How to identify autoimmune thyroiditis. Autoimmune thyroiditis. The worst thing. What to expect? Signs and symptoms. New Scientists' Research on the Gut-Brain Link in Autoimmune Diseases

Autoimmune thyroiditis is a pathology that affects mainly elderly women (45-60 years old). The pathology is characterized by the development of a strong inflammatory process in the thyroid gland. It occurs due to serious malfunctions in the functioning of the immune system, as a result of which it begins to destroy thyroid cells.

The susceptibility to pathology of precisely elderly women is explained by X-chromosomal abnormalities and the negative effect of estrogen hormones on the cells that form the lymphoid system. Sometimes the disease can develop in both young people and young children. In some cases, pathology is also found in pregnant women.

What can cause AIT, and can you recognize it yourself? Let's try to figure it out.

What it is?

Autoimmune thyroiditis is an inflammation in the tissues of the thyroid gland, the main cause of which is a serious failure in the immune system. Against this background, the body begins to produce an abnormal large amount of antibodies, which gradually destroy healthy thyroid cells. Pathology develops in women almost 8 times more often than in men.

Reasons for the development of AIT

Hashimoto's thyroiditis (the pathology got its name in honor of the doctor who first described its symptoms) develops for a number of reasons. The primary role in this matter is given to:

regular stressful situations;
emotional stress;
an excess of iodine in the body;
unfavorable heredity;
the presence of endocrine diseases;
uncontrolled reception;
negative impact external environment(it can be bad ecology and many other similar factors);
improper nutrition, etc.

However, don't panic - autoimmune thyroiditis- this is a reversible pathological process, and the patient has every chance to improve the thyroid gland. To do this, it is necessary to ensure a decrease in the load on its cells, which will help to reduce the level of antibodies in the patient's blood. For this reason, timely diagnosis of the disease is very important.

Classification

Autoimmune thyroiditis has its own classification, according to which it happens:

Painless, the reasons for the development of which have not been fully established.
Postpartum. During pregnancy, a woman's immunity is significantly weakened, and after the birth of a baby, on the contrary, it becomes more active. Moreover, its activation is sometimes abnormal, since it begins to produce an excessive amount of antibodies. Often the consequence of this is the destruction of "native" cells various bodies and systems. If a woman has a genetic predisposition to AIT, she needs to be extremely careful and carefully monitor her health after childbirth.
Chronic. In this case, we are talking about genetic predisposition to the development of the disease. It is preceded by a decrease in the production of hormones of organisms. This condition is called primary.
Cytokine-induced. Such thyroiditis is a consequence of taking medications based on interferon, used in the treatment of hematogenous diseases, etc.

All types of AIT, except for the first, show the same symptoms. The initial stage of the development of the disease is characterized by the onset of thyrotoxicosis, which, if diagnosed and treated late, can turn into hypothyroidism.

Development stages

If the disease was not detected in a timely manner, or for some reason it was not treated, this may become the reason for its progression. The stage of AIT depends on how long ago it developed. Hashimoto's disease is divided into 4 stages.

Euteroid phase. It has its own duration for each patient. Sometimes several months may be enough for the transition of the disease to the second stage of development, in other cases several years may pass between the phases. During this period, the patient does not notice any special changes in his state of health, and does not consult a doctor. The secretory function is not impaired.
At the second, subclinical, stage, T-lymphocytes begin to actively attack follicular cells, leading to their destruction. As a result, the body begins to produce significantly less St. T4. Eutheriosis persists due to a sharp increase in TSH levels.
The third phase is thyrotoxic. It is characterized by a strong jump in the hormones T3 and T4, which is explained by their release from the destroyed follicular cells. Their entry into the bloodstream becomes a powerful stress for the body, as a result of which the immune system begins to rapidly produce antibodies. When the level of functioning cells falls, hypothyroidism develops.
The fourth stage is hypothyroid. Thyroid function can recover on its own, but not in all cases. It depends on the form in which the disease proceeds. For example, chronic hypothyroidism can last for quite a long time, passing into the active stage, which changes the phase of remission.

The disease can be in one phase or go through all the stages described above. It is extremely difficult to predict exactly how the pathology will proceed.

Symptoms of autoimmune thyroiditis

Each of the forms of the disease has its own characteristics of manifestation. Since AIT does not pose a serious danger to the body, and its final phase is characterized by the development of hypothyroidism, neither the first, but the second stage has any clinical signs. That is, the symptomatology of the pathology, in fact, is a combination of those abnormalities that are characteristic of hypothyroidism.

We list the symptoms characteristic of autoimmune thyroiditis thyroid gland:

periodic or permanent depressive state(a purely individual feature);
memory impairment;
trouble concentrating;
apathy;
persistent drowsiness or feeling tired;
sudden jump weight, or a gradual increase in body weight;
deterioration or total loss appetite;
slowing down the pulse;
chilliness of the arms and legs;
loss of strength even with good nutrition;
difficulties with performing ordinary physical work;
inhibition of the reaction in response to the effects of various external stimuli;
dull hair, fragility;
dryness, irritation and peeling of the epidermis;
constipation;
decrease in sexual desire, or its complete loss;
violation menstrual cycle(development of intermenstrual bleeding, or complete cessation of menstruation);
swelling of the face;
yellowness skin;
problems with facial expressions, etc.

In postpartum, silent (asymptomatic) and cytokine-induced AIT, the phases of the inflammatory process alternate. At the thyrotoxic stage of the disease, the manifestation of the clinical picture occurs due to:

sharp weight loss;
sensations of heat;
increasing the intensity of sweating;
feeling unwell in stuffy or small rooms;
trembling in the fingers;
sharp changes in the psychoemotional state of the patient;
increased heart rate;
seizures;
deterioration of attention and memory;
loss or decrease in libido;
rapid fatigue;
general weakness, which even good rest does not help to get rid of;
sudden bouts of increased activity;
problems with the menstrual cycle.

The hypothyroid stage is accompanied by the same symptoms as the chronic one. Postpartum AIT is characterized by the manifestation of thyrotoxicosis symptoms in the middle of 4 months, and the detection of hypothyroidism symptoms at the end of 5 - at the beginning of 6 months of the postpartum period.

With painless and cytokine-induced AIT, no special clinical signs are observed. If the ailments, nevertheless, appear, they have an extremely low degree of severity. With an asymptomatic course, they are detected only during a preventive examination in a medical institution.

What does autoimmune thyroiditis look like: photo

The photo below shows how the disease manifests itself in women:

Diagnostics

Before the first alarming signs of pathology appear, it is almost impossible to detect its presence. In the absence of ailments, the patient does not consider it advisable to go to the hospital, but even if he does it, it will be almost impossible to identify the pathology with the help of analyzes. However, when the first unfavorable changes in the work of the thyroid gland begin to occur, clinical research biological sample will immediately reveal them.

If other family members have or have previously suffered from similar disorders, this means that you are at risk. In this case, it is necessary to visit a doctor and undergo preventive examinations as often as possible.

Laboratory tests for suspected AIT include:

a general blood test, with the help of which the level of lymphocytes is established;
a hormone test, necessary to measure serum TSH;
immunogram, which establishes the presence of antibodies to AT-TG, thyroperoxidase, as well as to thyroid hormones of the thyroid gland;
fine-needle biopsy, necessary to establish the size of lymphocytes or other cells (their increase indicates the presence of autoimmune thyroiditis);
Ultrasound diagnostics of the thyroid gland helps to establish its increase or decrease in size; with AIT, a change in the structure of the thyroid gland occurs, which can also be detected during an ultrasound scan.

