Treatment of autoimmune thyroiditis

Since this form of chronic inflammation of the thyroid gland is the result of a pathological reaction of the human immune system, the currently practiced treatment of autoimmune thyroiditis cannot restore the damaged gland's ability to function normally and synthesize the hormones necessary for the body and is aimed at replacing these hormones and combating the symptoms of the disease.

Iodine for autoimmune thyroiditis

Autoimmune thyroiditis occurs regardless of iodine intake, which, as is known, is not produced in the body. Most doctors believe that iodine in autoimmune thyroiditis (Hashimoto's hypothyroidism) increases the manifestations of the pathology. This opinion is partially confirmed by the more frequent manifestation of this disease in populations with increased iodine intake.

In addition, it is iodine that stimulates the synthesis and activity of the thyroid enzyme thyroid peroxidase (TPO), which is necessary for the production of thyroid hormones. And this enzyme is the target of an autoimmune attack in patients with autoimmune thyroiditis.

As clinical practice shows, the proportion of those who are negatively affected by the drug Iodomarin containing potassium iodide for autoimmune thyroiditis is significant. The main indications for using this drug are not the treatment of autoimmune thyroiditis, but the prevention of iodine deficiency in the body, as well as endemic, diffuse nontoxic or euthyroid goiter.

The dietary supplement Iodofol, which contains potassium iodide and folic acid, is also not prescribed for autoimmune thyroiditis; it is intended to prevent iodine and folic acid deficiency, including during pregnancy.

Scientific research over the last decade has shown that, firstly, a sharp increase in iodine levels in the body can cause reactive hypothyroidism. And secondly, that intolerance to high iodine levels is associated with a deficiency of such a microelement as selenium, and iodine acts synergistically with selenium. Therefore, a balanced intake of these elements is necessary: 50 mcg of iodine and 55-100 mcg of selenium per day.

Selenium is especially important in iodine-induced autoimmune thyroiditis: the results of numerous studies have shown a significant decrease in the level of serum antibodies to thyroglobulin TgAb after the use of drugs containing selenium (at an average daily dose of 200 mcg).

Drug treatment of autoimmune thyroiditis

As a result of autoimmune inflammation of the thyroid gland, the production of thyroid hormones decreases and hypothyroidism occurs, so drugs are used to replace the missing hormones. This treatment is called hormone replacement therapy, and it is lifelong.

The main hormone of the thyroid gland thyroxine is practically not produced in autoimmune thyroiditis, and endocrinologists prescribe the drug Levothyroxine, L-thyroxine or L-thyroxine for autoimmune thyroiditis. The drug acts similarly to endogenous thyroxine and performs the same functions in the patient's body to regulate oxidative reactions and metabolism of essential substances, the work of the cardiovascular and nervous systems. The dosage is determined individually - depending on the level of thyroid hormones in the blood plasma and taking into account the patient's body weight (0.00014-0.00017 mg per kilogram); tablets are taken once a day (in the morning, half an hour before meals). The drug Euthyrox for autoimmune thyroiditis, as well as Eferox - these are just other trade names for Levothyroxine.

Since the production of protective antibodies against the tissues of the thyroid gland is increased in this pathology, no immunomodulators are used for autoimmune thyroiditis - due to their ineffectiveness and uselessness. For this reason, the immunomodulatory anti-inflammatory drug Erbisol should not be taken for autoimmune thyroiditis.

Is the corticosteroid drug Diprospan prescribed for autoimmune thyroiditis? This drug has immunosuppressive, antiallergic, anti-inflammatory and anti-shock properties that help when subacute or amiodarone-associated thyroiditis joins autoimmune thyroiditis, as well as in the development of giant goiter or mucinous edema. However, all endocrinologists recognize the ineffectiveness of corticosteroids in the standard therapy of Hashimoto's thyroiditis - due to the ability of drugs in this group to aggravate hypothyroidism, in particular, to block the production of thyroid-stimulating hormone synthesized by the pituitary gland (TSH). In addition, significant doses of corticosteroids reduce the conversion of thyroxine (T4) to triiodothyronine (T3).

