Index – Science – Hashimoto’s: a mysterious disease that is spreading in Hungary as well
István Takács said that Hashimoto’s thyroiditis the chronic inflammation of the thyroid gland, which has a very precise histological picture. The professor said that the increase in the number of patients has been registered at an accelerating pace since the 1960s and 1970s, and this is a consequence of the fact that the laboratory test leading to the diagnosis of the disease, the anti-TPO test, is becoming more widely available. Anti-TPO is a component of peroxidized thyroid tissue and an antibody is formed against it, which is produced by the body’s immune antibody-producing cells against the thyroid gland, thus slowly eating away at the thyroid gland.
This is therefore one of the types of substances that form against the thyroid gland, which is the most common, and its detection can now be tested in almost every laboratory. Ever since this can be measured, the diagnosis of Hashimoto’s has been made more and more often. Today, a neck ultrasound examination and the laboratory results are enough to say whether someone has chronic thyroiditis.
What causes Hashimoto’sget thyroiditis? What causes the disease?
According to the professor, there is clearly no answer to this question. However, he adds that there are certain points. On the one hand, there are people who are genetically more prone to this disease, and on the other hand, there are environmental factors. It is increasingly likely that certain viral infections rewire the immune system so that immune cells begin to produce anti-thyroid immune material. When asked which viruses predispose the most, István Takács said that there is no named, precise virus after which the risk may be higher. It can also develop when someone is suddenly exposed to greater stress. What is certain, however, is that the incidence of Hashimoto’s is higher in countries with a good supply of iodine, where there is not a large iodine deficiency. Today, fortunately, Hungary also belongs to these states.
Iodine is important, according to the professor, because the more good it is, the greater the tendency to start the autoimmune process.
However, we do not yet know exactly where iodine is involved in all of this.
That’s why you have to be careful if someone takes too much iodine into the body. But we need iodine, because if we don’t get the right amount, iodine deficiency can easily develop. THE on the other hand, with iodized table salt, we take just as much into our body as we essentially need.
In the case of a patient with Hashimoto’s, iodine should not be withdrawn completely either, because then the risk of hypothyroidism increases. THE Hashimoto’s thyroiditis otherwise, the end is hypothyroidism.
This is a not rare condition with a very diverse clinical picture. 5 thousandths of the population, but 4-8 percent of people over the age of 60 suffer from hypothyroidism, which affects hundreds of thousands of people. The energy budget of the organization changes, as a result of this, for example hair loss may occur, the skin may become dry, the nail may become fragmented, we may experience constipation and weight gain. Cognitive abilities change, that is, mental abilities deteriorate. Fatigue and a tendency to dementia are seen. The whole disease old it is called myxedema, i.e. edema that does not hold a fingerprint develops all over the body.
In the case of young women, hypothyroidism also affects fertility, meaning they have a lower chance of conceiving.
Why do only women suffer from Hashimoto’s?
The disease affects seven times as many women as men. This most likely has hormonal causes, but the exact connection is currently unknown.
There is another very rare variant of the disease, Hashimoto’s encephalopathy, which attacks the brain. There, however, they have not yet been able to show that the disease is related to the thyroid gland. In this case too, the anti-TPO is elevated, it has a special histological picture, and this encephalitis responds very well to steroids.
How is Hashimoto’s treated?
The final point is hypothyroidism, and that the patient’s thyroid gland simply runs out over the years. However, this can now be treated well, says Professor Takács, adding that we give the patient the same hormone that the body produces, so in a different way for each person, but it is possible to adjust the functioning of the thyroid gland in the normal range. This means that the patient’s quality of life will not be worse, nor will his life be shorter. A gap sheet that can easily be replaced is created.
On the other hand, to stop the disease, we would have to stop the entire immune system. In the case of autoimmune diseases, where the end of the disease is a condition that impairs the quality of life, for example SLE, rheumatoid arthritis, we give something that affects the functioning of the immune system. An example is steroid treatment. However, this has a side effect, because, say, you will be more likely to get treated susceptible infections. As a long-term side effect of steroid treatment, the patient’s osteoporosis process accelerates, the risk of cataracts increases, and atherosclerosis accelerates.
However, this only appears as a side effect of long-term steroid treatment. All in all, it can be said that it is not worth shutting down the immune system in Hashimoto’s, and we do not even use it.
In fact, you can’t treat Hashimoto’s itself, just keep the patient’s condition as well
– adds the professor.
Among the Hungarian population, the rate of anti-TPO positivity, i.e. when it has been shown in the laboratory that the level of anti-TPO differs from normal, i.e. it may be Hashimoto’s, is between 10-20 percent in our country, so positive findings are very common. Then the value is slightly above normal, already in the abnormal range. International research shows that when examining deceased people who were not known to have thyroiditis, 15-20% of them had thyroiditis. So this means that being anti-TPO positive does not mean that you will ever have a thyroid problem.
Hashimoto’s is a very long-lasting disease, it really has no symptoms. There will be symptoms only when hypofunction develops. TSH, that is, the hormone that regulates the function of the thyroid gland, which shows whether there is hypofunction, well, if TSH goes up, hypofunction begins, that is, the body tries to stimulate the thyroid gland. This is when medicine usually intervenes and tries to keep the TSH within the range so that over- or under-functioning does not develop.
(Cover photo: Dr. István Takács. Photo: Péter Papajcsik / Index)