Autoimmune t. Autoimmune thyroiditis of the thyroid gland

Autoimmune thyroiditis- one of the most common diseases in Russia, especially in areas remote from the sea. But not every person realizes that his thyroid gland is not working at full capacity: this can only be detected by passing a special one. And therapists give directions for this test not so often, not seeing the need for it. The fact is that the symptomatic picture of the disease is so vague that even experienced doctor first of all, it will suggest the presence of other, non-endocrine pathologies.

AIT - what is it?

When our immune system begins to attack the cells of our own body, this process is called autoimmune. A certain virus enters the body, penetrates inside the cell and remains there, and the antibodies of our immunity do not have the ability to “get” the virus out of the cell in order to destroy it; their arsenal of capabilities is only the destruction of the cell along with the “enemy”.

Viruses enter the thyroid gland very often. The organ, located on the front surface of the neck, serves as a specific filter for the air we breathe, so all pathogenic organisms enter the thyroid tissue. Of course, not every person will immediately develop thyroiditis; this requires a hereditary predisposition, but considering how many people already suffer from this pathology, you can be sure that almost everyone has a relative with this autoimmune disease.

When immune cells attack an organ as a target, they damage it, after which it becomes scarred - gradually covered with replacement tissue, as happens in a disease called autoimmune thyroiditis. The worst thing that can be expected is that the organ will heal completely and stop producing hormones. Fortunately, all of these hormones are already available in a synthetic version in the form of tablets that will need to be taken as part of replacement therapy.

Symptoms

When a person hears the name of a diagnosis that sounds impressive, it seems to him that the disease is very dangerous. And he begins to look for information on the topic “Autoimmune thyroiditis.” The worst thing to expect is, as some people think, because, at first glance, they really make you tense. But it is important to remember that for most people it is a complete surprise, that is, they did not even suspect that they were sick with something. Therefore, of course, there are symptoms of AIT, and the list of them is wide, but to live life to the fullest together with them it is quite possible.

And this is the main problem of such a pathology as autoimmune thyroiditis. The worst thing is that you can wait endlessly for signs of the disease, but they will never appear until the function of the thyroid gland completely disappears.

It makes no sense to list all the symptoms, because the thyroid gland produces hormones that participate in absolutely all systems of the body. When an organ is damaged, the amount of hormone in the blood becomes less and all organs suffer. But only those systems that were problematic in the first place clearly signal this.

If a person has AIT, he will be rewarded with asthenia, irritability and drowsiness, a person with weak digestive system will suffer from constipation and diarrhea and so on.

That's why when we're talking about about the diagnosis of "autoimmune thyroiditis", the worst thing to expect is that the clinical manifestations will not make it possible to quickly make a diagnosis by contacting to the right doctor. In most cases, a person will rationalize all symptoms, explaining them as a characteristic of temperament or external factors.

Diagnostics

When a person sees an endocrinologist, the question of making a diagnosis is just two laboratory blood tests:

Firstly, this is blood for the content of thyroid hormone in the blood (T4) and pituitary hormone (TSH), which interacts with the thyroid gland, and the production of these hormones is always interrelated: if TSH decreases, T4 increases and vice versa.
Secondly, this is an analysis for the presence of antibodies to thyroid tissue cells.

If tests reveal both the presence of antibodies and an increase in TSH level, a diagnosis of autoimmune thyroiditis is made. The worst thing to expect is that the diagnosis has led to a final diagnosis, and now you will have to be treated for life, unless, of course, science invents other methods to replace replacement therapy.

Treatment

When the thyroid gland does not produce sufficient quantity hormone, the treatment is simply to give it to him in pill form. For this purpose, there are drugs on the pharmaceutical market:

"L-thyroxine";
"Euthirox".

The drugs are available in different dosages: 25, 50, 75, 100, 150 mcg. The doctor prescribes treatment starting with the smallest dosage, gradually increasing it and determining the dose that the person will drink constantly throughout his life. Therefore, when diagnosed with “autoimmune thyroiditis,” the worst thing to expect is the need to take the drug on an empty stomach every morning, regardless of the circumstances. But in fact, patients quickly get used to it.

Dosage adjustment

Of course, a certain one-time dosage will not last a lifetime, since the organ (thyroid gland) continues to be destroyed under the influence of antibodies and will produce less and less natural hormone. In addition, factors such as weight and even climate change can influence fluctuations in hormone levels.

Therefore, at least once every six months, it is necessary to take a test that determines the amount of TSH and T4 in order to understand whether the dosage of the drug needs to be increased or decreased. In any case, the dose change should not exceed 25 mcg in 14 days. With the right treatment, a person will not experience any unpleasant symptoms of a disease such as autoimmune thyroiditis. The worst thing to expect is that treatment will require regular blood donations, which means visiting a clinic and being patient in queues at the treatment room.