If the results of an ultrasound study indicate AIT, but clinical tests refute its development, then the diagnosis is considered doubtful, and does not fit into the patient's medical history.

What will happen if you do not treat?

Thyroiditis can have unpleasant consequences that differ for each stage of the disease. For example, in the hyperthyroid stage, the patient may be impaired heartbeat(arrhythmia), or heart failure occurs, and this is already fraught with the development of such a dangerous pathology as myocardial infarction.

Hypothyroidism can lead to the following complications:

dementia;
infertility;
premature termination of pregnancy;
inability to bear the fetus;
congenital hypothyroidism in children;
deep and lingering depression;
myxedeme.

With myxedema, a person becomes hypersensitive to any temperature changes downward. Even a banal flu, or another infectious disease, transferred with this pathological condition, can cause a hypothyroid coma.

However, you should not worry too much - such a deviation is a reversible process, and is easily treatable. If you choose the correct dosage of the drug (it is prescribed depending on the level of hormones and AT-TPO), then the disease may not remind of itself for a long period of time.

Autoimmune thyroiditis treatment

AIT treatment is carried out only on last stage its development - at. However, in this case, certain nuances are taken into account.

So, therapy is carried out exclusively with manifest hypothyroidism, when the TSH level is less than 10 mU / l, and St. T4 is lowered. If the patient suffers from a subclinical form of pathology with TSH at 4-10 IU / 1 L and with normal performance St. T4, then in this case, treatment is carried out only if there are symptoms of hypothyroidism, as well as during pregnancy.

Today, the most effective drugs in the treatment of hypothyroidism are medications based on levothyroxine. A feature of such drugs is that they active substance as close as possible to the human T4 hormone. Such funds are absolutely harmless, therefore they are allowed to be taken even during pregnancy and hepatitis B. The drugs practically do not cause side effects, and, despite the fact that they are based on a hormonal element, they do not lead to an increase in body weight.

Levothyroxine-based drugs should be taken "in isolation" from other medications, as they are extremely sensitive to any "foreign" substances. Reception is carried out on an empty stomach (half an hour before meals or the use of other drugs) with the use of abundant liquids.

Calcium supplements, multivitamins, iron medications, sucralfate, etc. should be taken no earlier than 4 hours after taking levothyroxine. The most effective means on its basis are L-thyroxine and Eutirox.

Today there are many analogues of these drugs, but it is better to give preference to the originals. The fact is that it is they that have the most positive effect on the patient's body, while analogues can only bring a temporary improvement in the patient's health.

If from time to time you switch from originals to generics, then you should remember that in this case you will need to adjust the dosage of the active substance - levothyroxine. For this reason, every 2-3 months it is necessary to take a blood test to determine the level of TSH.

Nutrition with AIT

Treatment of the disease (or a significant slowdown in its progression) will give more high results if the patient will avoid foods that are harmful to the thyroid gland. In this case, it is necessary to minimize the frequency of consumption of foods containing gluten. The ban includes:

cereals;
flour dishes;
bakery products;
chocolate;
sweets;
fast food, etc.

In this case, you need to try to eat foods fortified with iodine. They are especially useful in combating the hypothyroid form of autoimmune thyroiditis.

With AIT, it is necessary to take the issue of protecting the body from the penetration of pathogenic microflora with the utmost seriousness. You should also try to cleanse it of pathogenic bacteria that are already in it. First of all, you need to take care of cleansing the intestines, because it is in it that active reproduction takes place harmful microorganisms... To do this, the patient's diet should include:

fermented milk products;
Coconut oil;
fresh fruits and vegetables;
lean meat and meat broths;
different types of fish;
seaweed and other algae;
sprouted cereals.

All products from the above list help to strengthen the immune system, enrich the body with vitamins and minerals, which, in turn, improves the functioning of the thyroid gland and intestines.

Important! If there is a hyperthyroid form of AIT, all products containing iodine must be completely excluded from the diet, since this element stimulates the production of hormones T3 and T4.

With AIT, it is important to give preference to the following substances:

selenium, which is important in hypothyroidism, as it improves the secretion of hormones T3 and T4;
B vitamins, which help to improve metabolic processes and help keep the body in good shape;
probiotics, important for maintaining intestinal microflora and preventing dysbiosis;
plants-adaptogens that stimulate the production of hormones T3 and T4 in hypothyroidism (Rhodiola rosea, Reishi mushroom, ginseng root and fruits).

Treatment prognosis

What's the worst thing to expect? The prognosis of AIT treatment is generally quite favorable. If there is persistent hypothyroidism, the patient will have to take levothyroxine-based drugs for the rest of his life.

It is very important to monitor the level of hormones in the patient's body, therefore, every six months it is necessary to take a clinical blood test and an ultrasound scan. If, during an ultrasound examination, a nodular thickening in the thyroid area is noticed, this should be a good reason for consulting an endocrinologist.

If, during the ultrasound, an increase in nodules was noticed, or their intensive growth is observed, the patient is prescribed a puncture biopsy. The obtained tissue sample is examined in a laboratory in order to confirm or deny the presence of a carcinogenic process. In this case, an ultrasound scan is recommended every six months. If the node does not have a tendency to increase, then ultrasound diagnostics can be performed once a year.

According to doctors for recent times the percentage of various pathologies of the thyroid gland has significantly increased, therefore in this article we will consider autoimmune thyroiditis treatment in various ways, and - most importantly - effective recommendations alternative medicine about the factors influencing the development of the disease and its treatment. You will learn about the mechanism of occurrence of AIT, its signs and methods of diagnosis. This is, in fact, a review article on how to treat Hashimoto's thyroiditis.
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What do we know about the thyroid gland? Everyone immediately comes to mind the concept of “ Graves' disease". In fact, there are much more thyroid diseases, and not all of them boil down to the formation of a goiter on the neck, their symptoms are much more extensive. Today we will get acquainted with the most "incomprehensible" of them - autoimmune thyroiditis (AIT).

Autoimmune thyroiditis: signs, causes and mechanism of AIT

For the first time, the world learned about its existence at the beginning of the 20th century thanks to the works of the Japanese doctor Hashimoto (Hashimoto). Japanese described characteristic symptoms identified by him in 4 test patients.

Thanks to this, this disease received his name and became known as Hashimoto's thyroiditis.

Autoimmune thyroiditis - what is it. Signs, photo

Under a microscope, Hashimoto made out in the tissues of the thyroid gland clusters (infiltrates) of affected lymphocytes, plasma cells and connective tissues (focal fibrosis). And in 1956, when medical science made a great leap forward, antibodies to the gland's own proteins were found in the blood of patients... And thyroiditis began to be called "autoimmune".

The main signs of Hashimoto's thyroiditis are visible under a microscope:

the presence of dead cells in the tissues of the thyroid gland (lymphocytes and plasma cells)
outgrowth connective tissue(focal fibrosis)
detection of antibodies to thyreglobulin (AT TG) in the blood

What does autoimmune mean? If the word "immune" is more or less clear, then "auto" can be translated from Latin as "own". As a result, we get some kind of process directly related to the immune system of our own body. With the concept of "thyroiditis", everything is also quite simple: "thyroid-" is associated with Latin name thyroid gland (glazedula thyroida), and "-it" means inflammation.

In case of damage to the body by autoimmune thyroiditis, antibodies - substances designed to protect the body from harmful agents, cease to "recognize" their own organ and begin to "attack" the thyroid cells.

