Hashimoto's Thyroid Disease

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THESIS

I am referring to a condition called Hashimoto 's Thyroid Disease, which is a common hypothyroid disorder found among many different people and countries throughout the world. As you read through this paper, you will learn the basics about Hashimoto 's Thyroid Disease, including some of the causes, the signs and symptoms, and the treatment.

OUTLINE

Hashimoto 's Thyroid Disease

I. Introduction

II. Description and History

a. Thyroid

b. Hashimoto 's thyroiditis

III. Who is Involved/ what some risks are

a. People

b. Genetics

IV. Signs and Symptoms

V. Diagnoses and Treatment

VII. Conclusion

Hashimoto 's Thyroid Disease

Have you been living your life trying to be as healthy as you could possibly be? What if one day you had a visit with your doctor and found out that something is wrong? Well, this is exactly what happened to my mother and her sisters, which made me wonder if it could happen to me. I am referring to a condition called Hashimoto 's Thyroid Disease, which is a common hypothyroid disorder found among many different people and countries throughout the world. As you read through this paper, you will learn the basics about Hashimoto 's Thyroid Disease, including some of the causes, the signs and symptoms, and the treatment.

The reason I decided to research this subject was the fact that it has been a big topic of discussion in my house and family gatherings lately. My aunt had the first diagnosed case of this disease in our family. Some of her symptoms were dizziness, nauseous all the time, she couldn 't focus, and she had constant headaches. Because of her diagnoses and at the request of her doctor, all the family members went in and got tested for Hashimoto 's disease. Every single person in my mom 's family came up positive with the disease. Although none of my mom 's family (other than my one aunt Becky) is showing signs of the disease yet, it is still in its early stages and hopefully through my research I can find some help at prolonging the diseases progress and maybe even help my sisters to never contract it.

The thyroid gland is positioned at the front of your neck just underneath the Adam 's apple, and is commonly described as being butterfly-shaped. Figure one is an example of where the thyroid gland is located and of its unique shape.

Your thyroid is part of the endocrine system which involves many glands and tissues that produce hormones. The hormones help coordinate many of your body 's activities including digestion, metabolism, and reproduction. Your thyroid has an immense effect on your health (Nippoltd). The hormones produced in the thyroid "promote oxygen use in cells and regulate vital processes in every part of the body… they have a major impact on heat production, growth, use of energy and fertility" (Khalsa, 2005, p. 2). In the winter of 2005, Khalsa clearly described the thyroid as being the body 's thermostat. Khalsa stated:

"The thyroid produces two key hormones, thyroxin (T4) and L-triiodothyronine (T3).

Iodine, used in the manufacture of these hormones, is extracted from the blood and

trapped by the thyroid, where 80% of the body 's supply is stored. The thyroid produces

mainly thyroxin, which in turn, is converted into T3, the more active form. About 20% of

T3 is formed in the thyroid gland. The majority is manufactured from circulating thyroxin

in tissues outside the thyroid."

This process of the iodine being trapped and hormone production is regulated by a thyroid stimulating hormone which is secreted by the pituitary gland. If there is any malformation in this system of glands and hormone synthesis then production can have extensive consequences (Khalsa 12-16).

This particular type of hypothyroidism was named after Hakaru Hashimoto. Hashimoto was a Japanese physician who first described this disease in 1912 (Khalsa 12-16). Hashimoto 's thyroiditis is an autoimmune disorder in which your own immune system unseemly decides to attack the proteins in the thyroid gland which causes damage to the thyroid cells. This upsets the chemical balance of different reactions in the body (Nippoltd). Figure two shows an example of what an inflamed thyroid looks like from both the inside and outside of the body. Hashimoto 's disease can develop within either a few weeks or even up to a few years depending on the person who contracts it. Whichever the case, this chronic inflammation of the thyroid gland most likely results in one of the many different hypothyroid disorders. Hashimoto 's disease can also be called: autoimmune thyroiditis, chronic lymphocytic thyroiditis, lymphadenoid goiter, and struma lymphomatosa (Khalsa 12-16).