The next question is about medications: Wobenzym and autoimmune thyroiditis. The list of indications for the use of Wobenzym, an enzyme preparation that includes enzymes of animal and plant origin, along with other immune-related pathologies, includes autoimmune thyroiditis. The official instructions for the drug note the ability of the enzyme complex to influence the body's immunological reactions and reduce the accumulation of antibodies in affected tissues. Domestic specialists prescribe Wobenzym, but the American Food and Drug Administration does not consider this drug a medicine.

Endocrinologists also recommend taking vitamins for autoimmune thyroiditis in the form of various multivitamin complexes, including those containing microelements, especially selenium (see the section Iodine for autoimmune thyroiditis) and, without fail, vitamins B12 and D. Rose hips can be used as a vitamin remedy for autoimmune thyroiditis - in the form of an infusion.

A biologically active complex with folic acid, vitamins C, E, group B and iodine - Femibion is not prescribed for autoimmune thyroiditis, but is recommended for pregnant women for normal fetal development.

The antibacterial drug Metronidazole is not used in routine medical practice for autoimmune thyroiditis; it is prescribed only for inflammation of the thyroid gland of a bacterial nature.

For the treatment of Hashimoto's thyroiditis, homeopathy offers an antihomotoxic agent for injection and oral use, Thyreoidea Compositum, which contains 25 ingredients, including folates, iodine compounds, extracts of sedum, colchicum, hemlock, bedstraw, mistletoe, etc.

According to the instructions, this homeopathic medicine activates the immune system and improves the functioning of the thyroid gland, and it is recommended to prescribe it for thyroid dysfunction and autoimmune thyroiditis.

Side effects include exacerbation of existing hyperthyroidism, decreased blood pressure and body temperature, convulsions, enlarged lymph nodes, etc.

It should be borne in mind that surgical treatment of autoimmune thyroiditis – by thyroidectomy (removal of the thyroid gland) – can be used when the size of the gland increases rapidly or large nodes appear. Or when patients are diagnosed with hypertrophic autoimmune thyroiditis, causing compression of the larynx, trachea, esophagus, vessels or nerve trunks located in the upper mediastinum.

Folk treatment of autoimmune thyroiditis

The genetically determined failure of the immune system makes folk treatment of autoimmune thyroiditis applicable mainly as an adjuvant to relieve some symptoms of the disease (hair loss, constipation, joint and muscle pain, high cholesterol, etc.).

However, herbal treatment can also be useful for stabilizing the thyroid gland. Thus, it is recommended to use the cinquefoil plant for autoimmune thyroiditis. The roots of white cinquefoil (Potentilla alba) contain many useful compounds, but for the thyroid gland, the main medicinal qualities are the presence of iodine and selenium. An infusion should be prepared from dried and crushed roots: in the evening, a tablespoon of raw materials is poured into a thermos, poured with 240 ml of boiling water and infused overnight (at least 8-9 hours). For a week, take the infusion every other day - 80 ml three times a day.

Folk treatment of autoimmune thyroiditis with celandine (alcohol tincture) is not justified from a biochemical and pharmacodynamic point of view; in addition, the chelidonine alkaloids and sanguinarine contained in this plant are poisonous. And the advisability of using blue-green algae (dried cyanobacteria Arthrospira) in the form of a dietary supplement Spirulina for autoimmune thyroiditis has not been studied.

There are recipes that “combine” seaweed and autoimmune thyroiditis. For example, some advise drinking a decoction of a mixture of kelp, plantain and pine buds; others – be sure to include iodine-rich seaweed in your diet. Neither should be done. Why, see above – the section Iodine for autoimmune thyroiditis. And in Southeast Asia, the widespread consumption of seaweed in large quantities often ends in thyroid cancer: this is how the arsenic, mercury and radioactive iodine compounds accumulated by kelp affect this sensitive organ.

[ 1 ], [ 2 ], [ 3 ], [ 4 ]

Physiotherapy for autoimmune thyroiditis

It should be clarified right away: physiotherapy for autoimmune thyroiditis will not restore destroyed thyroid cells or improve the synthesis of thyroid hormones. Electrophoresis and massage for autoimmune thyroiditis can only be used to reduce the intensity of myalgia or arthralgia, i.e. the symptoms.

Ozone therapy is not used for autoimmune thyroiditis, but oxygenation is prescribed quite often to improve blood supply to organs and combat tissue oxygen starvation.