Prevention

If one of your close relatives suffers from AIT, there is a high probability of getting sick too; the pathology is especially often transmitted from mother to daughter. It is impossible to completely eliminate the risk of the disease, but it is possible to delay the onset of the pathology process as much as possible. To do this, you need to take iodine preparations, for example "Iodomarin", according to the instructions. Endocrinologists claim that taking iodine and regular rest on the seashore can increase the level of protective forces thyroid gland from antibodies and adjust the functioning of the immune system.

In addition, it is important to avoid factors that can provoke the development of the disease:

work or living in an environmentally unfavorable region is contraindicated, for example, for a person who has high risk If you get AIT, you shouldn’t get a job at a gas station;
it is important to avoid stress, not only emotional, but also physical, such as climate change;
it is important to protect yourself from colds, which make the immune system aggressive, and especially to monitor the absence of outbreaks chronic infection in the nasopharynx.

In these simple ways you can save yourself from the risk of developing a pathology such as autoimmune thyroiditis. The worst thing to expect: prevention may seem frivolous to a person, because it includes a list simple recommendations healthy image life. And in this case, a person, without following the recommendations, is likely to encounter the disease.

Weight gain

According to the majority of patients who have been diagnosed with autoimmune thyroiditis, the worst thing to expect is manifestations in the form of weight gain, which will be uncontrollable and rapid, because the doctor suggests taking hormones!

In fact, when the metabolism is deficient, it actually slows down, and a person can gain weight. But replacement therapy drugs normalize the level of the hormone, so with the right dosage, the metabolism of a person with AIT is the same as that of any other person. In order to protect yourself from gaining weight, it is enough to simply “stimulate” your metabolism by eating often, in small portions.

There is a probability of gaining excess weight not due to fat mass, but due to the accumulation of lymph. Therefore, endocrinologists advise their patients to monitor the amount of fluid consumed. You need to drink 1.2-2 liters of liquid per day, and you will have to give up the habit of drinking tea not because of thirst, but because of boredom. And this, with a diagnosis of “autoimmune thyroiditis,” is the worst thing to expect from the sphere of prohibitions, because otherwise the life of a person with AIT is no different from life healthy person.

AIT and pregnancy

Today, the diagnosis of AIT is increasingly being made to very young girls, although previously, according to statistics, the disease was detected at the age of 40-45 years. But absolutely all diseases become “younger,” not just endocrine pathologies.

Often young girls think that when diagnosed with autoimmune thyroiditis, the worst thing to expect is infertility. But this idea is fundamentally wrong, because with compensated AIT-euthyroidism, a woman is completely fertile and can have children. True, before this she will have to visit a family planning office, report her illness, so that the doctor can advise her on how to change the dosage of the replacement therapy drug from the first weeks of pregnancy.

AIT and life expectancy

Most people think when they are given absolutely any diagnosis, including “autoimmune thyroiditis,” that the worst thing to expect is a shortened life. In fact, in many countries it is recommended to take thyroid hormone after a certain age, even without diagnosed AIT, to prolong life and preserve youth.

Among the most common pathologies of the thyroid gland is a disease such as autoimmune thyroiditis (AIT). Among endocrinologists, it may be called differently: Hashimoto's thyroiditis, Hashimoto's disease, or even Hoshimoto's goiter. But this does not change the essence. This thyroid pathology is a chronic inflammatory process in the tissues endocrine organ having an autoimmune nature. Their target is the follicles of the thyroid gland and their constituent cells, which causes the destruction of the latter. For the most part, the course of the disease passes without obvious signs of thyroid dysfunction, however, in rare situations, the symptoms of autoimmune thyroiditis include the proliferation of endocrine organ tissue.

The diagnosis of autoimmune thyroiditis accounts for about a quarter of all diagnosed thyroid diseases. Moreover, the “weaker sex” is more susceptible to the development of such a pathology - according to statistics, almost 20 times more often. This is due to the influence on lymphatic system female hormones, particularly estrogen, and conditions that cause negative changes in the X chromosome. The risk group mainly includes people aged 40 to 50 years, but statistics show that young people and even children have begun to appear among patients.

The concept of autoimmune thyroiditis consolidates a whole “layer” of diseases that have one root.

These include:

Chronic AIT (CAIT), also called lymphocytic thyroiditis or lymphomatous (an outdated name for Hashimoto's goiter). The cause of this disease is the saturation of the tissues of the endocrine organ with T-lymphocytes, whose task, as is known, is to recognize and destroy foreign antigens, and these are the thyroid cells. Such processes naturally lead to the destruction of endocrine organ cells, which in turn can cause the appearance of the primary form of hypothyroidism. This type of pathology is hereditary in nature, which makes it possible for any family member to develop it. Often develops together with other autoimmune diseases.
Postpartum thyroiditis. The most common disease of this series and therefore the most studied. It develops as a result of too “zealous” activity of the immune system after pregnancy, during which the work of the immune system is naturally suppressed. If there is a genetic predisposition to thyroid dysfunction, postpartum thyroiditis can cause the development of a destructive form of AIT.
Silent thyroiditis, also called silent thyroiditis. Similar to the previous pathology, except for the cause, which is naturally not related to bearing a child. By the way, the cause of this form of the disease in question is not known.
Cytokine-induced. This type of thyroiditis may occur as a result of interferon therapy in patients with certain blood disorders and hepatitis C.