It is not quite known why the immune system begins to injure the thyroid, but one theory states that an infecting bacterium or virus with a protein similar to that of a thyroid 's own protein, might initiate the response (Khalsa 12-16). It may also have been caused by a genetic flaw (Nippoltd). Throughout the course of Hashimoto 's disease, the thyroid cells become inefficient at converting iodine into the thyroid hormone. This causes the glands to compensate by enlarging. The thyroid still has the ability to take up iodine, but just can not convert it to the hormone. Soon after, the thyroid stimulating hormone levels rise because the pituitary is still attempting to induce the thyroid to make the hormone, but the thyroid can not synthesize the hormone so the thyroxin level falls. Research has found that 95% of the people with Hashimoto 's disease have auto-antibodies (antibody against own tissues) that fight their own thyroid proteins (Khalsa 12-16).

Both males and females of all ages are able to develop this disease, but is most commonly found in female 's between the ages of thirty to fifty years old. In this age range the ratio between men and women is one in every fifty. Many experts have found that ten percent of women over the age of fifty have some indications of hypothyroidism (Khalsa 12-16).

"Sub-clinical hypothyroidism is most prevalent in the elderly, especially women, and most often progresses into overt hypothyroidism" (Morley and Berg 76). It has also been found that between twenty and twenty-five percent of the population have some form of genetic makeup that puts them at risk for a thyroid malfunction. Your heredity, gender, and age are a few factors that will help determine the likelihood of an individual at contracting Hashimoto 's disease (Nippoltd).

Thyroid disease is becoming more common and is likely to be found in most people 's heredity. Having a family history of a thyroid disease is not uncommon. In fact, if your mother, aunt, or grandmother has a hypothyroid disorder or any other thyroid problem, then your chances of inheriting a thyroid problem at some point in your life is more likely than not (Nippoltd). Figure three shows a picture of my relatives who have all recently found out they have Hashimoto 's disease. Due the effect of this disease on seven female family members, shows evidence that genetics has a part in developing Hashimoto 's thyroid disease.

The signs and symptoms of Hashimoto 's disease are not unique unto itself, so it is easy to see why Hashimoto 's disease can go unnoticed for quite some time. The symptoms vary widely from person to person depending on the lack of the thyroid stimulating hormone. At the beginning of this disorder a person may only notice slight symptoms like sluggishness and fatigue, but as the disease continues to progress they may develop more abundant symptoms. These symptoms include increased sensitivity to cold, constipation, pale and dry skin, thinning hair, puffy face, a hoarse voice, an elevated blood cholesterol level, unexplained weight gain, muscle aches, pain and stiffness in joints, swelling in the knees, muscle weakness, delayed reflexes, excessive or prolonged menstrual bleeding, and depression (Nippoltd). "When hypothyroidism begins in infancy and childhood, some complications may include growth retardation and reduced intelligence" (Khalsa 12-16). If an infant contracts hypothyroidism then there is a high likeliness of the infant producing cretinism later on in childhood.

"Cretinism is a condition of inadequate skeletal and nervous system development, causing the metabolic rate to lower forty percent of the average rate. A child may develop a retard growth, a mental problem, as well as delayed puberty…" (Martini 624).

The longer a person goes without being treated for hypothyroidism, the more severe the symptoms may be. Dr. Nippoltd describes that if Hashimoto 's is left untreated, it can lead to many more health problems. Some of these include but are not limited to:

Goiter: This comes from the continuous stimulation of your thyroid to release more hormones. It causes your thyroid to become enlarged, and may cause problems with swallowing and breathing.

Mental health issues: depression, decrease of libido (sex drive), and slowed mental functioning.

Myxedema: life-threatening condition that develops after long-term hypothyroidism which causes intense cold intolerance, drowsiness, followed by profound lethargy, and unconsciousness.

Birth defects: Babies born to an untreated mother may have a higher risk of birth defects than other babies born to healthy mothers. They will more easily have intellectual and developmental problems.