As a result, the necessary cells are destroyed, and connective tissue takes their place. The production of hormones weakens, and the patient develops a state of hypothyroidism (the prefix "hypo" indicates a decrease).

This process can be clearly seen in the photo:
data-lazy-type = "image" data-src = "https://prozdorovechko.ru/wp-content/uploads/2017/01/3.jpg" alt = "(! LANG: Signs, causes and mechanism of autoimmune thyroiditis" width="500" height="286" srcset="" data-srcset="https://i2.wp..jpg?w=500&ssl=1 500w, https://i2.wp..jpg?resize=300%2C172&ssl=1 300w" sizes="(max-width: 500px) 100vw, 500px" data-recalc-dims="1">!}

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We can conclude that autoimmune thyroiditis is hypothyroidism, which arose as a result of a malfunction of the immune system and the production of antibodies against its own cells of the thyroid gland, which leads to a decrease in the functions of the thyroid gland - hypothyroidism and premature aging of the body, as well as a malfunction hormonal background person.

Here are some photos of patients with this disease - in varying degrees of development and lesion of the thyroid gland:

Photo initial stage- slight redness of the skin in the area of the gland:

Data-lazy-type = "image" data-src = "https://prozdorovechko.ru/wp-content/uploads/2017/01/4.jpg" alt = "(! LANG: Initial stage - slight reddening of the skin in the area of the thyroid gland" width="500" height="383" srcset="" data-srcset="https://i0.wp..jpg?w=500&ssl=1 500w, https://i0.wp..jpg?resize=300%2C230&ssl=1 300w" sizes="(max-width: 500px) 100vw, 500px" data-recalc-dims="1"> Фото дальнейшего разрастания ткани, наблюдается увеличение щитовидной железы:!}

Data-lazy-type = "image" data-src = "https://prozdorovechko.ru/wp-content/uploads/2017/01/5.jpg" alt = "(! LANG: Further tissue overgrowth in Hoshimoto's thyroiditis" width="500" height="324" srcset="" data-srcset="https://i0.wp..jpg?w=500&ssl=1 500w, https://i0.wp..jpg?resize=300%2C194&ssl=1 300w" sizes="(max-width: 500px) 100vw, 500px" data-recalc-dims="1"> Фото более тяжёлой стадии — асимметричное увеличение железы, заметное без пальпации:!}
data-lazy-type = "image" data-src = "https://prozdorovechko.ru/wp-content/uploads/2017/01/6.jpg" alt = "(! LANG: Asymmetric thyroid enlargement" width="500" height="278" srcset="" data-srcset="https://i1.wp..jpg?w=500&ssl=1 500w, https://i1.wp..jpg?resize=300%2C167&ssl=1 300w" sizes="(max-width: 500px) 100vw, 500px" data-recalc-dims="1">!}

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As you can see from the photo, the disease tends to progress slowly, first destroying the thyroid gland, and then the entire body. With atrophic thyroiditis, the change in the gland is not externally displayed.

Causes of occurrence: what causes the disease

There are enough reasons that provoke the onset of Hashimoto's thyroiditis. What factors influence the trigger of autoimmune thyroiditis? Among them are:

damage to the immune system: poor ecology, haphazard use of drugs, malnutrition, etc.
long-term stressful conditions: shocks, anxieties and experiences
hereditary endocrine diseases in the family: not only AIT, but also diabetes mellitus, Basedow's disease
excess of iodine entering the body with food or drugs
uncontrolled use of interferon and other antiviral drugs, especially in the treatment of acute viral infections and even for prophylactic purposes

However, it's not all bad. A number of prominent representatives of medicine believe that the autoimmune process is a reversible phenomenon.
In the initial stages, as the patient's condition improves, after the excess load on the gland cells is eliminated, the antibody content in the blood gradually decreases. And the thyroid gland begins to work normally. Therefore, it is so important to diagnose thyroiditis in time.

Stages and symptoms of the development of autoimmune thyroiditis

There are several stages in the development of AIT. Each stage has its own symptoms. Let's talk about them briefly.

1. Hyperthyroidism observed in the initial stage of development of AIT and lasts from a month to six months. During this period, a large amount of thyroid hormones T3 and T4 is observed in the blood.

Why this happens: antibodies in large quantities destroy thyroid cells and hormones that the cell managed to synthesize before its destruction enter the intercellular space. They enter the bloodstream.
What symptoms occur:

pain in the area of the gland
the increased content of hormones causes nervousness and irascibility
sore throat and swelling in the throat, as if something were in the way
before bed - a lump in the throat
excessive sweating
rapid pulse
failure of the cycle of menstruation

2. Euthyroidism characteristic of the second stage of development of Hoshimoto's goiter. It is very similar in symptomatology to the state of a healthy person: the amount of hormones in the blood has leveled off, the inconveniences listed above have disappeared and the person often calms down - nothing bothers. But this is very deceiving.

During this period, neoplasms appear in the gland in the form of cysts and nodes, which gradually increase in size. The thyroid gland continues to be destroyed asymptomatically by the immune system. It can be resized: grow, shrink, or remain the same. Sometimes a slight redness is noticeable in the area where the gland is located - in front of the neck.

3. Hypothyroidism- the third stage of development of AIT. It is characterized by a significant reduction in the production of thyroid hormones, which are so necessary for normal metabolism and maintaining the state of the body in terms of high energy and beautiful appearance.

The main symptoms of autoimmune thyroiditis at the stage of hypothyroidism are:

despondency, a sense of hopelessness
tendency to depressive states
deterioration in performance
memory lapses are possible
impotence, weakness, slowness and fatigue
metabolic disorders: excess weight and the appearance of edema, poor thermoregulation of the body
dry skin and areas with its roughness - on the knees and elbows (hyperkeratosis)
bad hair and brittle nails
cysts are formed on the female reproductive organs and in the mammary glands
unbalanced menstrual cycle
early menopause
there is a failure in the entire metabolism of the body
shortness of breath on any exertion
possible heart failure, bradycardia
atherosclerosis at a fairly young age

The earlier the disease is detected, the easier the treatment is. This must be remembered and, at the slightest suspicion, undergo the prescribed tests and diagnostics.

Autoimmune thyroiditis treatment of this disease can only be started after a thorough diagnosis. As practice shows, in the early stages, autoimmune thyroiditis does not manifest itself in any way. That is, the disease does not have its own specific symptoms.
.jpg "alt =" (! LANG: Autoimmune thyroiditis treatment and diagnosis" width="500" height="302" srcset="" data-srcset="https://i2.wp..jpg?w=500&ssl=1 500w, https://i2.wp..jpg?resize=300%2C181&ssl=1 300w" sizes="(max-width: 500px) 100vw, 500px" data-recalc-dims="1">!}

Therefore, autoimmune thyroiditis is diagnosed for the following factors:

the amount of antibodies to proteins thyroglobulin and TPO (thyroid peroxidase) exceeds the norm
fibrosis of thyroid tissue

In order to exclude other diseases of the thyroid gland and make an accurate diagnosis, not only a clinical study (examination and palpation) is necessarily carried out, but also tests are taken:

for antibodies to thyroglobulin and TPO
for hormones T3, T4 and TSH

Sometimes they resort to biopsy: a piece of the thyroid gland is taken for examination; so the diagnosis of nodular goiter is excluded. To find out the size of the gland and the presence of nodes, an ultrasound is done. Also, the endocrinologist will definitely find out from the patient whether any of his relatives suffers from autoimmune diseases.

