Said István Takacs Hashimoto’s thyroiditis the Chronic inflammation of the thyroid gland, which has a very delicate histological picture. The professor added that the increase in the number of patients has been recorded at an accelerated pace since the sixties and seventies of the last century, and this is a result of the fact that the laboratory test that leads to the diagnosis of the disease, which is the anti-TPO test, has become more and more widely available. Anti-TPO is a component of peroxidative thyroid tissue, and an antibody is formed against it, which is produced by antibody-producing cells in the body against the thyroid gland, effectively slowly engulfing the thyroid gland.
This is one of the most common types of antibodies formed against the thyroid gland, and it can now be detected in almost every laboratory. Since this can be measured, Hashimoto has been diagnosed more and more. Today, an ultrasound scan of the neck and laboratory results are enough to tell if a person has chronic thyroiditis.
What causes Hashimoto’s?Have thyroiditis? What causes the disease?
According to the professor, there is no clear answer to this question. However, he adds, there are some points. On the one hand, there are people who are genetically more susceptible to this disease, and on the other hand, there are environmental factors. It is increasingly likely that some viral infections rewire the immune system so that immune cells begin to produce thyroid antibodies. When asked about which viruses are most alert, István Takacs said that there is no specific named virus after which the risk may be greater. It can also develop when someone is suddenly under more stress. What is certain, however, is that the incidence of Hashimoto’s is higher in countries with good iodine supplies, as there is no significant iodine deficiency. Today, fortunately, Hungary also belongs to these countries.
Iodine is important, according to the professor, because the higher the number of iodine, the greater the tendency to trigger an autoimmune process.
However, we don’t yet know exactly where the iodine goes into all of this.
This is why you need to be careful if someone takes in too much iodine in their body. But we definitely need iodine, because if we don’t get the right amount, iodine deficiency can easily develop. the On the other hand, with iodized table salt, we take in our bodies as much as we basically need.
In the case of a Hashimoto’s patient, iodine should not be withdrawn completely either, because then the risk of developing hypothyroidism is increased. the Hashimoto’s thyroiditis Otherwise, the end is hypothyroidism.
This is not a rare condition with a very diverse clinical picture. 5 thousand of the population, but 4-8 percent of people over the age of 60 suffer from hypothyroidism, which affects hundreds of thousands of people. The energy budget of the organization changes, as a result, eg Hair loss may occur, the skin may become dry, the nail may split, and we may experience constipation and weight gain. Cognitive abilities change, that is, mental abilities deteriorate. Shows fatigue and a tendency to dementia. The whole disease Old It is called myxedema, that is, edema that does not bear an imprint that develops throughout the body.
In young women, hypothyroidism also affects fertility, which means they have less chance of becoming pregnant.
Why do only women suffer from Hashimoto’s?
The disease affects women seven times as often as men. This most likely has hormonal causes, but the exact connection is currently unknown.
Another very rare type of the disease is Hashimoto’s encephalopathy, which attacks the brain. There, however, they have not yet been able to prove that the disease is related to the thyroid gland. Also in this case, anti-TPO is elevated, and has a particular histological profile, And this encephalitis responds very well to steroids.
How is Hashimoto’s treated?
The last point is hypothyroidism, And that the patient’s thyroid gland is simply depleted over the years. However, this can now be treated well, says Professor Takaks, adding that we give the patient the same hormone that the body produces, in a different way for each person, but it is possible to adjust the functioning of the thyroid gland in the normal range. This means that the patient’s quality of life will not be worse, and his life will not be shorter. An easily compensated deficiency is created.
On the other hand, to stop the disease, we must turn off the entire immune system. In the case of autoimmune diseases, where the end of the disease is a condition that impairs the quality of life, for example lupus and rheumatoid arthritis, we give something that affects the functioning of the immune system. An example of this is steroid treatment. However, this has side effects, because, for example, you will be more susceptible to sensitive infections. As a long-term side effect of steroid therapy, the patient’s osteoporosis process is accelerated, the risk of cataracts is increased, and atherosclerosis is accelerated.
However, all of this only appears as a side effect of many years of steroid treatment. In general, it can be said that it is not worth shutting down Hashimoto’s immune system, and we don’t even use it.
In fact, we cannot cure Hashimoto himself, we can only maintain the patient’s condition
– adds prof.
Among the Hungarian population, the rate of anti-TPO positivity, that is, when in the laboratory it was found that the level of anti-TPO differs from the normal level, that is, it may be Hashimoto’s, is between 10-20 percent in our region. country, so positive results are very common. Then the value is slightly above normal, already in the abnormal range. International research has revealed that when examining deceased persons who were not known to have thyroiditis, thyroiditis can be detected in 15-20% of their cases. So this means that being TPO positive does not mean you will have a thyroid problem.
Hashimoto’s disease is a long-term disease, and it really has no symptoms. Symptoms will only appear when impairment of function occurs. TSH, that is, the hormone that regulates the functioning of the thyroid gland, which shows if there is insufficiency, well, if the TSH rises, then hypofunction begins, that is, the body tries to stimulate the thyroid gland. This is when medicine usually steps in and tries to keep the TSH within the specified range so that neither over- or under-functioning does not develop.
(Cover photo: Dr. Istevan Takacs. Photo: Peter Papajcic/Index)