The last three types of AIT, namely postpartum, silent and cytokine-induced, have similarities in the stages of the pathology. The first of these is thyrotoxicosis, which develops not due to hyperfunction of the thyroid gland, but due to the destruction of the cells of which the tissues of the endocrine organ are composed. The next phase is transient hypothyroidism, which is caused by an increased level of thyroid-stimulating hormone (TSH) and a slight decrease in the concentration of thyroid hormones. Such hypothyroidism most often resolves itself when the factors that caused it disappear, and the functions of the endocrine organ return to normal. This is the third and final phase in most cases of the development of AIT of the above types. Photo.

If we talk about general phases the course of all types of AIT, the following positions can be distinguished:

Euthyroidism. A borderline state between the normal thyroid gland and pathological changes in its tissues. This phase is characterized by the absence of thyroid dysfunction. This phase can last from several years to several decades, and in some cases throughout life.
Hidden or subclinical. The development of the disease, which is characterized by the activation of autoimmune processes, leads to the destruction of the cells that make up the thyroid gland, which in turn leads to a decrease in the level of thyroxine and triiodothyronine. To compensate for this loss, the pituitary gland begins increased production of thyroid-stimulating hormone, whose task is precisely to stimulate the hormone-synthesizing function of the thyroid gland.
Thyrotoxicosis. An increased autoimmune response in the body leads to a more aggressive attack by T lymphocytes on thyroid cells. When destroyed, they release accumulated thyroid hormones, saturating the blood with them - this condition is called thyrotoxicosis. In addition to this, in circulatory system Parts of destroyed thyroid tissue also enter, which in turn leads to further synthesis of antibodies that destroy thyroid tissue.
Hypothyroidism. This phase begins when critical point destructive activity of the immune system against thyroid tissue. The remaining thyroid cells are no longer enough to cover the lack of thyroxine (T4), the level of which drops sharply. The duration of this stage of the disease is approximately a year and after its completion, thyroid function returns to normal. Although in some cases the hypothyroid state can last much longer.

Sometimes the course of the pathology can be single-phase, that is, consist only of thyrotoxicosis or hypothyroidism.

Taking into account clinical changes and the degree of enlargement of the thyroid gland, the following forms of AIT can be distinguished:

Latent. This form is characterized by the presence of only immunological symptoms, without clinical manifestations. Most often, the endocrine organ is of normal size, although in some cases it may be slightly enlarged (grade 1 or 2 according to Nikolaev). Upon palpation, the compaction of the gland tissue is not palpable and the functionality of the thyroid gland is within normal limits. Mild manifestations of thyrotoxic or hypothyroid conditions are possible.
Hypertrophic. In this form, the thyroid gland is enlarged in size (goiter). Conditions of hypothyroidism and thyrotoxicosis of moderate severity are often observed. Changes in the size of the thyroid gland can be either diffuse (uniform tissue enlargement) or nodular (autoimmune thyroiditis with nodulation). It is often found mixed look tissue changes - diffuse nodular. First stage This form of pathology may be caused by a thyrotoxic state, but for the most part the hormone-synthesizing function of the thyroid gland is within normal limits or even reduced. In any case, when autoimmune processes are activated, it ultimately leads to dysfunction of the thyroid gland against the background of destruction of its cells and, as a consequence, to the occurrence of pronounced hypothyroidism.
Atrophic. The dimensions of the thyroid gland in this form of Hashimoto's thyroiditis are within the normal range or below it. Symptoms are expressed by a monophasic state - hypothyroidism. Most susceptible atrophic form AIT elderly people. IN at a young age its occurrence may be due to exposure to radiation. This form of AIT is considered the most severe, since it is characterized by serious destruction of thyroid tissue, which is naturally characterized by its acute dysfunction.

A thyroid pathology such as AIT cannot appear “out of thin air.” Even a genetic predisposition to thyroid dysfunction is not a 100% condition for the occurrence of autoimmune thyroiditis.

Below are a number of factors that can trigger the appearance of this pathology:

consequences of ARVI;
development of chronic forms of infectious diseases of the nasopharynx;
unfavorable environmental conditions of the area of residence (excess of iodine, fluorine and chlorine);
self-medication (uncontrolled intake of iodine and hormone-containing medicines);
exposure to radiation, as well as prolonged exposure to bright sun;
severe psychological stress and trauma (for example, loss of loved ones or serious life disappointments).