In patients with increasing fibrosis symptoms of hypothyroidism develop... The thyroid gland changes. According to the type of lesion of the gland, two forms of thyroiditis are distinguished:

hypertrophic - the thyroid gland is enlarged, patients feel a lump in the throat, difficulty swallowing, and sometimes breathing
atrophic - the gland, on the contrary, is reduced or its size is within normal limits

Just as there are no specific symptoms of AIT, there is no specific treatment. Doctors still have not found methods that can effectively block the autoimmune process and the subsequent development of hypothyroidism.

Traditional method of AIT treatment

Modern medicine offers two ways to tame a formidable ailment - this is hormone treatment and surgery ... Replacement of thyroid hormones with synthesized hormones is preferable to surgery.
At enhanced function Your doctor will prescribe nonsteroidal anti-inflammatory drugs that block the production of antibodies. With an integrated approach to treatment, they also use vitamin complexes and remedies for correcting immunity.

If the function of the thyroid gland is depressed ( downgraded), synthetic hormones are prescribed for its treatment.

Hormone therapy and anti-inflammatory drugs

At the stage when hypothyroidism has already developed, doctors prescribe the following hormonal drugs:

Levothyroxine
Thyroidin
Triiodothyronine
Thyroid
Thyrocomb

The most common treatment is Levothyroxine. The dosage is selected individually for everyone. Clinical efficacy the drug - a decrease in the symptoms of hypothyroidism, observed 3-5 days after the start of admission. Substitution therapy can last for months, years, or a lifetime.

Since the disease progresses slowly, therapeutic measures effectively inhibit the process. And over time, a long-term remission is achieved.

The use of such drugs reduces goiter, prevents thyroid insufficiency and lowers thyroid hormone levels. In this case, blood lymphocytes are neutralized, which are capable of provoking the destruction of the thyroid gland.

The dosage is determined strictly individually.
If thyroiditis is subacute, then first remove inflammatory process... As a result, swelling and pain are reduced. Your doctor may prescribe a steroid drug called prednisone. The duration of treatment depends on the nature of the disease.

Non-steroidal anti-inflammatory drugs are also able to reduce the progressive processes in the thyroid gland. In parallel, they will create an immunosuppressive effect. But all this only works when mild form diseases.

With the proper approach to treatment, recovery occurs after a short time. But there are protracted cases and even relapses.
If the disease passes without symptoms, then it must be remembered that it proceeds spontaneously and it is necessary to block its development.

Surgical way to solve the problem

There are times when surgery is needed. The doctor prescribes surgical intervention only in exceptional cases: when the disease is combined with a large goiter. It can put pressure on the organs in the neck and obstruct breathing. The same situation occurs with the rapid progression of goiter or no result within six months of treatment.
Thyroid surgery is possible in two cases:

if a large goiter has developed, squeezing adjacent organs
if there is a suspicion of a malignant tumor of the gland against the background of AIT

Complete removal glands (thyroidectomy) is used in extreme cases... For example, if the thyroid gland is completely affected by fibrosis. Removal of one of the affected lobes is possible. More often performed partial removal of the affected tissue (resection) with the preservation of the active part of the gland.

Treatment of autoimmune thyroiditis with computer reflexology

The method of computerized reflexology makes it possible to completely restore the thyroid gland and its functions without hormones and surgeries.

The essence of the method is in the use of knowledge oriental medicine that the nervous, immune and endocrine systems are one. Almost all thyroid diseases begin with primary failure of the immune system rather than endocrine.

The ability to influence biologically hotspots, and through them the autonomic network of nerve endings - to the human brain, restores the function of the thyroid gland (regardless of whether it is decreased or increased).

What this gives in practice:

nodules and cysts gradually dissolve
ceases hormonal disbalance and the background of thyrohormones is normalized, the body itself begins to produce hormones in the required amount
makes it possible to completely stop taking hormonal drugs(if accepted)
menstruation is restored in women and there is an opportunity to give birth to a healthy child

The result is a gradual restoration of the immune system, which means that the main cause of autoimmune thyroiditis is eliminated.
I suggest watching a video from the private clinic of Gavrilova, which tells about such a treatment.

An excellent method for restoring many body functions. Unfortunately, this is alternative medicine and it is not widely used. Used in private practice.

Nutraceuticals or dietary supplements - Endonorm treatment

Recently, a lot of reviews have appeared on the Internet about Endonorm treatment. Endonorm is a new non-hormonal herbal product.

According to the manufacturers, an active substance, Albinin, has been synthesized from the medicinal plant Potentilla, which normalizes the production of hormones and restores not only the functioning of the thyroid gland, but also its structure.
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The drug is also effective in the treatment of autoimmune thyroiditis. But, like any dietary supplement, Endonorm is not perceived by traditional medicine as a medicine.

Treatment of autoimmune thyroiditis with homeopathy

If you do not want to take hormones for the rest of your life and suffer from their side effects, then turn to homeopathy. According to experts practicing the classical teachings of Hahnemann, homeopathy seems to be created for the treatment of autoimmune diseases. Since classical homeopathy does not cure a specific disease, but at a subtle level heals the body, restoring the immune, endocrine and other systems.

Homeopaths believe that traditional medicine does not even try to treat autoimmune thyroiditis, but only diagnoses and prescribes doses of hormones. Doctors do not care what the patient feels: whether he is suffering or not. The main thing for them is to cure the disease, not the person himself.

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Homeopathy heals the body at all levels: physical, emotional, and mental. Since complete healing can be talked about only if eliminated pathological processes in the body and psychological barriers in the head.

Especially surgical treatment harmful to the body... After the nodes are removed from the thyroid gland, they can be expected to appear in other organs, for example, in the uterus or breast in women. After all, all processes in our body are interconnected. If there are problems with the thyroid gland, then there is a high likelihood of pathology reproductive system and vice versa.

Homeopathy treatment is strictly individual. Each patient chooses his own drug in accordance with his constitutional type. There are no "thyroid pills" or "head pills" here.

There is no universal regimen for the treatment of autoimmune thyroiditis. And the choice of the drug depends on the expressed symptoms and characteristics of each person. But one selected homeopathic remedy will act on the body in a complex way.

How quickly will recovery come? Despite the fact that the drug begins to act immediately, it can take years until it is completely cured.

It depends on the stage of AIT and the duration of the previous hormone therapy. For some, this may seem like a long time. But remember that conventional medicine believes that autoimmune thyroiditis is incurable... Homeopathy, without surgery and hormones, even in an advanced case, will help alleviate unpleasant symptoms and stop the further development of the disease.

The best effect when using homeopathy is observed in patients whose disease period does not exceed 3 years. One year later, their thyroid antibody tests are negative. And there is no recurrence of AIT.

There is an interesting program for the cure of autoimmune diseases, developed by the academician of the EAEN, the chief immunologist Irkutsk region Gorodiskim B. V. I will cite the most important points from his speeches. I believe that this information will be useful for patients with autoimmune thyroiditis.
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Growth of autoimmune diseases awaits us

The immunologist believes that these diseases are like an iceberg - we see only a small part, the rest of the diseases are hidden and have not yet manifested themselves, but the process has long been started. And in the near future there will be a big surge in these diseases.

This is evidenced by the high level of registered antibodies - against almost every organ or organ system.

The reason for the outbreak of the disease

The main reason for this surge is the involution of the adrenal glands, their atrophy, which will lead to an increase in autoimmune diseases.

These are not diseases of the thyroid gland, joints or pancreas - this is a serious systemic disease the whole organism, which is based on the sixth degree of pollution and damage to the body.

The mechanism of the disease, the factors that affect it

There is complex mechanism violations - between the onset of the disease and its clinical manifestation can pass 8-10 years.