Most endocrinologists consider blood purification, i.e. therapeutic plasmapheresis for autoimmune thyroiditis to be useless, since it does not affect the cause of the pathology, and autoantibodies reappear in the blood after the procedure.

By the way, regarding cosmetic procedures. Neither hyaluronic acid injections, nor silicone injections, nor Botox are allowed for autoimmune thyroiditis.

As for therapeutic exercise, the most suitable are light aerobics to maintain mobility of the musculoskeletal system, as well as treatment of autoimmune thyroiditis with yoga - breathing exercises to train the diaphragm and chest muscles and feasible exercises to strengthen the muscular corset.

Lifestyle with Autoimmune Thyroiditis

In general, as you already understood, the usual healthy lifestyle changes somewhat with autoimmune thyroiditis...

As the obvious symptoms of Hashimoto's hypothyroidism appear, such as weakness, joint and muscle pain, irregular heartbeat, unstable blood pressure, the question of whether it is possible to play sports no longer arises, especially since doctors in this condition advise patients to minimize physical activity. Some doctors say that for people with serious thyroid dysfunction and an overwhelming feeling of fatigue, it is better to completely abandon muscle activity for a while. In addition, metabolic disorders in the body can be accompanied by increased trauma - dislocations, sprains and even fractures.

Restrictions in autoimmune thyroiditis may also affect the sphere of intimate relationships, as a persistent decrease in libido is often observed.

On important issues for patients – sun and autoimmune thyroiditis, as well as

The sea and autoimmune thyroiditis - experts give the following recommendations:

• ultraviolet radiation for any problems with the thyroid gland should be minimal (no lying on the beach);
• Sea water rich in iodine can be harmful if the level of thyroid stimulating hormone (TSH) in the blood is elevated, so only your doctor can give a specific answer to this question (after passing the appropriate analysis). Also keep in mind that you cannot swim for more than 10 minutes and at the hottest time of the day, and after swimming in the sea you should immediately take a fresh shower.

Diet and Nutrition for Autoimmune Thyroiditis

Diet and nutrition are of paramount importance in managing the disease in autoimmune thyroiditis.

Firstly, a violation of general metabolism requires a slight reduction in the caloric content of the daily diet - see Diet for thyroid disease.

This is also the answer to the question of how to lose weight with autoimmune thyroiditis: despite the weight gain, no diets for weight loss can be followed with this disease - to avoid worsening the condition.

But the main question is: what can’t you eat if you have autoimmune thyroiditis?

On the pages of the Journal of Clinical Endocrinology and Metabolism (USA), experts advise:

• Stay away from sugar and caffeine, as both can increase the production of adrenaline and cortisol (stress hormones), which can negatively affect thyroid function.
• To stop the growth of goiter, it is necessary to eliminate the "goitrogenic factor" - to reduce to a minimum or completely stop consuming goitrogens, which inhibit the movement of iodine ions in the thyroid gland and are contained in cruciferous vegetables, that is, in all types of cabbage, rutabaga and radish - in fresh form. Heat cooking inactivates these compounds.
• For the same reason, reduce the consumption of soy and soy products, peanuts, millet, horseradish, flaxseed, spinach, pears, strawberries and peaches.
• With celiac disease, you need to give up gluten - plant proteins of cereals: wheat, rye, oats and barley. The molecular structure of gluten is almost identical to the molecular structure of thyroid tissue, which provokes the production of antibodies.

Here's what a diet for autoimmune thyroiditis should include:

• animal protein (helps increase the production of endogenous thyroxine and triiodothyronine);
• carbohydrates (without them, memory loss, hair loss and cold allergies will increase);
• healthy fats (unsaturated fatty acids) – vegetable oil, fish oil, liver, bone marrow, egg yolks;
• selenium (55-100 mcg per day, found in walnuts, cashews, sea fish, pork, lamb, chicken and turkey fillet, asparagus, porcini mushrooms and shiitake, brown rice, etc.)
• zinc (11 mg per day, found in beef, sunflower and pumpkin seeds, beans and lentils, mushrooms, buckwheat, walnuts, garlic).

As leading experts at the American Association of Clinical Endocrinologists (AACE) say, autoimmune thyroiditis is more than just a thyroid disorder. Therefore, treating autoimmune thyroiditis is more than a medical problem.

[ 5 ], [ 6 ]