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Is Hypothyroidism An Autoimmune Disease?

Learn the difference between hypothyroidism and Hashimoto's in this article.
Is Hypothyroidism An Autoimmune Disease?
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What is hypothyroidism?

The thyroid is a butterfly-shaped gland that sits at the base of your neck. As part of the endocrine system, it produces and releases hormones to help regulate your body's energy use. The thyroid gland is responsible for significant body functions like heart rate, blood pressure, and blood temperature.

Hypothyroidism occurs when your body doesn't produce enough thyroid hormones. When your thyroid hormone production drops, your body processes slow down and change, affecting virtually every system in your body. Undiagnosed thyroid disease puts patients at risk for other ailments, such as cardiovascular diseases, osteoporosis, and infertility.

Hypothyroidism affects women more frequently than men, affecting about 1 in 8 women. People are commonly diagnosed over the age of 60 years, but hypothyroidism can begin at any age. The condition can be identified early through an at-home thyroid blood test or after symptoms appear.

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What is an autoimmune disease?

To understand autoimmune diseases, we first need to understand the immune system. The primary role of the immune system is to prevent or limit infection.

The immune system can distinguish between normal, healthy cells and abnormal, unhealthy cells. Cells may become unhealthy due to infectious viruses or bacteria or cellular damage from non-infectious factors like sunburn or cancer. When the immune system recognizes these harmful cells, it responds to protect the body.

However, the immune system does not always respond appropriately. If an immune response isn't activated enough when needed, it can cause problems like infection. However, suppose an immune response is started without a real threat or stays active after the danger passes. In that case, it can cause problems like allergic reactions or autoimmune conditions. 

An autoimmune condition causes your immune system to mistakenly attack otherwise healthy cells and tissues. 

Autoimmune diseases range from organ-specific to systemic. Common autoimmune conditions include type 1 diabetes, multiple sclerosis, rheumatoid arthritis, lupus, Crohn's disease, psoriasis, and Hashimoto's thyroiditis. Autoimmunity may also link to common health problems as arteriosclerosis, inflammatory bowel disease, schizophrenia, and certain types of infertility. 

Researchers are still uncertain what causes autoimmune disease. Still, these conditions may be linked to genetic, infectious, or environmental predisposing factors.

Autoimmune disorders affect approximately 5-8% of the U.S. population and affect women at a rate three times higher than men. For unknown reasons, the prevalence of autoimmune diseases is increasing.

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What is Hashimoto's thyroiditis?

Hashimoto thyroiditis, as mentioned above, is an autoimmune condition. It is the condition in which antibodies in the immune system mistakenly attack the thyroid gland. Antithyroid antibodies can cause chronic inflammation and lead to an underactive thyroid gland.

Signs and symptoms of Hashimoto's may include:

  • Fatigue
  • Increased sensitivity to cold
  • Constipation
  • Pale, dry skin
  • Puffy face
  • Hoarse voice
  • Unexplained weight gain
  • Muscle or joint aches, tenderness, and stiffness
  • Muscle weakness
  • Heavy or irregular menstrual periods
  • Depression

Hashimoto's thyroiditis is also known as chronic thyroiditis, lymphocytic thyroiditis, lymphadenoid goiter, or autoimmune thyroiditis. This condition was first described in 1912 by a Japanese physician, Hakuro Hashimoto, who first called it struma lymphomatosis.

The immune system attack on the thyroid gland is progressive. Early on, the thyroid gland compensates and produces more thyroid hormone to keep the hormone levels within normal ranges. A patient might start noticing mild symptoms of hypothyroidism at this stage. 

However, as the immune system destroys more thyroid tissue, the thyroid loses its ability to compensate. The patient becomes deficient in thyroid hormone— eventually resulting in the thyroid gland's loss of ability to produce thyroid hormone. 

You can take an at-home thyroid blood test to test for Hashimoto's thyroiditis. The presence of thyroid peroxidase antibodies (TPO antibodies) in the blood indicates Hashimoto's thyroiditis. 

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Is hypothyroidism an autoimmune disease?

The short answer is no; hypothyroidism is not an autoimmune disease. Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones. 

Simply put, hypothyroidism is a problem with your thyroid gland. Whereas Hashimoto's, as mentioned, is a problem with your immune system.

That said, Hashimoto's thyroiditis is the most common cause of hypothyroidism in the United States. This autoimmune condition most commonly affects older women, though it can affect either sex at any age. 

Additional causes of hypothyroidism include over-response to hyperthyroidism treatment, thyroid surgery, radiation therapy, certain medications like lithium, congenital disease, pituitary disorder, pregnancy, or iodine deficiency

Testing and treating thyroid dysfunction

A thyroid blood test helps you to understand your thyroid function. Often, labs look only at thyroid-stimulating hormone (TSH) to diagnose thyroid dysfunction. However, it's also important to measure the thyroid hormones fT3 and fT4 and TPO antibodies. Combined, these four biomarkers help you understand the big picture of what's happening with your thyroid function and where specifically to make improvements. 

Should your results show that your thyroid is underactive, it is treatable with thyroid hormone replacement medication. When choosing thyroid medication with your thyroid doctor, remember that there is no one-size-fits-all treatment. 

However, suppose your lab results show elevated TPO antibodies, but your TSH and thyroid hormone levels are still normal. This indicates that the autoimmune attack on your thyroid has not yet affected the function of your thyroid. Your thyroid gland is still producing an adequate amount of thyroid hormone. In that case, your doctor may suggest watchful waiting before starting thyroid hormone replacement medication.

A note from Paloma Health

We recommend you work with a thyroid doctor to understand and manage your thyroid function. Schedule a free consultation with a care advisor to determine if Paloma Health might be the right fit for you.

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Katie Wilkinson

Katie Wilkinson, previously serving as the Head of Content and Community at Paloma Health, fervently explores the nexus between healthcare and technology. Living with an autoimmune condition, she's experienced firsthand the limitations of conventional healthcare. This fuels both her personal and professional commitment to enhancing patient accessibility to superior care.

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