The process has been going on for a long time, the cells of the thyroid gland are being destroyed, antibodies have been working for destruction for a long time, but we do not even know about this until the number of damaged cells reaches a critical amount, and the body is simply no longer able to produce thyrohormones or any others. The clinical picture of autoimmune organ damage begins to appear. If at the beginning of the disease it is possible to correct the work of the gland, now it is much more difficult.

What is typical for an autoimmune disease at the stage of clinical manifestation:

1.6 degree of body pollution
2. serious violations pineal gland
3.interhemispheric asymmetry, reaching 70% - 70% of the hemispheres do not understand each other and cannot work as a paired organ
4. disturbances in the hypothalamic region, as a result of which the immune system, the autonomic nervous system suffer, metabolism and thermoregulation are disturbed.

The immune system has decided to destroy its own body - how does this happen? Various factors influence the development of autoimmune diseases, which are discussed below.

What factors can cause autoimmune diseases

Hoshimoto's thyroiditis is a complex systemic disease. Its development can be triggered by any of the following factors.
1. Failure in the ratio of cells of the immune system. The mechanism is the same as for allergies - the balance between the cells of the immune system - helpers, killers and suppressors - is disturbed. How it works in practice:

There are few or no T-suppressors, which means that they cannot slow down the destruction process and maintain immunity.
The cells that produce immunoglobulins begin to produce them against their own tissues, and not against microbes, as is normal. They produce them against the cells of the heart, liver, cells of the pancreas or thyroid gland.
Antibodies land on the cells of the listed organs, killers rush to them and begin to destroy them.

This is how the autoimmune process develops. And try to stop it!

2. Enzyme disorders- a prerequisite for autoimmune diseases. In the development of autoimmune disease great value has a gastrointestinal tract. The body lacks enzymes- After 40 years, we have only 20% of the necessary enzymes. There is already nothing to digest food. You need to eat less meat, heavy foods that require a lot of enzymes for their digestion. Enzymes are enough in green leaves of vegetables. They should be used with meat. We eat meat and potatoes. Therefore, we train ourselves to eat meat with enzymes - with a lot of greens.

This is an extremely important factor. And it is difficult to influence it - many damage to the human genetic apparatus at the genome level occurs at the enzymatic level. Outwardly, this manifests itself in increased pigmentation or depigmentation of the skin, the appearance of some nodules on the bones that were not there before. And the reason is that some gene is turned off, the enzyme is not formed - metabolic disorders begin.

Therefore, enzymatic disturbances are of colossal importance. Everything is built on enzymes today, any process depends on their presence. There are 40 thousand enzymes in our body. Only 4 thousand have been studied by mankind.
Micronutrients are also important. They take part in the synthesis of enzymes.

3. Streptococcus as a cause of cell membrane destruction... His chemical composition very similar to all the basement membranes on which the cells sit inside the vessels, in the joint, in the heart, in the kidneys. Immunity, seeks to deal with streptococcus, begins to destroy all basement membranes. Where did streptococcus come from? With tonsils and tonsillitis. Glomerulonephritis forms in the kidneys, protein appears, erythrocytes - there is a real inflammation.

Streptococcus is present in the body of many people. It is in the tonsils, in the blood, in the joints - it is everywhere! And when treating autoimmune diseases, the first thing to do is to remove it. For this stop eating sweets... Streptococcus loves him very much. There should be no sweetness in the body with an autoimmune disease. We refuse muffins, sweets and chocolate, otherwise there will be no effect from the treatment.

Highly efficiently therapeutic fasting - during fasting, we lose weight due to the fact that microbes die. They are not fed. And they begin to die by the billions. Already on the second day of fasting, there is an intense intoxication. The body is getting really bad. Microbes die in kilograms. You can help the body flush out toxins faster by increasing water intake and giving enemas or taking appropriate medications such as chitosan.

4. Deficiency of silicon in the body. It is important to take care of a sufficient amount of silicon in the body. It is essential for the proper functioning of the pineal gland, which is made up of silicon. In its absence or shortage, metabolism in the body is disrupted, joints are destroyed, the charge of cell membranes changes from negative to positive (normally, cell membranes are negatively charged).

It is silicon that gives a negative charge to the membrane - the outer surface of the cells is lined with sialic (or silicic acids - this is the same thing). Proteins combined with silicon give sialic acids. No silicon - no negative charge of cell membranes.

Who loves to feed on silicon? It is adored by microorganisms. Trichomonas, Streptococcus eats silicon with great pleasure. We almost always miss him physically. It is necessary to eat foods containing silicon:
celery and horsetail - they are leading in its content; it is found in asparagus, Jerusalem artichoke, bell pepper, potatoes and other vegetables. Rice, oats, millet and barley are in the lead in cereals.
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As you can see, any of the listed factors can affect the start of the onset of the destruction of the body. Autoimmune diseases are serious illness which have many different mechanisms of occurrence. Here are involved:

Therefore, alternative medicine believes that no non-steroidal drug or hormonal therapy can cure this serious disease. Only to remove the symptoms, and the process of destruction will continue.

Meat with thyroiditis - can or not

Also with autoimmune thyroiditis some nutritional points are important associated with the intake of protein foods.

Denatured protein is considered the most harmful at this moment, saying simple language- boiled (baked) meat, especially taken after 14.00. The body lacks enzymes to digest them.

There is another factor as well. As soon as we eat meat, sausage or other product with denatured protein, the level of leukocytes (cells that protect our body) in the human blood rises to 200, 300 and more thousand, when the body normally contains 6-10 thousand of them. Why are there so many of them? The body tries to defend itself against poorly digested protein when it has not been broken down into amino acids. This is especially bad if a person is taking immunosuppressants, which inhibit the release of leukocytes from the bone marrow.

Therefore, people with an autoimmune disease can eat meat from 7 am to 9 am, and then from 12 to 2 pm according to the biorhythms of the stomach and pancreas. Many recommend switch to vegetable protein during the treatment of exacerbations- walnut, pine nut, especially - Brazil nut. By eating 4 Brazil nuts, you can get daily dose Selena. It is especially recommended for men with sexual dysfunctions.
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Food foil for AIT

To alleviate the condition, it is possible to use food foil (it has a powerful anti-inflammatory effect), it gives the effect of an energy blanket, which the Germans often use to relieve pain.

We wrap the neck (gland area) with foil for the night, fix it - and in the morning it will be in the holes. The condition will improve a lot.

How to get rid of streptococcus

A banal will help to remove streptococcus tincture of calendula from the pharmacy - he is very afraid of her. It can be used not only externally, but also internally, both for adults and children. Dose - 1 drop per year of life. An adult needs 40 drops three times a day, small children - 1-2 drops.

For adults we drip on water, for children - on a crouton and dry it naturally for three hours so that the alcohol evaporates. You can do it for future use and so work with the child, ridding him of streptococcus. Calendula works better than any antibiotic.

You can also buy a natural antibiotic at the pharmacy. wide range Actions Citrosept, obtained from grapefruit seeds by Norwegian scientists. Apply as directed.

Streptococcus is afraid of incense kerosene... Tincture works well walnuts on kerosene of a special fraction, which can be bought at a pharmacy or an online store. It is called Todikamp.

Application is both local and inside. We recommend 1 drop per 2 kg of body weight 1-3 times a day 30 minutes before meals, but start with 5 drops (there is a purchase instruction). It can be added to the ointment or the drug itself can be applied to the pharynx, to the joints - its habitat.
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It is also necessary to remove the connective tissue that has formed scars as a result of prolonged chronic inflammation... Enzyme preparations will help with this.

