Hashimoto's Thyroiditis (Chronic Lymphocytic Thyroiditis)

Hashimoto's disease is a health problem of autoimmune origin targeting the thyroid gland. In this disease, the immune system perceives the thyroid tissue as a foreign structure and attacks it, causing damage to hormone-producing cells over time. As a result, thyroid hormone production decreases, and in most cases, a picture of hypothyroidism emerges.

Insufficient secretion of thyroid hormones can lead to a slowing of metabolism, low energy, and the affection of many systems in the body. Hashimoto's is generally a long-term and slowly progressing disease, but it can be brought under control with appropriate treatment.

In advanced stages of hypothyroidism; more serious findings such as fluid accumulation in the heart and lung membranes, carpal tunnel syndrome, sleep apnea, increase in prolactin hormone, decrease in sexual desire, and low blood sodium can be seen.

Causes and Risk Factors of Hashimoto's (Chronic Lymphocytic Thyroiditis)

The basis of Hashimoto's disease lies in the immune system misidentifying its own tissues. The thyroid gland is targeted by the immune system and undergoes loss of function over time.

The main factors paving the way for this condition are as follows:

• Genetic predisposition
• History of autoimmune diseases
• Hormonal changes
• Smoking
• Pregnancy and the postpartum period
• Presence of thyroid disease in the family

Risk groups that can be seen together with Hashimoto's disease are as follows:

• Type 1 diabetes
• Vitiligo
• Celiac disease
• Addison's disease
• Rheumatoid arthritis
• Pernicious anemia
• Lupus
• Individuals with Anti-TPO positivity
• People with heart failure

The disease is more common in women, and hormonal structure along with genetic factors can influence this situation. Although it is rarer in men, it holds an important place among the causes of hypothyroidism in men.

Which Diseases Does Hashimoto's Cause?

Hashimoto's disease that is not treated or brought under control can lead to various complications over time.

Goiter: Due to decreased hormone production, the stimulation of the pituitary gland increases, and this situation can lead to the enlargement of the thyroid gland.

Heart Problems: Hypothyroidism can weaken heart functions and cause an increase in cholesterol levels. This situation raises the risk of cardiovascular diseases.

Psychological Problems: Depression, mood swings, and mental slowing can be seen starting from the early period.

Reproductive Health Problems: Menstrual irregularity, ovulation problems, and decreased libido in women; and decreased sexual desire and a drop in sperm count in men can be seen.

Risks in Pregnancy: Untreated hypothyroidism can increase the risk of miscarriage and premature birth. Additionally, developmental problems may occur in the baby.

In addition to these, musculoskeletal system problems, psychiatric pictures, and thyroid nodules can develop. The formed nodules must be monitored regularly.

Effects of Hashimoto's Disease on Sexual Life

Hashimoto's thyroiditis may negatively affect sexual life not directly, but through the metabolic and hormonal changes it creates in the body. Because it is an autoimmune disease, inflammation in the body increases and the metabolic rate slows down. Even if the synthetic thyroid hormone (T4) given externally is at a sufficient level, the process of converting this hormone into its active form (T3) may slow down. Additionally, disruptions in the entry of the T3 hormone into the cell cause tissues to be unable to use oxygen effectively.

This situation results in decreased energy production at the cellular level. Low energy creates a picture of constant fatigue, reluctance, and general malaise in the person. This resulting picture stands out as an important factor in the decrease of sexual desire.

As inactivity due to fatigue increases in Hashimoto's thyroiditis, problems related to the circulatory system also begin to be seen more frequently. The slowing of blood flow can lead to a decline in sexual functions by preventing the sexual organs from being sufficiently supplied with blood and decreasing oxygenation.

Especially in women, the state of weight gain or the inability to lose weight due to the disease can lead to a deterioration of body perception over time. The decrease in a person's self-confidence and dissatisfaction with their body can psychologically increase sexual reluctance and make it difficult to focus during sexual intercourse.

In some Hashimoto's patients who are followed up with the use of only T4 hormone for a long time, the insufficiency of the conversion to T3 may cause these symptoms to persist even if blood values are within normal limits. In addition, side effects such as loss of bone density that can occur due to long-term hormone use can also indirectly affect the person's sexual life negatively.

