancing
Hypothyroidism is most commonly a result of an
autoimmune condition known as Hashimoto's thyroiditis, in which the body's
own immune cells attack and destroy the thyroid gland.