Symptoms of autoimmune thyroiditis

Unfortunately, the human body cannot always work smoothly and clearly - for example, the immune system may fail, and the body's defenses will begin to synthesize antibodies against its own cells and tissues. This condition is called autoimmune pathology, and one of the consequences of an autoimmune failure is thyroiditis. The symptoms of autoimmune thyroiditis are not always typical and pronounced, and this can significantly complicate diagnosis.

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First signs

If the thyroid gland continues to function, the patient may not initially feel the presence of the disease. Only in some cases is there a feeling of discomfort in the front of the neck.

However, externally, some changes can be noticed in the patient:

• slowness in movements appears;
• the face is swollen, pale, sometimes with a slight yellowness;
• there may be a painful blush on the cheeks and nose;
• the condition of the hair (both on the head and on the body) worsens – it falls out and becomes brittle. Sometimes the loss even affects eyebrows and pubic hair;
• facial muscles weaken, facial expressions become inexpressive;
• slowness and slurred speech is observed (due to swelling of the tongue);
• shortness of breath appears, the patient breathes mainly through the mouth;
• the skin becomes dry, loses elasticity, and cracked and rough areas appear.

Over time, the patient himself begins to feel the manifestations of the disease:

• constant feeling of fatigue, decreased performance, drowsiness;
• hoarseness of voice, memory impairment;
• problems with defecation, constipation;
• menstrual cycle disorders in women (up to and including amenorrhea), infertility, mastopathy, discharge from the mammary glands;
• impotence or decreased libido in men;
• dryness of the oral mucosa;
• in children - delayed development and growth.

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Temperature in autoimmune thyroiditis

The tendency for temperature to decrease in autoimmune thyroiditis is successfully used to diagnose the disease. This diagnostic method is called a temperature test.

The essence of the test is that a decrease in temperature readings is considered one of the symptoms of this pathology. In order to take a measurement, you need to take an ordinary thermometer and prepare it for measuring temperature in the evening. In the morning, without getting out of bed, you should take a thermometer and measure the temperature readings in the armpit area - they should correspond to 36.6 ° or a little more. If the readings are lower, then this may already indicate a malfunction of the thyroid gland.

To clarify the results, measurements must be taken over five consecutive days, after which the average value must be calculated.

In childhood and men, the test can be performed on any day. The same applies to women over 50. Patients of reproductive age begin testing on the second day of menstruation (to avoid measurement errors).

A persistently low body temperature is one of the signs of decreased gland function.

Psychosomatics of autoimmune thyroiditis

Psychosomatics of the disease indicates the presence of a psychological component: scientists have identified some relationship between the emotional state of patients and the work of the immune system. Thus, psychological disorders, depressive states, stress provoke a chain of intracellular processes, including the production of hormones that are responsible for the "extraordinary" states of the body. As a result, a disease develops that affects the most weakened organ - in this case, such an organ is the thyroid gland.

Autoimmune thyroiditis and depression are often interrelated. The patient experiences decreased motor activity, indifference to the world around him, and low mood. This condition often serves as a reason for the patient to seek medical (primarily psychological) help.

Lymphadenopathy from autoimmune thyroiditis

In autoimmune thyroiditis, the lymph nodes around the thyroid gland (especially in its lower part) are usually enlarged, hypertrophied, but their size cannot be larger than the size of an average bean. The internal structure of the thyroid gland is grayish-pink in color, it is uniform. Lymph follicles can be visualized.

The main characteristics of the tissue structure of the thyroid gland in autoimmune thyroiditis are:

• filling it with lymphocytes instead of the gland's native cells;
• the appearance of lymphatic follicles and germinal centers;
• reduction in the number and volume of glandular follicles;
• sclerosis of interstitial tissues.

Due to excessive proliferation of lymphoid tissue in the thyroid gland and the loss of native productive cells, autoimmune thyroiditis is often referred to as "lymphoid goiter".

