Hashimoto Thyroiditis

Hashimoto’s Thyroiditis is defined as an autoimmune disease (Bishay, 2016). The lymphocytes of the body attack the thyroid and affect the functioning of it. This has some serious consequences to the person experiencing this life altering disease (Kırmızıbekmez, 2014). This is a disease which affects body’s functionality, energy, sleeping, fatigue, metabolism and much more (Bishay, 2016). Hashimoto’s takes a toll on its victims and often they can fall into depressed and discouraged states (Lieu, 2011). Psychologists, specifically health psychologists, could play a key role in managing symptoms and improving quality of life if they are involved in the treatment and coping of the patient dealing with this disease. The purpose of this paper is
to examine Hashimoto’s thyroiditis from the psychological theory of Planned Behavior and identify problems and complications from this disease, symptoms and issues of health, treatment, and a proper approach for Health Psychologists to help patients dealing with this disease.
The Theory of Planned Behavior offers great insight in how a patient thinks about treatment and their disease (Rich, 2015). First, they examine their behavior and then observe the beneficial parts of their behavioral and the negative effects of their behavior. This will then determine how the person feels about their behavior and its effects and any change will occur due to the perceived pros and cons. This is very important when examining Hashimoto’s Thyroiditis, because if they do not view any of their behaviors as negative, they will never be able to effect a change to benefit their health (Rich, 2015).
An individual experiencing this life altering disease is affected in many ways. In addition to their life being changed forever, their family is changed as well because they must alter their lifestyle to accommodate for the Hashimoto’s patient’s needs in order to keep them healthy and experiencing a decent quality of life. Patients suffer mental difficulties, bodily fatigue, exhaustion, weight gain, joint pain, decreased blood pressure and heart rate, and memory problems (Bishay, 2016). One of the most serious implications of this disease is depression (Giynas Ayhan, 2014). Seeing the degradation of the patients life is very discouraging and can often result in spiraling depression cycle. Often behaviors in the patient’s life aggravate the symptoms of this disease which is where the role of a health psychologist begins (Giyans Ayhan, 2014).
A health psychologist could be very beneficial when it comes to coping and dealing with the symptoms of Hashimoto’s Thyroiditis.
They could walk them through The Theory of Planned Behavior to help them examine their behavior to elicit a change (Rich, 2015). Due to the symptoms as mentioned previously, a patient will have a struggle to live daily life. This is a life altering disease and can cause some severe bodily dysfunction (Bishay, 2016). This will also affect the family of the person with this disease drastically. Because of the drastic effect on the diseased person and their family, this offers a health psychologist a unique opportunity to engage both the family, and the patient (Fisher, 2014). Using the Theory of Planned Behavior, the psychologist will be able to point out actions to the patients and family to examine what behaviors are having a negative and positive effect. Once examined, the information could used to make an effective change. (Rich,
2015).
Hashimoto’s has a very limited research history. There is no cure. There is only a limitation of symptoms (Bishay, 2016). An old method of research was into B lymphocytes and it examined the CD5 and CD5+ B lymphocytes and how they synthesized antibodies that kill the thyroid (Suranyi, 1989). This research showed that the count of these white blood cells were elevated in Hashimoto’s patients due to the body attacking the thyroid gland. This works by these B cells marking the thyroid as a pathogen and causing the natural killer cells and T cells to attack the tissue (Suranyi, 1989). Research conducted in 2010 points a decrease in L thyroxine and an increase in immunoglobulin G (Yamauchi, 2010). L thyroxine is the body’s free T4. This hormone is used to help with the body’s metabolism and if decreased can cause lethargy and lack of energy and increase in depression. The immunoglobulin increase indicates the body is fighting an infection, but in this case, it is fighting itself (Yamauchi, 2010).
Knowing the limited treatment and research and the effect on the body, treatments for Hashimoto’s patients drastically vary. One treatment involves L-Selenomethionine and Anti-Thyroid Perioxidase (Elias, 2007). This uses a drug to stop the thyroid producing specific thyroid markers to stop the body from attacking itself but often is not effective and can have side effects that would prevent adherence to treatment (Elias, 2007). Low dose naltrexone has also been used to treat Hashimoto’s thyroiditis, depression, and other autoimmune diseases (Mishoulon, 2016). Naltrexone is normally used to treat recovering addicts but it can also be used for autoimmune patients to lower inflammation in the body (Mishoulon, 2016).
The treatments mentioned above are some of the ones being used today.
As seen from the symptoms, this is a debilitating disease that can often alter a person’s life in many ways. Adherence to treatment should be key in a patient’s life when dealing with this chronic illness (Fisher, 2014). Another key symptom to be noticed and observed for a health psychologist is depression (Giynas Ayhan, 2014). Adherence is important for a health psychologist to enforce because without adherence the patient cannot show any improvement. The Theory of Planned Behavior can be used in the case of adherence to show the negative effects of stopping treatments. A simple step using motivational interviewing, or simply stating the obvious could point out the negative effects to cause a change in behavior (Rich, 2015). Depression should be treated with caution in this case, but can be traced back to adherence to treatment. If the patient has a beneficial treatment and stops taking the medicine it could have the symptoms reoccur and cause a relapse. Relapse can increase the chance of depression (Giynas Ayhan, 2014). While it may seem like an easy fix, in the case of Hashimosto’s adherence to treatment is the most important and can limit symptoms such as
depression.
Depression in Hashimoto’s is caused by a decrease in triiodothyronine and thyroxine (Liu, 2011). Due to this decrease in thyroid hormones it causes a change in body hormones and emotions within the brain. This also effects the pituitary gland and hypothalamus which can alter brain chemistry. With the alteration in hormones and the effects on emotions, the metabolism is also effected which can cause some serious fatigue and exhaustion. This exhaustion and change in hormone levels can lead to depression in Hashimoto’s patients. This, however, can be limited by adherence to treatment (Liu, 2011).
Hashimoto’s Thyroiditis is an autoimmune disease. The body attacks the thyroid and causes changes in the body’s metabolism and energy. It causes depression and life altering effects to both the victim and their family. An important view is needed for a health psychologist to examine a patient with Hashimoto’s Thyroiditis to better understand them and how to effect proper treatment and help them with adherence to treatment. The Theory of Planned Behavior is a great psychological perspective to understand Hashimoto’s because it helps the psychologist point the patient and their family to the behaviors that can be potentially affecting them in a negative way. There are several treatment that a psychologist can help patients adhere to which include: low dose naltrexone and anti-thyroxine drugs. Hashimoto’s in a debilitating disease that can benefit from a health psychologist’s point of view and effort to improve a patient’s quality of life.