"Studies have also shown that about twenty five percent of patients with Hashimoto 's develop pernicious anemia, diabetes, adrenal insufficiency, as well as some other autoimmune problems" (Khalsa 12-16).

In order to diagnose Hashimoto 's disease a simple blood test is taken to measure the levels of the thyroid hormone and thyroid stimulating hormone. One is a hormone test which can determine the amount of hormone produced by the thyroid and pituitary glands. If your thyroid is under active, then the level of thyroid hormone will be low. The thyroid stimulating hormone level will then be elevated because the pituitary gland keeps trying to stimulate the thyroid gland to produce more of the thyroid hormone. The other test that is used to diagnose Hashimoto 's disease is the antibody test, if positive, this test will show abnormal antibodies (Nippoltd).

Treatment can be difficult and has not been proven. Actual treatment begins with a synthetic thyroid hormone replacement. This can take the form of either medication or natural supplements which are found to be simple and effective (Nippoltd).

Thyroid hormone replacement helps prevent and even corrects hypothyroidism by inhibiting the enlargement of the gland; In most cases decreasing its size. "Iodine is the raw material of thyroid hormone, so diets deficient in iodine can promote hypothyroidism" (Khalsa 12-16). Khalsa goes on to explain that about two hundred million people around the world have goiters from insufficient iodine, but in developed nations it is rare because iodine has been added to the salt. An excess in iodine can suppress production of thyroid hormones as well, and an increase in iodine can bring on symptoms for people with thyroid antibodies that have no autoimmune symptoms. Countries with the highest iodine intake like Japan and the US have the greatest prevalence of chronic autoimmune thyroiditis, but Hashimoto 's disease increases with people in countries who have low iodine diets when they are given the iodine supplements. This same effect was even proven with animals in laboratory test studies (Khalsa 12-16). Just don 't forget to speak with your health provider first before taking iodine tablets.

Herbal supplements are another treatment that will tone the endocrine system by using slow acting and long term, stamina enhancing tonic herbs. These natural supplements can help reduce inflammation, support the immune 's function causing a reduction in hyperimmune responses by using amphoterics, and promote thyroxin production. Some of the herbs you can use are anti-inflammatory, antimicrobials, antioxidants, and even superior immune enhancers; the most common are baical skullcap root, astragalus root, guduchi, saw palmetto berry, and many more.

Toba Kerson has done research that has shown thyroid diseases can affect the heart because of the stress put on it. An under-active thyroid can cause a person 's blood pressure to drop due to the decrease in the metabolic rate, and the use of oxygen (Kerson and Kerson 47). In the year 2000, there was a study on the effect of thyroid hormones on cardiac functions with people with hypothyroidism. Ten patients in a hypothyroid state were examined, and then reexamined after their symptoms had subsided. Each of their myocardial oxidative metabolisms were measured and different work indexes were taken. Researchers found that when compared to hormone replacement, "hypothyroidism patients had a much higher systemic vascular resistance and left ventricular (heart) mass than normal patients. With more findings, researchers concluded that patients with a hypothyroid disorder, and a preexisting heart disease, are prone to a worsened heart disorder" (Bengel et al). Another study provided the first evidence for a genetic association between autoimmune thyroid disease and the interleukin (IL-4) cytokine gene (Hunt et al.).

Hashimoto 's disease is common in our world today, and if taken care of, and treated properly, it can be easily identified, contained, reduced and controlled. If you feel different lately, and begin to show any of the signs, or feel any of the symptoms then have yourself examined. Simple tests taken now can save you from a lot of pain and a lot of hassle later on.

Before I did this research I thought there was a pretty good possibility for me to contract Hashimoto 's disease. But I have now learned that this disease attacks mostly women so I have no need to worry about myself, but I 'm still worried about my mother and also my four sisters. Hopefully through my research they can stay on top of their body conditions and know what to do if they contract Hashimoto 's disease themselves.

GLOSSARY

AMPHOTERIC- Having the characteristics of an acid and a base and capable of reacting chemically either as an acid or a base.