Therapeutic fasting for autoimmune thyroiditis

Why is the autoimmune process supported? Because antigens circulate in the blood with disintegrated thyroid cells. Such patients are collected in private clinics, where they are treated with fasting. In two weeks, rheumatoid arthritis, autoimmune thyroiditis and other diseases disappear.

Why is this happening: we did not eat protein, new antigens ceased to be created in the blood and the body coped with that load - it utilized all the old cells that circulated in the blood. Thus, the inflammatory process stopped - in just two weeks.

Therefore, today, good clinics that deal with the treatment of autoimmune diseases, no one practically uses anti-inflammatory drugs. Patients are either put on fasting, or fed with amino acids and given enzyme preparations. That's all the treatment. Further, the restoration of the affected organ or system is already underway.

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For those who, after reading the last paragraph, decided to start a hunger strike: this is not a simple hunger strike, it is a healing one with the introduction of certain substances that will help stop the destruction of the body. Such a hunger strike is carried out under the guidance of a specialist - otherwise your hemoglobin will drop, there will be stagnation of bile, aggravation of the pancreas and other troubles.

Hirudotherapy

Leeches have proven themselves well in autoimmune processes - hirudotherapy... Leeches inject about 200 drugs into the body, 6 very strong proteolytic enzymes, hirudotherapy greatly increases our electromagnetic field (in 40 minutes it sometimes increases tens of times).

These events will surely lead to effective result ... The cure of the autoimmune process will be better if you use the device that Gorodiskiy Bogdan Vladimirovich invented. This "CEM TESN" device can perform almost all the described measures for the restoration of an organ affected by an autoimmune disease. You can find out the peculiarities of therapy with the use of the CEM TESN apparatus - an EHF device - by following the link.

Autoimmune thyroiditis of the thyroid gland: treatment with folk remedies

Herbal medicine for autoimmune thyroiditis cannot replace the main treatment - as doctors say. Alternative medicine practice suggests otherwise. But a professional phytoimmunologist should work here.
It is applied in periods when the flow of AIT passes into the states:

eutheriosis - the level of thyrohormones is normal
subclinical hypothyroidism - the level of T3 and T4 hormones is normal, and thyroid stimulating hormone (TSH) is slightly elevated

Herbal medicine with phyto-gatherings

In this case, using herbs, you can try to influence the mechanism of autoimmune aggression.

For these purposes, plants-immunomodulators are applicable, containing the iodine compound - diiodotyrosine:

watercress medicinal
gorse dye
Icelandic moss and other lichens: parmelia, cladonia

It is worth noting that algae (fucus and kelp), rich in iodides, are contraindicated in the treatment of AIT, as they can provoke further development of the disease. The main principle of herbal medicine for this disease is to avoid herbs and foods that increase the iodine content in the body, causing an excess of iodine.

Also, as support for immunity, you can use decoctions, which include:

meadowsweet (also called meadowsweet)
sweet clover
powerful immunomodulator - echinacea

For thyroiditis, herbal medicine is more commonly used to relieve certain symptoms. So, for constipation, toadflax, Icelandic moss, nettle, soapwort, highlander, marshmallow and mullein are added to decoctions. Strong laxative herbs (buckthorn, senna) are drunk separately.

The fees necessarily include medicinal plants that help reduce blood viscosity and cholesterol:

mountain arnica
burdock roots
oat grass
dandelion roots
viburnum
raspberries
coltsfoot
peony evading
sweet clover

And you can't do without tonics. These include medicinal fruits and herbs growing in the Far East, Altai and Siberia: aralia, eleutherococcus, Rhodiola rosea and ginseng.

Also, for autoimmune thyroiditis, the following are used: aquatic plant - duckweed, knotweed and common cocklebur. But do not forget, although herbal medicine sometimes works wonders, such treatment should not be perceived as a panacea.

Oil extracts from herbs

Oil extracts are used for topical application - light rubbing in the area of the gland. They do it very simply: they take in equal proportions a crushed grass mixture or a mono-plant and the same amount of vegetable oil. Extraction lasts a month in a warm and dark place. You can shake it. After a month, we decant the oil and at night we do a pleasant massage of the thyroid gland, lubricating the outside of the neck with oil.

Most useful calendula oil- it perfectly relieves inflammation. Also used string oil and celandine.
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Juice treatment

Traditional medicine advises daily use of beetroot, carrot, lemon juice. Other mixtures of juices are also used. See the recipes for their preparation below:
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We always start with a small dose - two teaspoons, and in the absence of negative phenomena - we increase their intake.

New Scientists' Research on the Gut-Brain Link in Autoimmune Diseases

Each of us has a certain set of microorganisms from birth. Few of us realize how dangerous altering the gut microbiota can be.
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Almost 80% of autoimmune diseases are caused by this change in the intestinal microflora. There is a direct link between the gut microbiota and the brain, between the microorganisms of our entire body and our behavior. It turns out that microbes throughout the body are responsible for a number of differences that exist between people.

For example, it depends on what microorganisms live on our skin whether mosquitoes will bite us. Microorganisms on the skin secrete substances that mosquitoes react to. From what microbes are found in our intestines, it depends on how toxic some painkillers will be to the liver, how effective medicines will be for the heart.

The totality of all human microorganisms is, in fact, separate body in the human body.
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Microbes have a number of functions:

they help us digest food
they help train our immune system
they help us resist disease
they influence our behavior

As part of the Human Microbiome Project (HMP), the National Institutes of Health (USA) has spent $ 173 million to study microorganisms that live inside and outside humans. They created a map of the settlement of various microorganisms in the human body and conducted a series of experiments to change the microbiota by moving from one person to another.

A number of studies have been carried out when changes in the microbiota led to the disappearance of a number of diseases. First, the experiments were carried out on mice, and then on people from among the volunteers.

The gut microbiota is often affected by pathogens. Microorganisms foreign to a given individual begin to intensively produce foreign signal proteins, leading to a "war" of the immune system.

Various autoimmune diseases arise in exactly the same way, only the strains of the pathogens are different. Everything is solved by transplanting the intestinal microbiota, that is, taking its microorganisms from a healthy person and transplanting it to patients with autoimmune diseases. Experiments have shown that a person is able to recover very quickly ...

Almost fantastic! Truth? But watch this video and a lot becomes a reality! There is not specifically about autoimmune diseases, but there are many examples with experiments on transplanting gut microbiota or vaginal flora. I just couldn't help but share.

Another interesting fact is that if you are healthy, then even a bad microflora, pathogenic, will be under the control of a healthy biomass of microorganisms and the disease will not be able to develop. There are microbes, but they are suppressed.

In this article, we have covered autoimmune thyroiditis treatment traditional methods modern medicine, the possibility of using homeopathic medicines and herbal medicine from the arsenal folk remedies, and most importantly - recommendations of alternative medicine about the factors influencing the development of the disease and its treatment. You learned about the mechanism of occurrence of AIT, its signs and methods of diagnosis.

Autoimmune thyroiditis- This is one of the most common diseases of the thyroid gland (every 6-10 woman over 60 suffers from this disease). Often this diagnosis causes anxiety for patients, which leads them to an endocrinologist. I would like to reassure you right away: the disease is benign and if you follow the recommendations of your doctor, then there is nothing to be afraid of.

This disease was first described by the Japanese scientist Hashimoto. Therefore, the second name of this disease is Hashimoto's thyroiditis. In fact, Hashimoto's thyroiditis is just one type of autoimmune thyroiditis.

