Hashimoto's thyroiditis is an autoimmune disease characterized by the body's immune system attacking the thyroid gland, causing inflammation. It is the leading cause of hypothyroidism in the United States, occurring more often in women than men, possibly due to hormonal factors. Symptoms are generally mild but include fatigue, weight gain, dry skin and hair, and constipation. The condition is diagnosed through blood tests showing low thyroid hormone and high thyroid stimulating hormone levels. While there is no cure, symptoms can be managed through lifelong thyroid hormone replacement medication.

1. Hashimoto Thyroiditis
March 2023

2. Introduction
Hashimoto's thyroiditis is a prevalent reason for hypothyroidism and is
characterized as an autoimmune ailment. This condition involves the
body's immune system attacking the thyroid gland tissue, leading to
inflammation of the gland (thyroiditis). The thyroid gland is an endocrine
gland that secretes thyroxine (T4) and triiodothyronine (T3), which play
vital roles in regulating basic metabolic rate, protein synthesis, and other
bodily functions. This condition was named after Dr. Hakaru Hashimoto,
who first described it in 1912.
Presentation title 2

3. Epidemiolog
y
In the United States, Hashimoto's
thyroiditis is the leading cause of
hypothyroidism. It is an autoimmune
disease with an estimated
prevalence in pediatrics of 1–2%. It
occurs more often in women than in
men, which may be related to
hormonal factors. The risk for
women is about 10 times higher
than for men.

4. Causes
Hashimoto's thyroiditis is categorized
as an autoimmune disorder, wherein
the body mistakenly perceives the
thyroid gland as foreign tissue and
attacks it. The root cause of this
autoimmune reaction is yet to be
determined, although it is known to
run in families. Those diagnosed with
Hashimoto's thyroiditis typically exhibit
elevated levels of antibodies against
thyroid-specific proteins, such as
thyroperoxidase and thyroglobulin, in
Presentation title 4

5. 5

6. Signs & Symptoms
• The signs and symptoms of
Hashimoto's thyroiditis are similar to
those of hypothyroidism and tend to
be mild and non-specific, making
them easily mistaken for signs of
aging or other medical conditions. As
the condition progresses, symptoms
become more apparent. The majority
of complaints reported by patients are
related to a decrease in metabolic
activity in the body.
6

7. • Common symptoms and signs
of Hashimoto's thyroiditis
include: – Fatigue –
Depression – Modest weight
gain – Cold intolerance –
Excessive sleepiness – Dry,
coarse hair – Constipation –
Dry skin – Muscle cramps
• – Increased cholesterol levels
– Decreased concentration –
Vague aches and pain –
Swelling of legs • As
hypothyroidism becomes more
severe, there may be: –
puffiness around the eyes, – a
slowing of the heart rate, – a
drop in body temperature, –
and heart failure.
• Severe hypothyroidism can
potentially result in myxedema
coma, a life-threatening
condition that requires
immediate hospitalization and
treatment with thyroid
hormone. If left untreated,
hypothyroidism can lead to
several complications,
including cardiomyopathy
(enlarged heart), worsening
heart failure, as well as pleural
or pericardial effusions (fluid
buildup around the lungs or
heart, respectively).
Presentation title 7

8. Individuals diagnosed with Hashimoto's thyroiditis may initially
undergo a hyperthyroid phase, known as hashitoxicosis, in
which an excessive amount of thyroid hormone is released due
to the destruction of the gland. Other symptoms may include
swelling of the thyroid gland and difficulty in swallowing solids
or liquids.

9. Diagnosis
To diagnose Hashimoto's thyroiditis, a physician
typically evaluates the patient's symptoms and
complaints, which are usually indicative of
hypothyroidism. They also conduct a thorough
examination of the neck to check for any enlargement
of the thyroid gland and take a detailed family history.
Blood tests are essential for diagnosing this condition.
In cases of chronic hypothyroidism, thyroid hormone
levels decrease, leading to an increase in the level of
thyroid stimulating hormone (TSH)
9

10. Treatment
Unfortunately, there is currently no known cure for
Hashimoto's thyroiditis. However, the symptoms
caused by the absolute or relative lack of
hormones as a result of the condition can be
alleviated through thyroid hormone replacement
medication, which replaces the hormones that the
thyroid produced before the inflammation began.
Synthetic T4 or thyroxine (levothyroxine) is typically
the preferred treatment for Hashimoto's thyroiditis,
and common brand names for this medication
include Synthroid, Levothroid, and Levoxyl. The
dosage of levothyroxine may need to be adjusted
after yearly TSH level checks. It's important to note
that since Hashimoto's thyroiditis is an autoimmune
condition where the body attacks its own tissue,
there is no known method of prevention.
Presentation title 10

11. Presentation title 11
Severe gingivitis
Periodontitis
Oral Lichen Planus
Xerostomia
Delayed Wound Healing
Oral
Manifestation

12. Presentation title 12
• Establish a dental home
• Toothpaste / Mouth rinse
formulated for Dry mouth
• Xylitol
• Consult the PCP/Endocrinology
Dental Team

13. Reference
• James Hennessey, Leonard Wartofsky, Hashimoto’s Disease, The Journal of Clinical Endocrinology & Metabolism, Volume 92,
Issue 7, 1 July 2007, Page E1, https://doi.org/10.1210/jcem.92.7.9995
• Li D, Li J, Li C, Chen Q, Hua H. The Association of Thyroid Disease and Oral Lichen Planus: A Literature Review and Meta-
analysis. Front Endocrinol (Lausanne). 2017 Nov 9;8:310. doi: 10.3389/fendo.2017.00310. PMID: 29170653; PMCID:
PMC5684121.
• Aldulaijan HA, Cohen RE, Stellrecht EM, Levine MJ, Yerke LM. Relationship between hypothyroidism and periodontitis: A
scoping review. Clin Exp Dent Res. 2020 Feb;6(1):147-157. doi: 10.1002/cre2.247. Epub 2019 Sep 26. PMID: 32067402;
PMCID: PMC7025985.
• Chandna S, Bathla M. Oral manifestations of thyroid disorders and its management. Indian J Endocrinol Metab. 2011
Jul;15(Suppl 2):S113-6. doi: 10.4103/2230-8210.83343. PMID: 21966646; PMCID: PMC3169868.
• Natori J, Shimizu K, Nagahama M, Tanaka S. The influence of hypothyroidism on wound healing. An experimental study.
Nihon Ika Daigaku Zasshi. 1999 Jun;66(3):176-80. doi: 10.1272/jnms.66.176. PMID: 10401234.
13

14. Thank you !