Hashimoto's thyroiditis is the most common thyroid condition in America. Caused by an autoimmune disorder, thyroid cells that produce thyroid hormones are damaged. The disease can appear in tandem with adrenal insufficiency, a disease characterized by the reduction of adrenal hormone production. When both conditions appear together, the condition is called polyglandular autoimmune syndrome type II.
Cause
Hashimoto's thyroiditis and adrenal insufficiency are caused by an autoimmune condition. The immune system is composed of specialized cells to destroy invading organisms and toxic substances; with an autoimmune disorder, the immune system mistakenly recognizes the cells of the thyroid and adrenal glands as foreign and destroys their capacity to produce thyroid and adrenal gland hormones, according to the University of Maryland Medical Center.
Signs and Symptoms
Signs and symptoms of Hashimoto's disease are fatigue, hair loss, enlarged neck, goiter, brain fog, constipation, minor weight gain, irregular menstrual periods, stiff joints and swollen face.
Adrenal insufficiency will present with fatigue, brown patches on the skin, nausea, vomiting, muscle weakness, dizziness, anxiety and depression, and women lose underarm and public hair along with regular menstrual periods, according to the Milton S. Hershey Medical Center at Penn State University.
Polyglandular Autoimmune Syndrome Type II
When polyglandular autoimmune syndrome type II, or Schmidt's syndrome, occurs, additional disorders appear, including infertility, discoloration of skin patches, autoimmune hepatitis, alopecia, celiac disease, myasthenia gravis and pernicious anemia, according to the Johns Hopkins Medical Institutions.
Diagnosis
Hashimoto's disease is diagnosed by measuring the levels of thyroid hormones T4, T3 and TSH, or thyroid stimulating hormone, as well as the thyroid autoantibodies antithyroid peroxidase and antithyroglobulin antibody, notes the University of Maryland Medical Center.
Adrenal insufficiency may be diagnosed when glucose, sodium and cortisol are deficient and potassium is elevated in the blood. A physician will also assess the skin for the characteristic brown patches, according to the Milton S. Hershey Medical Center at Penn State University.
Treatment
Hashimoto's disease results in hypothyroidism, or a deficiency of thyroid hormone production. Therefore, the primary treatment for this condition is thyroid hormone replacement. Thyroid medication must be taken daily for life. Regular blood tests are required to assess the levels of thyroid hormone; too little, and hypothyroid symptoms persist; too much, and hyperthyroid symptoms appear, according to Cedars-Sinai Hospital.
To treat adrenal insufficiency, hormone replacement therapy is administered. Daily doses of cortisol are taken orally for life, in the form of mineralocorticoid, adrenal genital corticoid or glucocorticoid medications. Inadequate cortisol may affect electrolyte and glucose levels in the blood; therefore, a proper diet and fluid intake is important and monitoring glucose levels necessary, according to the Milton S. Hershey Medical Center at Penn State University.