What is autoimmune thyroiditis? Autoimmune thyroiditis is a chronic disease of the thyroid gland, which results in destruction (destruction) of thyroid cells (follicles) due to exposure to antithyroid autoantibodies.

Causes of autoimmune thyroiditis

What are the causes of the disease? Why does it arise?

1. Immediately it should be noted that your fault in the occurrence of the disease is not. There is a hereditary predisposition to autoimmune thyroiditis. Scientists have proven this: genes have been found that determine the development of the disease. So, if your mom or grandmother suffers from this condition, you too have increased risk get sick.

2. In addition, the occurrence of the disease is often promoted by the stress suffered the day before.

3. The dependence of the incidence of the disease on the age and sex of the patient was noted. So in women it occurs much more often than in men. According to various authors, women are 4-10 times more likely to be diagnosed with this. Most often, autoimmune thyroiditis occurs in the middle age: from 30-50 years. Nowadays, this disease often occurs in more early age: Autoimmune thyroiditis also occurs in adolescents and children of different ages.

4. Pollution environment, the poor environmental situation in the place of residence can contribute to the development of autoimmune thyroiditis.

5. Infectious factors (bacterial, viral diseases) can also be triggering factors for the development of autoimmune thyroiditis.

The most important system of our body with you is the immune system. It is she who is responsible for the recognition of foreign agents, including microorganisms, and does not allow their penetration and development in the human body. As a result of stress, with an existing genetic predisposition, for a number of other reasons, a failure occurs in the immune system: it begins to confuse "ours" and "others". And he begins to attack "his". These diseases are called autoimmune. This is a large group of diseases. In the body, the cells of the immune system - lymphocytes produce the so-called antibodies - these are proteins that are produced in the body and directed against their own organ. In the case of autoimmune thyroiditis, antibodies to the cells of the thyroid gland are produced - antithyroid autoantibodies. They cause destruction of thyroid cells and, as a result, hypothyroidism can then develop - a decrease in the function of the thyroid gland. Given this mechanism of development of the disease, there is also another name for autoimmune thyroiditis - chronic lymphocytic thyroiditis.

Symptoms of autoimmune thyroiditis

What is the clinical picture of the disease? What symptoms of the disease should lead you to an endocrinologist?
It should be noted right away that autoimmune thyroiditis is often asymptomatic and is detected only during examination of the thyroid gland. At the onset of the disease, in some cases throughout life, may persist normal function the thyroid gland, the so-called euthyroidism - a condition in which the thyroid gland produces normal amounts of hormones. This condition is not dangerous and is the norm, it only requires further dynamic monitoring.

Symptoms of the disease occur if, as a result of the destruction of thyroid cells, a decrease in its function occurs - hypothyroidism. Often at the very beginning of autoimmune thyroiditis, an increase in the function of the thyroid gland occurs, it produces more hormones than normal. This condition is called thyrotoxicosis. Thyrotoxicosis can persist, or it can turn into hypothyroidism. Symptoms of hypothyroidism and thyrotoxicosis are different.

Symptoms of hypothyroidism are:

Weakness, decreased memory, apathy, depression, depressed mood, pale dry and cold skin, rough skin on the palms and elbows, delayed speech, swelling of the face, eyelids, overweight or obesity, chilliness, cold intolerance, decreased sweating, increase, swelling of the tongue, increased hair loss, brittle nails, edema on the legs, hoarseness, nervousness, menstrual irregularities, constipation, joint pain.

Possible symptoms of hypothyroidism

Symptoms are often nonspecific, occur in a large number of people, and may not be associated with a dysfunction of the thyroid gland. However, if you have most of the following symptoms, thyroid hormones should be tested.

The symptoms of thyrotoxicosis are:

Increased irritability, weight loss, mood swings, tearfulness, heart palpitations, a feeling of interruption in the work of the heart, increased blood pressure, diarrhea (loose stools), weakness, tendency to fracture (reduced bone strength), feeling of heat, intolerance to hot climates, sweating, increased hair loss, menstrual irregularities, decreased libido (sex drive).

It also happens that in case of autoimmune thyroiditis with symptoms of thyrotoxicosis, tests show a decreased function of the thyroid gland, therefore, the diagnosis should be made solely by outward signs impossible even for an experienced doctor. If you have noticed in yourself similar symptoms, you should immediately see an endocrinologist for a thyroid function test.

Complications of autoimmune thyroiditis

Autoimmune thyroiditis is a relatively harmless disease only if maintained normal amount hormones in the blood - a state of euthyroidism. Hypothyroidism and thyrotoxicosis - dangerous conditions that require treatment. Untreated thyrotoxicosis can cause severe arrhythmias, severe heart failure, and myocardial infarction. Severe, untreated hypothyroidism can lead to dementia (dementia), advanced atherosclerosis, and other complications.

Diagnostics of the autoimmune thyroiditis

In order to identify the presence of autoimmune thyroiditis, it is necessary to undergo an examination, which includes an examination by an endocrinologist, hormonal research, and ultrasound of the thyroid gland.

The main studies are:

1. Hormonal research: determination of TSH, free fractions T3, T4,
T3, T4 are increased, TSH is decreased - indicates the presence of thyrotoxicosis
T3, T4 are reduced, TSH is increased - a sign of hypothyroidism.
If T3 sv, T4 sv, TSH are normal - euthyroidism - normal thyroid function.
Your endocrinologist can comment on your hormonal research in more detail.

2. Determination of the level of antithyroid autoantibodies: antibodies to thyroid peroxidase (AT-TPO or antibodies to microsomes), antibodies to thyroglobulin (AT-TG).
In 90-95% of patients with autoimmune thyroiditis, an increase in AT-TPO is determined, in 70-80% of patients, an increase in AT-TG is determined.

3. It is necessary to perform an ultrasound of the thyroid gland.
For autoimmune thyroiditis, a diffuse decrease in the echogenicity of the thyroid tissue is characteristic, there may be an increase or decrease in the size of the thyroid gland.

In order to accurately diagnose autoimmune thyroiditis, 3 main components are necessary: a decrease in the echogenicity of thyroid tissue and other signs of autoimmune thyroiditis by ultrasound of the thyroid gland, the presence of hypothyroidism, the presence of autoantibodies. In other cases, in the absence of at least one of some components, the diagnosis is only probable.

Autoimmune thyroiditis treatment

The main goal of treatment is to maintain persistent euthyroidism, that is, the normal amount of thyroid hormones in the blood.
In the presence of euthyroidism, treatment is not carried out. Regular examination is shown: hormonal examination T3 sv, T4 sv, TSH control 1 time in 6 months.

In the stage of hypothyroidism, levothyroxine (L-thyroxine, Eutirox) is prescribed - this is a thyroid hormone. This drug is prescribed in order to replenish the amount of thyroid hormones missing in the body, since hypothyroidism is characterized by a decrease in its own production of hormones by the gland. The dosage is selected individually by an endocrinologist. Treatment begins with a small dose, it gradually increases under the constant control of thyroid hormones. A maintenance dose of the drug is selected, against the background of the intake of which the normalization of the level of hormones is achieved. This maintenance dose of levothyroxine is usually taken for life.

In the stage of thyrotoxicosis, the decision on treatment is chosen by the doctor. Drugs that reduce the synthesis of hormones (thyreostatics) are usually not prescribed for this disease. Instead of them, symptomatic therapy, that is, medications are prescribed that reduce the symptoms of the disease (reduce the sensation of palpitations, interruptions in the work of the heart). Treatment is selected individually.

