What is it about ?
The thyroid is a small, butterfly-shaped gland that sits at the base of the neck, just below the Adam’s apple.
It produces thyroid hormones (T3 (triiodothyronine) and T4 (thyroxine)). These hormones play an important role at all stages of life. They allow
- normal growth and development,
- the regulation of many processes, including metabolism (they stimulate the metabolism),
- and that the pregnancy is proceeding normally.
The thyroid can experience several types of problems:
- abnormal operation:
- it makes too little thyroid hormone (hypothyroidism). It slows down your metabolism,
- it makes too many thyroid hormones (hyperthyroidism). It boosts your metabolism,
- an abnormal shape (too big and / or formation of nodules),
- sometimes both types of problems at the same time.
Autoimmune chronic thyroiditis is a mild chronic inflammation of the thyroid. The disease is called autoimmune because the body makes antibodies against its own thyroid (anti-thyroperoxidase antibody (anti-TPO antibody)). The thyroid becomes damaged: it becomes inflamed and swells, and sometimes produces too little thyroid hormone (lazy thyroid (hypothyroidism)). Autoimmune chronic thyroiditis is the most common cause of hypothyroidism.
A person with chronic autoimmune thyroiditis is at risk of developing other thyroid diseases, such as hypothyroidism during pregnancy and thyroiditis after childbirth.
What is its frequency?
In the general population, antibodies to the thyroid (anti-TPO antibodies) are found in 5 to 20 out of 100 people. Only a small proportion will develop symptoms of hypothyroidism.
How to recognize it?
Usually there are no symptoms. The disease can progress very slowly and go unnoticed for years. A deficiency in thyroid hormones can cause fatigue, weight gain, depression, feeling cold, dry skin, hair loss, etc. The thyroid is usually swollen and firm on palpation. It also happens to feel one or more balls (nodules). The thyroid gland can grow so large that it becomes visible in the neck (goiter).
How is the diagnosis made?
The concentration of anti-thyroperoxidase antibodies will be determined when the blood test shows a deficiency in thyroid hormones. There is an increase in the level of these antibodies in chronic autoimmune thyroiditis. Since these antibodies can also be present without necessarily being an inflammation of the thyroid, there is no need to determine the concentration as part of a routine blood test.
What can you do ?
There is nothing you can do to prevent a thyroid problem on your own. If you have an underactive thyroid and need to take medication, it is very important that you take it correctly.
Thyroid hormone treatment is taken once a day: in the morning, on an empty stomach. Some drugs, such as iron and calcium, interfere with the absorption of thyroid hormone. You should therefore take these medicines at least 4 hours after the thyroid hormone begins. If you are taking other medicines, such as hormone replacement therapy during menopause, the dose of thyroid hormone should be increased.
If you have a thyroid problem and would like to be pregnant or are already pregnant, talk to your doctor, as this requires adjusting your treatment.
What can your doctor do?
Chronic inflammation of the thyroid is a mild condition that does not always require treatment. If you have an underactive thyroid (hypothyroidism), your doctor may prescribe thyroxine (a thyroid hormone). Thyroxine is also used when the swelling is too great (goiter).
Usually hypothyroidism is temporary and goes away on its own. But sometimes it becomes chronic and permanent treatment with thyroid hormones is necessary. Regular blood tests are necessary to determine the correct dose of treatment. Cortisone treatment is not indicated.
If the cells of the thyroid gland are damaged, too much thyroid hormone can temporarily enter the bloodstream. This causes symptoms of an overactive thyroid (hyperthyroidism) that will need to be treated with medication.
In the presence of a nodule in the thyroid that does not decrease or if the thyroid remains fairly large despite treatment with thyroid hormones, the general practitioner will refer you to the radiologist for an ultrasound and possibly a biopsy (sample of thyroid tissue for examination with microscope). If necessary, he will refer you to a specialist in diseases of the endocrine glands and hormones (endocrinologist).
Want to know more?
- Hypothyroidism: when the thyroid falls asleep – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Hyperthyroidism: when the thyroid is racing – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Ultrasound here Where to find on this page of Cliniques St Luc UCL
- The thyroid puncture, here, Where to find on this page of Cliniques St Luc UCL
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