When the immune system attacks the thyroid
Hashimoto's thyroiditis is the most common cause of an underactive thyroid in Germany. Even so, many people wait years for a diagnosis. One reason is that the symptoms begin gradually and are easily mistaken for other conditions or simply for exhaustion.
Hashimoto's is an autoimmune disease. This means that the body's own immune system mistakenly recognises thyroid tissue as foreign and begins to attack it. Over the course of this chronic inflammation, the thyroid is increasingly destroyed, which limits its ability to produce enough thyroid hormones.
Why women are affected more often
Hashimoto's affects women far more often than men. Estimates suggest that up to nine out of ten people affected are female. The exact reasons are not yet fully understood, but researchers assume that sex hormones play a role. Oestrogen appears to influence the immune system in a way that favours autoimmune reactions. Genetic factors also play a part: anyone with relatives who have Hashimoto's or other autoimmune diseases carries a higher risk.
The typical course of the disease
Hashimoto's progresses very differently from person to person. In early phases, the inflammation can cause the thyroid to temporarily release too many hormones, which leads to symptoms of an overactive thyroid. Later, an underactive thyroid usually predominates. Typical complaints of hypothyroidism caused by Hashimoto's include:
- Persistent tiredness and exhaustion despite enough sleep
- Weight gain without any change in diet
- Sensitivity to cold
- Problems concentrating and memory gaps
- Dry skin and brittle hair
- Low mood, up to and including depression
Diagnosis: what matters
The diagnosis is made through blood tests. Alongside the TSH value, which measures the activity of the pituitary gland, antibodies are also tested when Hashimoto's is suspected, above all TPO antibodies and thyroglobulin antibodies. An ultrasound of the thyroid can also provide information about structural changes.
Many people report that they struggled with symptoms for a long time before a doctor recognised the connection with the thyroid. An early diagnosis can help to manage the course of the disease better.
Living with Hashimoto's
A cure for the autoimmune disease itself is not yet possible. The aim of treatment is to make up for the hormone deficiency and to improve quality of life. Many people also report that changes in lifestyle, for example in diet, stress management or sleep, subjectively make a difference. The scientific evidence on this is still being built up, but the exchange of experience among those affected clearly shows that the topic is complex and very personal.
Hashimoto's is a serious but treatable condition. Being well informed makes it easier to take an active part in your own healthcare and to make better decisions together with your doctors.