Hashimoto's is an autoimmune thyroid disease that occurs when the body's own immune system attacks the thyroid gland. The inflammation of the thyroid gland results in decreased hormone production, affecting the body's metabolic balance and causing noticeable symptoms across various systems. Early recognition and appropriate management of the disease are important for maintaining quality of life.
What is Hashimoto's?
Hashimoto's disease is an autoimmune disorder where the body exhibits an aggressive reaction against the thyroid gland. This disease is most commonly seen in middle-aged women and may lead to hypothyroidism over time as thyroid hormone levels decrease.
It is associated with symptoms such as fatigue, weight gain, depression, and swelling in the neck. A diagnosis of Hashimoto's can be made using TSH, T3, T4, and antibody tests; treatment may include hormone supplementation.
Why Does Hashimoto's Occur?
Hashimoto's thyroiditis occurs when the immune system perceives the thyroid gland as foreign tissue. Under normal circumstances, the body's defense system, which protects against harmful microorganisms such as viruses and bacteria, begins producing antibodies against thyroid cells. These antibodies can cause inflammation and damage in the thyroid tissue. Over time, the thyroid gland shrinks, hormone production decreases, and hypothyroidism develops.
- Genetic Predisposition
Hashimoto's is more common in individuals with a genetic predisposition to autoimmune diseases. The risk increases if family members have thyroid disease, type 1 diabetes, or celiac disease.
- Hormones
Hashimoto's disease is about 10 times more common in women than in men. This situation is associated with the role of estrogen hormone in influencing the immune system. Hormonal changes during the post-partum period or pre-menopause can trigger the development of Hashimoto's.
- Stress
Intense stress can disturb the immune system's balance, increasing the autoimmune response. The increase in the number of patients diagnosed with Hashimoto's after prolonged periods of stress supports this connection.
- Environmental Factors
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Iodine intake: Can enhance immune response by causing more stimulation of thyroid cells.
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Exposure to radiation: Particularly receiving radiotherapy in the neck area or exposure to environmental radiation increases the risk.
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Certain viral infections: As the body fights a virus, it may mistakenly target thyroid cells.
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- Nutritional Factors
Imbalanced and inadequate nutrition, vitamin D, selenium, and zinc deficiencies can negatively affect the proper functioning of the immune system.
- Autoimmune Diseases
Hashimoto's may sometimes be associated with other autoimmune diseases such as type 1 diabetes, vitiligo, celiac disease, and rheumatoid arthritis, indicating a more general imbalance in the immune system.
What are the Symptoms of Hashimoto's Disease?
Over time, the immune system's influence over the thyroid gland may lead to reduced hormone production, potentially resulting in the development of hypothyroidism. A decrease in thyroid hormones directly affects the body's energy balance and metabolism.
Common symptoms of Hashimoto's disease include:
- Fatigue and Lethargy
Thyroid hormones play a role in all energy processes in the body. As these hormones decrease, energy production slows down, and an individual may continuously feel tired, sleepy, and fatigued. This fatigue, which does not improve with rest, is one of the most noticeable symptoms of the disease.
- Weight Gain and Metabolic Slowdown
In Hashimoto's disease, insufficient functioning of the thyroid gland can slow down metabolism. This may cause weight gain, even when the person eats less than normal.
- Skin and Hair Changes
A decrease in thyroid hormones can manifest as dry skin, pallor, and thickening. Hair loss, nail breakage, and thinning of hair strands are also common. Some individuals may also experience skin itching and a feeling of coldness.
- Sensitivity to Cold
As a result of decreased thyroid hormones, body temperature may drop. Therefore, individuals with Hashimoto's often feel chilly. Increased sensitivity to cold is a prominent symptom of hypothyroidism.
- Digestive Problems and Abdominal Bloating
Low thyroid hormones can result in gas buildup, difficulty digesting, and a feeling of fullness in the stomach. Particularly, the condition referred to as Hashimoto’s abdominal bloating clearly demonstrates the disease's impact on the digestive system.
- Mood Changes
Depressive mood and forgetfulness are frequently observed in individuals with Hashimoto's. Due to the effect of thyroid hormones on brain chemicals, a person may feel unmotivated, unhappy, or constantly anxious.
- Muscle and Joint Pain
Stiffness, cramps, joint pain, and muscle weakness are frequent complaints associated with Hashimoto’s disease. These symptoms result from the diminished regulatory effect of thyroid hormones on muscle tissue.
