1. Hashimoto disease
Practice Essentials
Hashimoto thyroiditis is part of the spectrum of autoimmune thyroid diseases (AITDs) and is characterized by
the destruction of thyroid cells by various cell- and antibody-mediated immune processes. This condition is the
most common cause of hypothyroidism in the United States in individuals older than 6 years.
Essential update: Role of vitamin D deficiency in Hashimoto thyroiditis
In a recent study, investigators found that levels of serum 25-hydroxyvitamin-D [25(OH)D] in patients with
Hashimoto thyroiditis were significantly lower than those in control patients. In this report by Bozkurt et al,
there was also found to be a correlation between the severity of vitamin-D deficiency and the disease duration,
thyroid volume, and antibody levels. There were 3 groups studied: (1) euthyroid patients with HT who were on
levothyroxine, (2) euthyroid patients who were newly diagnosed with HT, and (3) healthy controls. Group 1
had the lowest 25(OH)D levels. Severe vitamin-D deficiency (< 10 ng/ml) was present in 48.3% of group 1,
35% of group 2, and 20.5% of controls.
Signs and symptoms
Hypothyroidism usually has an insidious onset, with signs and symptoms slowly progressing over months to
years. Thus, the presentation of patients with hypothyroidism may be subclinical, may be asymptomatic, and
may be found from routine screening of thyroid function.
Common, early presenting symptoms of hypothyroidism are nonspecific and may include the following:
; Fatigue
; Constipation
; Dry skin
; Weight gain
Other symptoms of hypothyroidism include the following:
; Cold intolerance
; Voice hoarseness and pressure symptoms in the neck from thyroid enlargement
; Slowed movement and loss of energy
; Decreased sweating
; Mild nerve deafness
; Peripheral neuropathy
; Galactorrhea
; Depression, dementia, and other psychiatric disturbances
; Memory loss
; Joint pains and muscle cramps
; Hair loss
; Menstrual irregularities
; Sleep apnea and daytime somnolence
Diagnosis
Physical findings are variable and depend on the extent of the hypothyroidism and other factors, such as age.
Examination findings may include the following:
; Puffy face and periorbital edema typical of hypothyroid facies
; Cold, dry skin, which may be rough and scaly
; Peripheral edema of hands and feet, typically nonpitting
; Thickened and brittle nails (may appear ridged)
![Hashimoto disease
Practice Essentials
Hashimoto thyroiditis is part of the spectrum of autoimmune thyroid diseases (AITDs) and is characterized by
the destruction of thyroid cells by various cell- and antibody-mediated immune processes. This condition is the
most common cause of hypothyroidism in the United States in individuals older than 6 years.
Essential update: Role of vitamin D deficiency in Hashimoto thyroiditis
In a recent study, investigators found that levels of serum 25-hydroxyvitamin-D [25(OH)D] in patients with
Hashimoto thyroiditis were significantly lower than those in control patients. In this report by Bozkurt et al,
there was also found to be a correlation between the severity of vitamin-D deficiency and the disease duration,
thyroid volume, and antibody levels. There were 3 groups studied: (1) euthyroid patients with HT who were on
levothyroxine, (2) euthyroid patients who were newly diagnosed with HT, and (3) healthy controls. Group 1
had the lowest 25(OH)D levels. Severe vitamin-D deficiency (< 10 ng/ml) was present in 48.3% of group 1,
35% of group 2, and 20.5% of controls.
Signs and symptoms
Hypothyroidism usually has an insidious onset, with signs and symptoms slowly progressing over months to
years. Thus, the presentation of patients with hypothyroidism may be subclinical, may be asymptomatic, and
may be found from routine screening of thyroid function.
Common, early presenting symptoms of hypothyroidism are nonspecific and may include the following:
; Fatigue
; Constipation
; Dry skin
; Weight gain
Other symptoms of hypothyroidism include the following:
; Cold intolerance
; Voice hoarseness and pressure symptoms in the neck from thyroid enlargement
; Slowed movement and loss of energy
; Decreased sweating
; Mild nerve deafness
; Peripheral neuropathy
; Galactorrhea
; Depression, dementia, and other psychiatric disturbances
; Memory loss
; Joint pains and muscle cramps
; Hair loss
; Menstrual irregularities
; Sleep apnea and daytime somnolence
Diagnosis
Physical findings are variable and depend on the extent of the hypothyroidism and other factors, such as age.
Examination findings may include the following:
; Puffy face and periorbital edema typical of hypothyroid facies
; Cold, dry skin, which may be rough and scaly
; Peripheral edema of hands and feet, typically nonpitting
; Thickened and brittle nails (may appear ridged)](https://image.slidesharecdn.com/hashimotodisease-130321222125-phpapp02/85/Hashimoto-disease-1-320.jpg)