Autoimmune thyroiditis that occurs in childhood, among the reasons necessarily has heredity.

Signs of autoimmune thyroiditis depend on the phase of the disease. Euthyroidism and latent hypothyroidism, which can last a very long time for a long time, most often, are completely asymptomatic. The dimensions of the endocrine organ are within normal condition, upon palpation painful sensations missing, functionality is not impaired. Occasionally, the size of the thyroid gland is slightly enlarged, and discomfort is also felt in the neck area (the so-called “lump in the throat”), slightly increased fatigue and pain in the joints.

The phase of thyrotoxicosis leaves its mark on the picture of the disease. Symptoms characteristic of a thyrotoxic state are characteristic of the first few years of development of autoimmune thyroiditis.

Each type of autoimmune thyroiditis has its own characteristics in terms of symptoms. For example, symptoms of postpartum AIT include a mild thyrotoxic state approximately 3 months after birth, signs of which include increased fatigue and weakness, as well as slight weight loss.

In some cases, thyrotoxicosis can be more intensely expressed and then its signs become:

violation heart rate;
elevated temperature;
increased sweating;
emotional instability;
insomnia;
involuntary contraction of the muscles of the arms and legs (tremor).

The hypothyroidism phase of postpartum thyroiditis appears approximately 4-5 months after the birth of the child. Postpartum depression often goes hand in hand with it.

The symptoms of the painless type of AIT are most often represented by a mild thyrotoxicosis state. In cases with cytokine-induced autoimmune thyroiditis, thyrotoxicosis and hypothyroidism also do not differ in severity.

With autoimmune thyroiditis that has not yet entered the hypothyroid phase, its diagnosis is quite difficult. To make a diagnosis of AIT or CAIT, endocrinologists need to analyze both the clinical manifestations of the pathology and the results laboratory tests. If, as a result of taking an anamnesis, it is determined that close relatives have autoimmune diseases, the likelihood of developing AIT increases significantly.

Below is a list of tests that must be taken in case of suspected autoimmune thyroiditis of the thyroid gland, as well as their interpretation:

General blood analysis. This analysis determines increased level lymphocytes.
Immunogram. With AIT, the appearance of antibodies to thyroxine (T4), triiodothyronine (T3), thyroglobudin (TG) and others will be observed.
Blood test for hormone levels. This laboratory test determines the content of free thyroxine (T4) and triiodothyronine (T3), as well as the level of thyroid-stimulating hormone (TSH). If the content of thyrotropin is higher than normal, and the level of thyroxine is within its limits, we can talk about a subclinical (latent) form of hypothyroidism. And an elevated TSH with thyroxine below normal signals a manifest (obvious) form of a hypothyroid condition of the thyroid gland.
Ultrasound examination (ultrasound) of the endocrine organ. Thanks to it, you can determine changes in the size of the thyroid gland in one direction or another, as well as possible pathologies structural in nature. The results of ultrasound in this case act as additional information necessary to determine the condition of the thyroid gland.
Puncture of thyroid tissue. Using this study, it is possible to determine the number of T-lymphocytes in the tissues of the endocrine organ, as well as other cellular changes characteristic of AIT. But the main reason for using this analysis is the suspicion of malignant processes in the thyroid gland.

To confirm the diagnosis of autoimmune thyroiditis, the diagnosis must reveal following states:

the level of antibodies to thyroid peroxidase (AT to TPO) in the blood is increased;
ultrasonography determined reduced echogenicity of thyroid tissue;
There are symptoms of the primary form of hypothyroid condition of the thyroid gland.

A definitive diagnosis is made only if all of the above are present, otherwise we can only talk about the likelihood of AIT.

Separately, they can act as symptoms of other diseases. Considering that treatment of autoimmune thyroiditis is carried out only during the hypothyroidism phase, diagnosis during the euthyroidism phase is not mandatory.

How to treat AIT or chronic thyroiditis? There is still no treatment directed specifically against its nature. Endocrinologists are still searching for ways to combat the autoimmune component of this pathology. Of course, medicine does not stand still and currently there are drugs that provide a certain effect in the fight against AIT, but their effectiveness and, importantly, safety leave much to be desired. Therefore, each phase of the disease requires its own approach, depending on the specific course of this form of thyroiditis.

In case of autoimmune thyroiditis, during the phase of thyrotoxicosis, it is not recommended to take drugs with thyreostatic action (reducing the hormone-synthesizing function of the thyroid gland), since there is no hyperfunction of the endocrine organ, and increased content hormones in the blood is explained by the destruction of its cells. If the thyrotoxic phase is complicated by problems with the cardiovascular system, it is advisable to use beta-adrenergic blockers.

When the hypothyroid phase occurs, hormone replacement therapy is prescribed. On this moment The most common drug for this purpose is L-thyroxine. Its dosage is calculated individually for each patient, depending on his weight and the degree of damage to the thyroid gland. The effectiveness of replacement therapy is monitored every 3-6 months, through tests for thyroid hormones and TSH, as well as taking into account the overall clinical picture. This should only be done by the attending physician.

