Autoimmune disease results when the immune system misidentifies a body cell or tissue and attempts to neutralize it as if it were a foreign substance. Inflammation, one component of the immune response, is common in these conditions and results from chronic overactivation of the immune system. Many body systems can be affected, among them the thyroid gland, which can manifest as both hyperthyroid and hypothyroid autoimmune states. Autoimmunity and thyroid autoimmune conditions occur more frequently in women and affect a significant portion of the population.
Hashimoto's Disease
Also known as Hashimoto's thyroiditis, this is the most common form of hypothyroid disease. A partial list of symptoms includes fatigue, muscle and joint pain, cold intolerance, emotional irritability, cognitive impairment and menstrual irregularities. Combinations of any, all or none of these symptoms can manifest in any given individual. Degree and length of time of hormone deficiency also contribute to the expression of symptoms. Because the symptom picture can vary widely, diagnosing Hashimoto's is best done using a combination of blood hormone levels and the patient's subjective complaints. Left untreated, Hashimoto's thyroiditis may progress into potentially life threatening heart complications, clinical depression or even coma. Treatment with thyroid hormone is the medical standard of care and can take several weeks until discernible improvement is attained.
Grave's Disease
Grave's disease, also referred to as toxic diffuse goiter, is the most common cause of autoimmune hyperthyroidism. Symptoms include goiter, or enlarged thyroid gland, and exophthalmos, a protrusion of the eyes from retraction of the eyelid. Grave's opthalmopathy, as the eye condition is also known, occurs in 25 percent of patients and often resolves within one to two years. Other components of the symptom picture include nervousness, muscle weakness, heat intolerance, insomnia, irregular heart rate, diarrhea and weight loss. A causative factor for Grave's disease remains unidentified. It occurs five times more often in women than men and is estimated to affect 1.3 percent of the U.S. population. Age at diagnosis is usually under 40 and heredity plays a role. Medical treatment involves destroying the thyroid with radioactive iodine, antithyroid drugs or surgery to remove the gland.
Subacute Lymphocytic Thyroiditis
Also known as silent sporadic thyroiditis or painless sporadic thyroiditis, this condition is characterized by goiter, which is followed by a hypothyroid state and is usually self-limiting, resolving on its own within four months to a year. It is four times more prevalent in women. Lab tests reveal antithyroid antibodies in 50 percent of cases, while thyroid stimulating immunoglobulins will be absent.
Riedel's Thyroiditis
This condition, also known as fibrous thyroiditis, involves a hard, even rock-like swelling and fibrosis of the thyroid. Symptoms of compression of the throat and difficulty breathing occur from the mechanical effect of the swelling and fibrosis. Reidel's thyroiditis occurs most often in the age range of 30 to 60 years, with antithyroid antibodies being present in the majority of cases. Treatment involves surgery to relieve the compression, and immune suppressant and anti-inflammatory drugs.