- Menstrual Irregularities
Thyroid hormones are among the hormones that regulate the menstrual cycle in women. In Hashimoto’s disease, menstrual periods can be irregular, longer, or manifest as excessive bleeding.
- Swelling or Discomfort in the Neck
Chronic inflammation of the thyroid gland may eventually cause the gland to enlarge. This condition can lead to a sensation of fullness or pressure in the neck, similar to the condition commonly known as a goiter.
The severity and combination of symptoms can vary in each individual. Some people may only experience mild fatigue, while others may develop significant weight gain or emotional fluctuations. Thus, thyroid function tests are important for early diagnosis and monitoring.
How is Hashimoto's Disease Diagnosed?
The diagnosis process for Hashimoto's thyroiditis may begin with the examination of TSH and thyroid hormone levels during routine checks, or when patients visit a doctor with symptoms such as fatigue or hair loss. If a specialized physician suspects Hashimoto’s disease after reviewing the patient’s medical history and conducting a physical examination, various tests will be requested.
Initially, blood levels of TSH, T3, and T4 hormones are examined. An ultrasound test is conducted to determine the structure and size of the thyroid gland. The main diagnostic indicator is whether the levels of anti-TPO and anti-thyroglobulin antibodies are elevated.
The purpose of the tests is to diagnose the disease as well as to determine the stage of the disease. Initially, antibody levels are high, even though hormone levels are normal. Over time, changes can occur in hormone levels.
How is Hashimoto's Treated?
Since Hashimoto's thyroiditis is an autoimmune disease, if the loss of function in the thyroid gland is detected early, hormone balance can be maintained, and the disease can be brought under control.
The aim of treatment for Hashimoto’s is to keep thyroid hormone levels within normal ranges, rebalance metabolism, and improve quality of life.
Hormone Replacement Therapy
In Hashimoto’s disease, when the thyroid gland is unable to produce enough hormones, these hormones are provided externally in the form of medication. This treatment restores the body's energy balance, normalizes metabolism, and significantly reduces symptoms. Regular continuation of treatment is the most important factor in keeping the disease under control.
Dietary Adjustment (Hashimoto’s Diet)
Diet is a supportive component of Hashimoto's treatment. An appropriate diet plan can help balance the immune system and regulate the digestive system.
Aspects to consider in a Hashimoto's diet:
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Gluten and processed foods should be reduced as much as possible.
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Foods rich in selenium, zinc, and vitamin D should be consumed.
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Excessive iodine intake should be avoided, and iodized salts should not be used without a doctor's recommendation.
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Refined sugars, fried foods, and those containing trans fats can negatively affect the immune system.
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Probiotics support digestion and can reduce abdominal bloating and constipation.
Regular Monitoring and Blood Tests
Hashimoto's disease is a chronic condition. Therefore, it is very important to attend regular doctor visits at specified intervals. Typically, thyroid function tests are conducted every 3-6 months after the initial diagnosis. Once hormone levels stabilize, a check-up once or twice a year may suffice.
Lifestyle Adjustments
Treatment is not limited to medication alone. Certain lifestyle changes can aid in balancing the immune system:
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Stress management: Stress can trigger the autoimmune process.
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Regular exercise: Gentle walks and muscle-strengthening exercises can support metabolism.
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Adequate sleep: Lack of sleep can negatively affect hormone balance. It is recommended to get at least 7-8 hours of quality sleep per day.
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Avoid the use of tobacco and alcohol.
These habits can support the treatment process and slow the progression of the disease.
Frequently Asked Questions
Why does Hashimoto's cause abdominal bloating?
In Hashimoto’s disease, a decrease in thyroid hormones can slow down the digestive system. This can lead to reduced bowel movements, gas, and fluid retention, causing abdominal bloating.
How should Hashimoto's patients eat?
A gluten-free, natural, and anti-inflammatory diet is recommended for Hashimoto's nutrition. Foods rich in zinc, selenium, and vitamin D should be preferred; refined sugars, trans fats, and processed foods should be avoided.
Is Hashimoto's genetic?
Yes. People with a genetic predisposition are more likely to develop Hashimoto's disease.
Does Hashimoto's make it difficult to lose weight?
As the metabolism slows with reduced thyroid hormones, weight loss can become more challenging. However, with appropriate treatment, hormone balance can be achieved, making weight control possible.