If AIT is complicated by thyroiditis resulting from previous viral infection(subacute thyroiditis), glucocorticoids are prescribed. Used as a means to reduce the level of antibodies to thyroid cells. non-steroidal drugs anti-inflammatory action.

Immunocorrective drugs and vitamin complexes.

If the proliferation of thyroid tissue begins to affect neighboring organs, that is, to compress them, surgical intervention is indicated - resection. This method is radical, but in this case it is necessary.

Not all people respond well to hormonal treatment. For the most part, this comes from excessive “reading” - on some resources, reviews describe frightening stories about negative consequences hormone replacement therapy, which are mostly unfounded. Against this background, treatment of autoimmune thyroiditis with homeopathy or other non-traditional or folk remedies. Of course, such methods of therapy will not make things worse, and in some cases there is an improvement in the patient’s condition. One thing should be remembered: any treatment (whether it is a homeopathic method or another) must be carried out under the supervision of a specialist endocrinologist. Self-medication for autoimmune thyroiditis can cause irreparable harm!

If we talk about the prognosis for the development of AIT, it can be given a satisfactory assessment, although it is impossible to completely cure autoimmune thyroiditis. Timely diagnosis and therapy makes it possible to quite seriously slow down the processes of destruction of thyroid tissue and, accordingly, its dysfunction. In such cases, there is a long remission of the pathology, which can last up to 20 years, not counting rare and short periods exacerbation of autoimmune thyroiditis. The main danger of AIT and high levels of antibodies to TPO is the possibility of developing a hypothyroid state of the thyroid gland in the future.

If a woman develops postpartum thyroiditis after pregnancy, in 2 out of 3 cases it will appear after the next child. And in about a quarter of cases, postpartum thyroiditis turns into chronic autoimmune thyroiditis and the consequences of this form of AIT are a persistent hypothyroid state of the thyroid gland.

Autoimmune thyroiditis and its chronic form are among the most common diseases of the thyroid gland. The danger of this pathology lies primarily in the difficulty of diagnosing it, since in the initial stages the euthyroid phase and the subclinical phase of AIT can be completely asymptomatic. Symptoms mainly appear in the active stage of the disease.

Considering that the risk group is mostly people aged 40-50, they should regularly undergo examination of the condition of their thyroid gland. The same applies to parents, among whom there are patients with pathologies of the thyroid gland - a predisposition to dysfunction of the endocrine organ can be transmitted genetically, which means that the causes of autoimmune thyroiditis or its chronic form include heredity. And the last thing to remember: self-medication is not the answer - the harm can far exceed the planned benefit.

The thyroid gland is often susceptible to negative effects, both from external aggressive factors and from the body itself. Ailments endocrine system may pose a serious danger to human life. Not every person has come across the concept of thyroiditis, and does not know what it is. Let's try to understand this issue more carefully.

The thyroid gland is an organ of the endocrine system, consisting of two lobes connected by an isthmus. This organ is formed from specific follicles, which, under the direct influence of TPO (thyroid peroxidase), produce iodine-containing hormones - T4 and T3.

They influence the energy balance and take part in the metabolic processes that occur in the cellular level. TSH (thyrotropin) is used to control and further distribute hormonal substances in the blood.

Description of the pathology

Thyroid aitis is a disease that occurs due to excessive activity of leukocytes. The immune system can fail at any time. Active immune agents can mistake thyroid follicles for foreign formations, trying to eliminate them.

Sometimes the damage to the organ is minor, which means that the symptoms of autoimmune thyroiditis may go unnoticed for a long time. However, if the immune response is so strong that active destruction of the follicles begins, pathological process it's hard not to notice.

Leukocyte fractions settle at the site of damaged glandular structures, which leads to gradual increase organ to abnormal sizes. Pathological tissue proliferation leads to general dysfunction organ. The body begins to suffer from hormonal imbalance against the background of autoimmune thyroiditis.

Classification

For the autoimmune process occurring in the structure of the thyroid gland, several classifications are provided. Main types:

Acute type of pathology;
Chronic aitis (hypothyroidism);
Subacute viral type aitis;
Postpartum thyroid disease;
Specific disease (tuberculosis, fungal, etc.).

In addition to a hereditary predisposition to autoimmune thyroiditis, there are several factors that provoke pathology:

disruption of the structure of the thyroid gland as a result of injury or surgery;
past infectious and viral diseases (flu, measles);
the presence of a focus of chronic infection in the body (tonsillitis, sinusitis);
influence of negative environmental conditions;
irradiation of organs during radiation therapy or in the course of professional activity;
emotional stress can provoke acute thyroiditis;
intestinal problems;
uncontrolled reception;
selenium deficiency;
Autoimmune thyroiditis can be caused by diabetes or thyroid disease.

