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Thyroiditis-chronic (Hashimoto’s disease)


Chronic thyroiditis is swelling (inflammation) of the thyroid gland that often results in reduced thyroid function (hypothyroidism).


Alternative Names

Total thyroidectomy; Partial thyroidectomy; Thyroidectomy; Subtotal thyroidectomy


Causes

Chronic thyroiditis or Hashimoto's disease is a common thyroid gland disorder. It can occur at any age, but is most often seen in middle-aged women. It is caused by a reaction of the immune system against the thyroid gland.


The disease begins slowly. It may take months or even years for the condition to be detected. Chronic thyroiditis is most common in women and in people with a family history of thyroid disease. It affects between 0.1% and 5% of all adults in Western countries.


Hashimoto's disease may, in rare cases, be related to other endocrine (hormonal) disorders caused by the immune system. Hashimoto's disease can occur with adrenal insufficiency and type 1 diabetes. In these cases, the condition is called type 2 polyglandular autoimmune syndrome (PGA II).


Less commonly, Hashimoto's disease occurs as part of a condition called type 1 polyglandular autoimmune syndrome (PGA I), along with:

  • Adrenal insufficiency (poor function of the adrenal glands)
  • Fungal infections of the mouth and nails
  • Hypoparathyroidism (underactive parathyroid gland)

Symptoms

  • Constipation
  • Difficulty concentrating or thinking
  • Dry skin
  • Enlarged neck or presence of goiter
  • Fatigue
  • Hair loss
  • Heavy and irregular periods
  • Intolerance to cold
  • Mild weight gain
  • Small or shrunken thyroid gland (late in the disease)

Other symptoms that can occur with this disease:

  • Joint stiffness
  • Weight gain (unintentional)
  • Swelling of the face

Note: There may be no symptoms.


Treatment

A lack of thyroid hormone may develop. You may receive thyroid hormone replacement therapy (levothyroxine) if your body is not producing enough of the hormone. Or, you may receive it if you have signs of mild thyroid failure (such as elevated TSH). This condition is also known as subclinical hypothyroidism.


If there is no evidence of thyroid hormone deficiency, you may just need to be seen regularly by a health care provider.


Surgery

Sometimes a thyroidectomy (Thyroid Gland Removal) is needed to relieve the symptoms for Hashimoto’s.


Thyroid gland removal is surgery to remove all or part of the thyroid gland. Your thyroid gland is a butterfly-shaped gland that lies over your trachea (the tube that carries air to your lungs). It is just below your voice box.

  • Total thyroidectomy removes the entire gland.
  • Subtotal or partial thyroidectomy removes part of the thyroid gland.
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