Scientists admit that excessive function of the gland is combined with damage to thyrocytes, which is the cause of autoimmunization. This is manifested by an abundance of lymphoid tissue in the gland and the appearance of antithyroid antibodies in the blood test.

Hair loss in autoimmune thyroiditis

Hair loss in autoimmune thyroiditis is associated with a significant imbalance of thyroid hormones. As a rule, hair does not fall out completely, but only partially - this is called focal alopecia, when the patient discovers areas of baldness.

The human immune system, which has suffered from disruption due to thyroid dysfunction, begins to produce antibodies against hair follicles. At the same time, hair growth is inhibited, and not only on the scalp, but also in the pubic area, under the arms, etc. This process is quite unpleasant, because the patient can lose up to 25% of hair in a short period of time.

A timely diagnosis of autoimmune thyroiditis and adequately prescribed treatment can stop the process of hair loss and even restore damaged areas of the scalp.

Night sweats in autoimmune thyroiditis

Excessive sweating and hormonal disorders of the thyroid gland are invariable signs of its increased function. It is no secret that this gland produces a number of hormones that are extremely important for the human body. Iodine-containing hormones - iodothyronines - participate in metabolic processes. The hormone thyroxine is also important for these processes. Calcitonin ensures the presence of calcium in the skeletal system, has an effect on increasing and decreasing the likelihood of osteoporosis.

Any experienced doctor, having learned about such a symptom as increased sweating at night, can suspect a thyroid disease. Of course, to confirm the diagnosis, it is necessary to undergo a series of examinations - a blood test for the amount of hormones, an ultrasound examination of the thyroid gland, etc.

With proper treatment, sweating symptoms decrease and gradually disappear completely.

Classification of autoimmune thyroiditis

In the development of the disease, there are four stages of autoimmune thyroiditis - the degree of their manifestation and duration may vary in different patients:

• stage of early thyrotoxicosis;
• transitional stage of euthyroidism;
• stage of transient hypothyroidism;
• recovery stage.

If the patient is not prescribed timely and complete treatment, the early thyrotoxic stage may be prolonged or relapse (repeat). It is generally accepted that without treatment, the number of affected thyroid cells is significantly higher. For this reason, the risk of permanent hypothyroidism in autoimmune thyroiditis is quite high.

The degree of the disease is determined by the extent of damage to the thyroid gland:

• autoimmune thyroiditis grade 1 - externally, the enlargement of the thyroid gland is not noticeable, but when palpated, the isthmus of the gland can be determined;
• autoimmune thyroiditis grade 2 - an enlarged thyroid gland can be noticed when swallowing, and the entire gland can be felt when palpated;
• autoimmune thyroiditis grade 3 – enlargement of the gland is noticeable to the naked eye.

In some cases, the development of atypical variants of the disease is possible, but this is quite rare.

Depending on the nature of the course of the disease, acute, subacute and chronic periods are distinguished.

Acute autoimmune thyroiditis is characterized by the following symptoms:

• weight loss;
• increased heart rate;
• nervousness;
• constant fatigue, sleep disturbances;
• panic attacks;
• deterioration of attention;
• menstrual cycle disorders in women;
• intolerance to stuffy rooms;
• tremor;
• numbness of the limbs;
• dry mouth;
• dyspepsia;
• increased blood pressure;
• facial swelling;
• difficulty swallowing;
• hoarseness of voice;
• impotence in men.

Subacute autoimmune thyroiditis is the next stage of the disease, in the absence of treatment of the acute disease. It is characterized by the following symptoms:

• pain in the neck area in the area of the thyroid gland projection;
• slow heart rate;
• hair fragility and loss;
• dryness and roughness of the skin;
• weight gain;
• memory impairment;
• development of a depressive state;
• hearing loss;
• joint and muscle pain;
• swelling;
• problems with defecation;
• lowering blood pressure;
• swelling of the tongue;
• deterioration of the nail condition;
• chills;
• weakness.