Clinical symptoms

For initial stage The disease, which can last for several years, is characterized by the absence of symptoms of autoimmune thyroiditis. Antibodies slowly destroy thyroid cells, gradually reducing its function. The development of the disease provokes discomfort in the front of the neck, negative changes in appearance patient. Hashimoto's thyroiditis goes through several stages, successively replacing each other.

First stage

– this stage is characterized by normal functioning of the thyroid gland. Thyroiditis, the symptoms of which are still subjective, is observed in the dynamics of development. Euthyroidism does not have signs of hypo- and hyperthyroidism. This borderline state, in which the thyroid gland is enlarged, which is confirmed by palpation during examination, but synthesizes enough hormones. If euthyroidism is caused by iodine deficiency, single or multiple euthyroidism develops. The condition is accompanied by the following symptoms:

increasing weakness and fatigue;
insomnia or drowsiness;
difficulty swallowing, sensation of a foreign object in the throat;
weight loss.

Second stage

The subclinical stage is characterized by a massive attack of antibodies on gland cells. Due to their death, areas that are usually at rest are connected to synthesis. The response to the influence of T-lymphocytes is the accelerated production of thyrotropin. Hashimoto's thyroiditis at this stage has a number of symptoms:

swelling and painful blush on the face;
skin loses elasticity;
hoarseness appears in the voice;
neuroses.

Third stage

– immune cells do not stop the destruction of the organ, and the damaged gland releases a large number of hormones T3 and T4. This condition leads to sharp deterioration well-being, so patients should be observed by an endocrinologist. Manifestations of thyrotoxicosis in autoimmune thyroiditis are:

increased sweating;
thinning hair and nails;
promotion blood pressure, tachycardia;
shortness of breath when walking;
fast fatiguability;
decreased bone strength;
increased excitability, feeling of anxiety.

Fourth stage

Hypothyroidism - at this stage there is a decrease in thyroid function, causing a persistent lack of hormones. The gland is seriously damaged by antibodies and needs time and treatment to recover. Hormone deficiency is manifested by inhibition of all processes in the body. Characteristic symptoms thyroiditis in the last stage:

apathy, weakness, depression;
pale, swollen skin;
hair loss on the body and head;
rough voice;
joint pain;
feeling of chilliness;
constipation, digestive tract problems.

Acute thyroiditis, especially in purulent form, has intense pain in the neck and jaw. Chills occur and the temperature rises. This condition requires immediate assistance doctors. Acute non-purulent thyroiditis is characterized by a less pronounced picture of the disease; its signs are:

hand tremors;
chills;
sweating;
weight loss.

Acute thyroiditis without adequate treatment turns into hypothyroidism. Inflammation of the thyroid gland gives way to fibrosis. Hashimoto's thyroiditis causes problems in women menstrual cycle, and for men - sexual dysfunction.

Forms of the disease

The classification of types of autoimmune thyroiditis includes several diseases combined common nature:

– this form appears in most cases. The disease progresses slowly, without active changes in the condition, and can last for years. Chronic thyroiditis is characterized negative impact T lymphocytes on thyroid cells. The destruction of its structure causes primary hypothyroidism. Clear signs Thyroiditis is often absent, which makes diagnosis difficult.
Postpartum AIT appears 14 weeks after the birth of the child in 5-6% of women. It is caused by the reactivation of the immune system, which was depressed during pregnancy. Symptoms of autoimmune thyroiditis are often attributed to postpartum depression. If the problem is left untreated, destructive autoimmune Hashimoto's thyroiditis develops.
Painless thyroiditis has symptoms similar to postpartum thyroiditis: fatigue, sweating, weakness, rapid heartbeat. The mechanism of the disease has not been studied.
Cytokine-induced thyroiditis occurs due to the use of interferon for the treatment of blood diseases and hepatitis C.

In chronic thyroiditis of the thyroid gland and other types of disease, there are three main forms. The basis for the classification was clinical manifestations and changes in organ size:

Latent form - signs of autoimmune thyroiditis are weakly expressed, there are no compactions in the organ. The size of the gland is slightly increased, hormone synthesis is normal.
Hypertrophic form - accompanied by the formation of goiter and nodes. At diffuse form The thyroid gland increases evenly. Symptoms of thyroiditis with nodulation or a combination of the two forms may be observed. Organ function in this condition is moderately impaired, but progressive autoimmune attacks lead to its decline.
Atrophic form - characterized by a decrease in the size of the gland and hormone deficiency. This condition occurs in older people or after exposure to radiation. This is the most severe form of autoimmune thyroiditis of the thyroid gland.

Diagnostics

Symptoms and treatment of the disease are the function of the endocrinologist, but before making a diagnosis, he must conduct a complex examination. Diagnosis of autoimmune thyroiditis is carried out during laboratory research and ultrasound procedures of the thyroid gland. Clinical picture illness is also a significant factor for an experienced doctor.