Hashimoto's (Chronic Lymphocytic Thyroiditis) Disease and Pregnancy

There are different views regarding the effects of Hashimoto's disease on pregnancy. Although scientific data has not established that this disease definitely prevents pregnancy, there are approaches arguing that it can make pregnancy difficult. It is stated that some new methods and antioxidant supports that have begun to be applied in Hashimoto's thyroiditis in recent years may show positive effects on this process.

When a person diagnosed with Hashimoto's becomes pregnant, the most critical point is keeping thyroid hormone levels within normal limits throughout the pregnancy. It is of great importance to keep T3 and T4 hormones in balance with medication support and to prevent the TSH value from rising above a certain level. The main goal here is to ensure hormonal balance in the mother-to-be and to prevent the developing baby from being exposed to hypothyroidism.

Regular follow-up during pregnancy and readjusting medication doses according to hormone needs will be sufficient for the healthy growth and development of the baby. In Hashimoto's patients who are appropriately monitored and whose hormonal balance is ensured, it is possible for the pregnancy to continue in its normal course.

In conclusion, it can be said that when necessary precautions are taken and hormone levels are kept under control, Hashimoto's disease alone does not constitute an absolute obstacle to pregnancy.

Which Tests are Used in the Diagnosis of Hashimoto's?

In the majority of Hashimoto's patients, thyroid hormones may initially be within normal limits. However, hypothyroidism may develop over time.

The main methods used in diagnosis are as follows:

• TSH, FT3, and FT4 hormone levels
• Anti-TPO and Anti-TG antibody tests
• Thyroid ultrasonography

Fine-needle aspiration biopsy can be performed in cases deemed necessary to evaluate the structure of nodules detected via ultrasound.

Hashimoto's (Chronic Lymphocytic Thyroiditis) Treatment

The main goal of treatment is to ensure thyroid hormone balance and to bring the patient's complaints under control. If hypothyroidism has developed, hormone replacement therapy is applied and dose adjustments are made at certain intervals.

During the treatment process:

• Hormone levels are monitored regularly
• Dose adjustments can be made at 6–8 week intervals
• In the stable period, controls are continued every 4–6 months

The frequency of follow-up should be increased especially in women planning pregnancy or in the process of pregnancy. In individuals with a risk of nodule development, ultrasound controls should be performed regularly.

How Should Nutrition Be in Hashimoto's Disease?

Although there is no specific diet for Hashimoto's, balanced and healthy nutrition is of great importance. Selenium intake can provide a decrease in antibody levels, but it does not completely stop the progression of the disease.

In some individuals, it has been observed that a gluten-free diet alleviates symptoms.

People using thyroid hormone should take the medication on an empty stomach and should not consume milk, yogurt, or whole grain products that can reduce absorption in the same meal.

How Much are Hashimoto's Thyroiditis Treatment Prices?

Costs regarding treatment in Hashimoto's thyroiditis may vary depending on many factors such as the stage of the disease, the change in thyroid hormone levels, the status of autoimmune activity, blood analyses to be performed, imaging tests, and the frequency of monitoring. Since the treatment approach is planned specifically for the individual, the healthiest method for clear and up-to-date fee information is to have an individual evaluation.

Provinces Where We Provide Hashimoto's Thyroiditis (Chronic Lymphocytic Thyroiditis) Treatment Service

In the follow-up of Hashimoto's thyroiditis; the effect of the immune system on the thyroid, the functional capacity of the gland, and the hormone balance are handled in detail. According to the requirement, the course of the disease is determined with laboratory tests, ultrasound examinations, and supportive diagnostic methods.

Regular controls are of great importance during the treatment process. Medication adjustments can be made in line with changes in hormone balance, clinical symptoms, and the response given to the applied treatment; personalized follow-up plans are created for situations requiring long-term monitoring.

Services provided within this scope are carried out within the framework of the same standards in the provinces of Adana, Mersin, Osmaniye, and Hatay. Thanks to regular evaluation and controlled monitoring, it is aimed to manage Hashimoto's thyroiditis and protect the quality of life.