At this stage, most functions in the body are disrupted, which can subsequently cause damage to other organs and systems.

Chronic autoimmune thyroiditis is characterized by slow destruction of the thyroid gland - this can continue for many years. The chronic course is characterized by relative asymptomaticity, or weak symptoms of hypothyroidism and thyrotoxicosis. Diagnostic studies often do not reveal pathology: the patient is prescribed exercise therapy, therapeutic nutrition, sedatives, but such treatment does not bring relief to the patient.

The initial signs of a chronic disease appear simultaneously with the enlargement of the thyroid gland – during this period the structure of the glandular tissue changes and becomes more dense.

The patient may complain of a feeling of pressure in the neck, a foreign body in the throat. Difficulties with swallowing and even breathing (if the gland is significantly enlarged) appear. In addition, as the pathology increases, hormonal imbalance also progresses. The patient becomes irritable, there is an increase in heart rate, lethargy, hyperhidrosis, and weight loss.

In childhood, the disease manifests itself in delayed development of the child, both physically and mentally.

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Forms of autoimmune thyroiditis

Diffuse autoimmune thyroiditis (hypertrophic form) occurs with an increase in the entire thyroid gland, which provokes a feeling of pressure in the front of the neck and difficulty swallowing. Externally, the anterior lower cervical area increases in volume, and the compacted and fluctuating gland is easily palpated. At the initial stages of development, the thyroid gland changes its size evenly, but somewhat later, autoimmune thyroiditis with nodulation may develop, in which individual nodules are formed. Visually, this gives the surface of the thyroid gland a typical unevenness and bumpiness.

Basically, an increase in the size of the thyroid gland is often combined with signs of its decreased function, when the production of thyroid hormones decreases. Metabolism and metabolic processes slow down, edema appears, which directly affects the increase in body weight. Patients note the presence of a constant feeling of cold, excessive dryness of the skin, deterioration of the condition of hair and nails. Anemia develops, and with it comes apathy, drowsiness, dizziness. The process of memorization worsens, absent-mindedness and inattention appear. Hormones produced by the thyroid gland affect changes in the function of the pituitary system and sex glands. As a result, male patients note a disorder of potency. Women complain of failures in the menstrual cycle, the inability to get pregnant.

Toxic autoimmune thyroiditis at the initial stages of progression may be accompanied by hyperthyroidism with excessive production of hormones. As a consequence of this excess, metabolic processes are stimulated and internal organs are toxically affected. Patients are concerned about the following symptoms:

• the skin becomes hyperemic and hot to the touch;
• rapid heartbeat and increased sweating appear;
• Hot flashes often occur.

Increased metabolism leads to severe weight loss, despite increased appetite. Over time, when hormone reserves are exhausted, the disease progresses to the stage of hypothyroidism.

Subclinical autoimmune thyroiditis is a form of the disease that is confirmed by laboratory tests (increased TSH levels with normal free T4 and T3 levels), but does not manifest itself in clinical signs. This form is much more common than the one that is expressed by obvious symptoms. This tendency affects the fact that the diagnosis of autoimmune thyroiditis may be delayed.

Subclinical course is typical for such a disease as normotrophic autoimmune thyroiditis. This form is characterized by completely normal size of the gland and absence of symptoms of the disease.

Atrophic autoimmune thyroiditis also occurs without an enlarged thyroid gland. This disease can be observed in patients who have previously undergone radiation exposure (radiation therapy). The symptomatic signs of the atrophic form coincide with the signs of hypothyroidism - decreased thyroid function.

Thyroid diseases are sometimes difficult to recognize and detect in a timely manner. Thus, symptoms of autoimmune thyroiditis may manifest themselves only in the late stages of the disease. Therefore, great importance is attached to preventive examinations and tests that help to identify the disease as early as possible in order to start the necessary treatment in time.

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