What tests does the examination include:

it is necessary to take a general blood test to count lymphocytes;
tests for hormones, T4,;
immunogram to determine the level of antibodies;
allows you to determine the dimensions and structural changes thyroid gland;
identifies cells characteristic of Hashimoto's autoimmune thyroiditis.

The presence of relatives with disorders of autoimmune processes confirms the diagnosis.

Features of treatment and drugs

Knowing what autoimmune thyroiditis is, patients wonder whether it is possible to cure the thyroid gland? Treatment of the disease depends on its stage. Euthyroidism does not require treatment, but it is necessary to conduct an examination every six months with a blood test. Chronic thyroiditis is kept from progressing to hypothyroidism by taking synthetic hormones. The use of thyroid drugs is the basis for the treatment of autoimmune thyroiditis. They have a positive therapeutic effect on patients. The mechanism is due to several factors:

exclusion of clinical manifestations of hypothyroidism;
an increase in the concentration of thyroxine, which slows down the release and growth of the thyroid gland;
decrease in the amount of antithyroid antibodies.

The diagnosis of Hashimoto's thyroiditis requires long-term use of thyroid medications:

L-thyroxine;
Thyrotome;
Triiodothyronine.

Treatment of autoimmune thyroiditis in the subacute stage is performed with glucocorticoids, which suppress autoimmune reactions. They are an effective replacement for thyroid drugs at high titers of autoantibodies. Treatment of thyroiditis with glucocorticoid drugs is indicated for severe pain syndromes. Therapy with Prednisolone may cause side effects: stomach ulcer, arterial hypertension,

Surgery

The main indicator for surgical intervention is the suspicion of malignant degeneration of the tumor. Besides surgery prescribed for the following list of indications:

goiter growth that cannot be stopped conservative treatment;
acute thyroiditis, threatening compression of the trachea;
node discovery;
visual disfigurement of the neck.

Surgery for autoimmune thyroiditis is more technically complex than for others pathological changes thyroid gland. There is a high incidence of surgical complications.

Forecast

If treatment for autoimmune thyroiditis is started in a timely manner, the prognosis is favorable. Competent therapy causes stable remission for 15 years. The risk of recurrence of postpartum thyroiditis is 70%, so women should be aware of the risk before becoming pregnant. Doctors have not learned how to completely cure inflammation of the gland, but restoring its functions is a feasible task for medicine.

Deals with issues of prevention, diagnosis and treatment of diseases of the endocrine system: thyroid gland, pancreas, adrenal glands, pituitary gland, gonads, parathyroid glands, thymus gland, etc.

What is AIT with damage to the thyroid gland and how dangerous is this disease? This is an inflammatory process that has. This disease has another name - thyroiditis or Hashimoto's goiter. This pathology accounts for 30% of all diagnosed disorders occurring in thyroid gland. This disease occurs in approximately 3-4% of the total population. Only 1% have severe symptoms. This type of pathology is more often diagnosed in women than in men (approximately 4-8 times). Also, AIT of the thyroid gland develops with a much higher frequency in people over 60 years of age. The number of sick children is insignificant - less than 1%.

Autoimmune thyroid diseases develop against the background of a genetic defect, which is most often inherited from parents to children, and leads to improper functioning of the immune system.

In a healthy person it is in full able to distinguish foreign cells from its own. The body's protective function is based on the destruction pathogenic microorganisms. In case of AIT and other diseases of an autoimmune nature, the human immune system begins to fight against its own cells, producing special antibodies. Against the background of such a negative process, damage to the thyroid gland occurs with its partial destruction. This provokes, which is accompanied by a lack of certain hormones.

Despite genetic predisposition, rapid development of this disease observed after exposure to certain factors:

stress, strong emotional stress, chronic fatigue;
use of hormone replacement therapy for gynecological diseases, during the IVF procedure and in other cases;
lack of iodine or exceeding the recommended dosage when consuming it. When using iodine-containing drugs in any form (tablets, antiseptic solutions and others) there is an accumulation of the main active substance in the thyroid gland. Iodine is thyroglobulin. If there is too much of it, processes of irritation of the immune system become more active, which releases antibodies in response;

uncontrolled use of antiviral drugs (amixin, interferon and others). They are prescribed with great caution in the presence of hepatitis, multiple sclerosis, during chemotherapy. The use of these drugs for prophylactic purposes can lead to the initiation of an autoimmune process;
transfer of acute viral diseases, the presence of chronic foci of infection in the body (in the sinuses, tonsils, carious teeth and others);
unfavorable environmental conditions;
consumption of water and food products that contain large amounts of fluorine, chlorine and other substances;
radiation exposure.

