Hashimoto's Thyroiditis in Patients With Normal Thyroid-stimulating Hormone Levels

Regina Promberger; Michael Hermann; Johannes Ott

Disclosures

Expert Rev Endocrinol Metab. 2012;7(2):175-179. 

In This Article

Abstract and Introduction

Abstract

Hashimoto's thyroiditis (HT) is one of the most common autoimmune endocrine disorders and often leads to hypothyroidism. It has been shown to substantially affect a patient's quality of life. Associated conditions and diseases were thought to be attributable to hypothyroidism. Yet, many patients still suffer from various symptoms even though all thyroid parameters are within the normal range. Independently of thyroid gland function, HT is associated with a wide range of organ-specific and non-organ-specific autoimmune disorders, as well as other diseases, including neuropsychological/psychiatric deficits, decreased left ventricular performance, disorders of the gut, fibromyalgia and reproductive health issues, among others. The underlying pathomechanisms remain unclear. Future treatment options might include thyroidectomy, selenium administration, prophylactic levothyroxine supplementation and dehydroepiandrosterone. However, further research is warranted to clarify the main pathophysiologic implications of thyroid autoimmunity and also to establish treatment options for euthyroid patients who suffer from HT-related symptoms and diseases.

Introduction

Hashimoto's thyroiditis (HT) is characterized by the presence of antibodies against thyroid peroxidase (anti-TPO) and/or antibodies against thyroglobulin (TG-Ab). It is one of the most common autoimmune endocrine disorders of the female population and the most prevalent cause of subclinical or overt hypothyroidism in areas with sufficient iodine intake.[1] It is associated with a wide range of organ-specific and non-organ-specific autoimmune diseases, some malignant diseases, and others.[2] Moreover, it has also been shown to substantially affect a patient's quality of life.[3,4]

To date, symptoms, complications and other diseases linked with HT were considered to be caused, first and foremost, by overt hypothyroidism. However, in our experience, many patients complain of still experiencing 'thyroid symptoms', including chronic weakness, tiredness, lack of concentration and dry skin, among others, despite the fact that all thyroid parameters are within the normal range. This is in accordance with reports from various HT support groups on the internet.[101] In this article, we aim to provide an overview on the impact of HT when thyroid gland function is normal.

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