CRETINISM- A congenital condition caused by a deficiency of thyroid hormone during prenatal development and characterized in childhood by dwarfed stature, mental retardation, dystrophy of the bones, and a low basal metabolism.

CYTOKINE- Any of several regulatory proteins, such as the interleukins and lymphokines, that are released by cells of the immune system and act as intercellular mediators in the generation of an immune response.

ENDOCRINE SYSTEM - the glands and parts of glands that produce endocrine secretions, help to integrate and control bodily metabolic activity, and include especially the pituitary, thyroid, parathyroid 's, adrenals, islets of Langerhans, ovaries, and testes.

MYOCARDIAL -The muscular tissue of the heart.

THYROXIN -An iodine-containing hormone, C15H11I4NO4, produced by the thyroid gland that increases the rate of cell metabolism and regulates growth and that is made synthetically for treatment of thyroid disorders.

WORK INDEXES- Samples taken to test and compare.

Works Cited

Bengel, Frank M., Stephan G. Nekolla, Tareq Ibrahim, Carmen Weniger, Sibylle I. Ziegler, and

Markus Schwaiger. "Effect of Thyroid Hormones on Cardiac Function, Geometry, and Oxidative Metabolism Assessed Noninvasively by Positron Emission Tomography and Magnetic Resonance Imaging." The Journal of Clinical Endocrinology & Metabolism 1822-1827 24 July 2006 1822-1827 http://jcem.endojournals.org/cgi/content/full/85/5/1822?SEARCHID=1&hits=10&VOLUME=85&ISSUE=5&gca=jcem%3B85%2F5%2F1822&FIRSTINDEX=0&FULLTEXT=hypothyroidism&

Google Images (2006).

Hunt, P.J., S. E. Marshall, A. P. Weetman, J. I. Bell, J. A. H. Wass, and K. I. Welsh. "Cytokine

Gene Polymorphisms in Autoimmune Thyroid Disease." The Journal of Clinical Endocrinology & Metabolism 1984-1988 24 July 2006 http://jcem.endojournals.org/cgi/content/abstract/85/5/1984?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=hypothyroidism&searchid=1&FIRSTINDEX=0&volume=85&issue=5&resourcetype=HWCIT

Kerson, Toba Schwaber, and Lawrence A. Kerson. Understanding Chronic Illness: The medical

And psychosocial dimensions of nine diseases. New York: Collier Macmillan, 1985.

Khalsa, Karta Purkh Singh. "Hashimoto 's Disease & Hypothyroidism." Oriental Medicine

Journal 13.2(2005): 12-16.

Martini, Frederic H.. Fundamentals of Anatomy & Physiology. 6th. San Francisco: Pearson

Benjamin Cummings, 2004.

Morley, John E, and Lucretia Van den Berg. Endocrinology of Aging. Totowa, N.J.: Humana

Press, 2000.

Nippoltd, Todd. "Diseases and conditions." MayoClinic.com. 24 July 2006. MayoClinic. 24 July

2006 http://www.mayoclinic.com/health/hashimotos-disease/DS00567

Fig. 1: anatomy of thyroid gland (Google images, 2006).

Fig. 2: appearance of an inflamed thyroid on the inside and outside (Google images, 2006).

Fig. 3: picture of my aunts, mom, and grandma who have all developed Hashimoto 's (Family file, 2006)

Cited: Google Images (2006). Khalsa, Karta Purkh Singh. "Hashimoto 's Disease & Hypothyroidism." Oriental Medicine Journal 13.2(2005): 12-16. Martini, Frederic H.. Fundamentals of Anatomy & Physiology. 6th. San Francisco: Pearson Benjamin Cummings, 2004. Morley, John E, and Lucretia Van den Berg. Endocrinology of Aging. Totowa, N.J.: Humana Press, 2000. Fig. 1: anatomy of thyroid gland (Google images, 2006). Fig. 2: appearance of an inflamed thyroid on the inside and outside (Google images, 2006). Fig. 3: picture of my aunts, mom, and grandma who have all developed Hashimoto 's (Family file, 2006)