Forms of the disease

Aitis of the thyroid gland - what is it, what forms of this disease can develop in humans? This pathological condition It is customary to divide it into several varieties:

or lymphomatous thyroiditis. Develops against the backdrop of production immune system antibodies and T-lymphocytes to thyroid cells. have genetic reasons occurrence, often accompanied by diabetes mellitus;
postpartum thyroiditis. Fairly common autoimmune disease thyroid gland, which develops due to the enormous stress on a woman’s body during pregnancy and childbirth. Often also appears in the presence of a genetic predisposition;
painless or silent thyroiditis. The causes of this disease have not been fully identified;
cytokine-induced thyroiditis. Develops in patients with hepatitis who are treated with drugs containing interferon.

Classification of the disease according to the degree of damage to the thyroid gland

Autoimmune thyroiditis is divided into several forms depending on the degree of damage to the thyroid gland:

latent form. It is characterized by the absence of clinical manifestations, but there are certain immunological disorders. In most cases, the thyroid gland has normal sizes or slightly enlarged. There are no formations or compactions. The functioning of the thyroid gland and the amount of hormones produced are normal;
the hypertrophic form is accompanied by the development of goiter. When diagnosed, an increase in the size of the thyroid gland and disruption of its functioning are observed. Uneven growth of the organ body may occur. This condition is defined as AIT type. If present, they speak of a nodular form of the disease. There are also cases when one patient has a combination of several subtypes of one disease;
atrophic form. The first sign is a sharp reduction in hormone production. This form is most common in older people. At a young age, the development of this disease is possible only with radioactive radiation.

Symptoms

AIT of the thyroid gland is accompanied by the following symptoms:

drowsiness, fatigue, depressive states, impairment of intellectual function;
development of negative changes in the thyroid gland. It has uncharacteristic dimensions, structure, etc.;
swelling;
disorders of the cardiovascular system;
active hair loss;
joint pain;
menstrual irregularities in women.

The diagnosis of AIT is made based on the following methods of examining the human body:

general blood analysis. The development of the disease is indicated by an increased number of lymphocytes;
An immunogram is performed. It determines the presence of specific antibodies to thyroglobulin, thyroid peroxidase and thyroid hormones;
. The level of total and free, T4, is determined;
. The presence of pathologies of an autoimmune nature may be indicated by a decrease (diffuse), heterogeneous tissue structure, poor circulation in the organ, the presence of and;
. This procedure will help identify an increase in the number of lymphocytes and other changes that are characteristic of thyroiditis.

Treatment

At autoimmune lesion treatment of the thyroid gland cannot be aimed at eliminating the underlying cause of the disease. Suppression of the immune system will lead to a decrease in the production of antibodies against one’s own cells, and will provoke a significant decrease in the body’s protective functions. As a result, a person will be susceptible to viral, infectious diseases, which poses a serious danger.

Therefore, treatment of thyroiditis involves the use of drugs that eliminate certain symptoms. If there is a shortage, they resort to replacement therapy. Drugs containing synthetic analogues of thyroxine are prescribed. At the right approach For treatment, any side effects from these medications are excluded. The only drawback is that synthetic thyroxine must be taken for life to maintain optimal hormonal levels.

Glucocorticoids are also often prescribed to eliminate inflammatory process thyroid gland. If a patient has a sharp increase in the number of antibodies, drugs such as Metindol, Voltaren and others are prescribed. When disorders rapidly progress and conservative treatment does not produce results, surgical intervention is indicated. The thyroid gland is removed, and the person takes hormones for the rest of his life.

Prevention of the disease consists of timely application See your doctor if you have any bothersome symptoms. If the development of this pathology is recorded in the family, it is necessary to constantly examine blood relatives in order to identify possible violations in their body. In the presence of thyroiditis, a person’s normal health remains for 15 years, after which a significant deterioration occurs. This disease cannot be cured completely.

Bibliography

Henry, M. Kronenberg Diseases of the thyroid gland / Henry M. Kronenberg et al. - M.: Reed Elsiver, 2010. - 392 p.
Grekova, T. Everything you didn’t know about the thyroid gland / T. Grekova, N. Meshcheryakova. - M.: Tsentrpoligraf, 2014. - 254 p.
Danilova, N. A. Diseases of the thyroid gland. Effective methods treatment and prevention / N.A. Danilova. - M.: Vector, 2012. - 160 p.
Dreval, A.V. Thyroid diseases and pregnancy / A.V. Dreval, T.P. Shestakova, O.A. Nechaeva. - L.: Medicine, 2007. - 625 p.
Thyroid diseases in women reproductive age. Guide for doctors. - M.: GEOTAR-Media, 2013. - 487 p.

⚕️Melikhova Olga Aleksandrovna - endocrinologist, 2 years of experience.

Deals with issues of prevention, diagnosis and treatment of diseases of the endocrine system: thyroid gland, pancreas, adrenal glands, pituitary gland, gonads, parathyroid glands, thymus gland, etc.