Treatment with folk remedies

Self-medication should be warned. Only a doctor can prescribe the correct treatment for you and only under the systematic supervision of hormone tests.
In case of autoimmune thyroiditis, it is not recommended to use immunostimulants and immunomodulators, including those of natural origin. It is important to follow the principles healthy eating: eat more vegetables and fruits. If necessary, during periods of stress, physical and emotional stress, during illness, you can take multivitamin preparations, for example, Vitrum, Centrum, Supradin, etc. Better yet, avoid stress and infections altogether. They contain vitamins and minerals necessary for the body.

Long-term intake of excess iodine (including taking baths with iodine salts) increases the incidence of autoimmune thyroiditis, as the amount of antibodies to thyroid cells increases.

Recovery prognosis

The outlook is generally favorable. In the case of persistent hypothyroidism - lifelong treatment with levothyroxine drugs.
Dynamic monitoring of hormonal parameters must be performed regularly once every 6-12 months.

If nodules are detected on an ultrasound of the thyroid gland, then it is imperative to consult an endocrinologist.
If the nodes are more than 1 cm in diameter or they grow in dynamics, compared with the previous ultrasound, it is recommended to perform a puncture biopsy of the thyroid gland, to exclude malignant process... Ultrasound control of the thyroid gland 1 time in 6 months.
If the nodes are less than 1 cm in diameter, then it is necessary to perform an ultrasound scan of the thyroid gland 1 time in 6-12 months to exclude the growth of nodes.

Doctor's consultation on autoimmune thyroiditis:

Question: In the analyzes, a significant increase in antibodies to thyroid cells is determined. How dangerous is autoimmune thyroiditis if thyroid hormones are normal?
Answer: High level antithyroid antibodies can be found even in healthy people. If thyroid hormones are normal, then there is no cause for concern. This does not require treatment. It is only necessary to monitor thyroid hormones once a year, if necessary - ultrasound of the thyroid gland.

Question: How to make sure that the function of the gland has returned to normal during treatment?
Answer: It is necessary to assess the level of T4 sv, T3 sv - their normalization indicates the elimination of violations of the hormonal function of the gland. TSH should be assessed no earlier than one month after the start of treatment, since its normalization is slower than the level of T4 and T3 hormones.

Endocrinologist M.S. Artemyeva

The thyroid gland is one of the most susceptible organs to aggressive environmental influences. In addition, the internal processes of the body sometimes have a not very favorable effect on the thyroid gland. In this regard, thyroid diseases are often encountered, which can pose a direct threat to human life. These diseases include thyroid AIT (autoimmune thyroiditis).

AIT

Autoimmune thyroiditis is a disease in which the thyroid gland becomes inflamed. The occurrence of this pathology is influenced by malfunctions in the immune system, the result of which is that the body's own immunity begins to destroy the thyroid cells.

AIT is a fairly common pathology. It most often occurs:

in women 45-60 years old - this is explained by the detrimental effect of estrogens on the cells of the lymphoid system and X-chromosomal abnormalities;
cases of detection are much less common;
after artificial termination of pregnancy and natural childbirth;
in women during menopause;
in adolescence.

In cases where the damage to the gland is not too large, the disease long time may be asymptomatic. If the body gives a powerful immune response, then the destruction of the follicles begins and everything becomes obvious. The organ is rapidly increasing, this is due to the sedimentation of lymphocytes at the site of the damaged structures of the gland. This entails malfunctions of the thyroid gland: hormonal disorders appear.

Causes

The onset and development of the disease is influenced by a number of factors, including:

frequent stress and general emotional stress;
excessive concentration of iodine in the body, or, conversely, a deficiency of this element;
the presence of any diseases of the endocrine system;
unauthorized and improper intake of antiviral drugs;
the detrimental effect of an unfavorable environment;
lack of proper nutrition;
exposure to radiation exposure;
severe infectious or viral diseases;
hereditary predisposition. This factor affects 25-30% of all cases.

Hence, we can conclude that the development of AIT can provoke any damage to the thyroid gland, due to which thyroid antigens enter the blood.

Classification

Chronic AIT - the emergence of this form is precisely influenced by heredity. The development of this form of the disease is always preceded by a decrease in the production of hormones - hypothyroidism.
Postpartum autoimmune thyroiditis often occurs due to a decrease in the immunity of a woman during the period of bearing a child and its sharp activation after childbirth. During this enhanced functioning of the immune system, excessive amounts of antibodies can be produced. Because of which, the destruction of organ cells will occur. A woman who has a bad heredity in this regard needs to be especially careful after giving birth.
Cytokine-induced AIT develops as a result of taking medical supplies based on interferon, as well as agents used in the treatment of hepatitis C and diseases of the hematopoietic system.
Painless autoimmune thyroiditis still has no established cause.

In addition to the main classification, this disease there are forms:

The hypertrophic form of thyroiditis is characterized by a significant increase in the size of the thyroid gland. The clinical picture at the same time has a certain similarity with the symptoms of hyperthyroidism.
The atrophic form is a decrease in the synthesis of thyroid hormones. In this case, the size of the gland will not correspond to the norm - it gradually decreases.

However, despite the form, severity and nature of thyroiditis, the thyroid gland continues to perform its functions. Her work can be classified as follows:

Hypothyroid type of work, when the production of hormones in the body is significantly reduced.
The euthyroid type is characterized by a stable hormonal background.
Hyperthyroid - This type is characterized by increased production of hormones.

Symptoms

The initial stage of the disease can be completely asymptomatic. It is for this reason that it is very difficult to diagnose in the early stages.

It is easier to determine AIT after the thyrotoxic phase, which can last from three months to six months. Therefore, towards the end of this period, the patient feels the following changes:

a steady increase in body temperature, not exceeding 37.5 degrees. More high rise speaks of the rapid development of the disease;
frequent mood swings;
excessively strong heart contractions;
trembling in the body;
heavy sweating;
soreness in the joints and insomnia - the result of these manifestations is general weakness.

In the course of the progression of autoimmune thyroiditis, the symptoms worsen and become even more pronounced:

severe swelling of the face, yellowness of the skin;
clouding of consciousness, poor concentration of attention, periodic or constant depression, inhibition of reactions, mimic disorders;
dryness and peeling of the skin, deterioration of the quality of nails and hair;
deterioration or complete loss of appetite;
increase in body weight - either a sharp jump, or a gradual stable increase;
painful menstruation, decreased libido, infertility. Many patients are concerned about the question - is it possible to become pregnant with autoimmune thyroiditis. In the event that the disease has gone too far, and infertility has developed, conception becomes impossible;
decreased heart rate, risk of developing heart failure;
lowering body temperature, chills;
hoarseness, hearing impairment;
increase or decrease in the size of the thyroid gland;
discomfort in the neck, especially during a night's sleep.

Diagnostics

For staging accurate diagnosis and the subsequent selection of treatment, it is very important to consult a doctor at the first disturbing symptoms.

He will collect the patient's family history, conduct a visual examination with palpation of the thyroid gland, prescribe additional methods research and indicate which tests to take. There are certain criteria that the doctor focuses on when making a diagnosis:

An increase in the size of the thyroid gland of more than 18 mm and 25 mm in women and men, respectively.
The appearance of antibodies and their high titer to thyroid hormones.
Finding the level of hormones T3 and T4 outside the normal range (moreover, both below the normal range and above).

What tests to take if you suspect a disease

Diagnostic measures to identify AIT include:

A complete blood count is done to determine the level of lymphocytes.
Immunogram - to detect the presence of antibodies to thyroid hormones.
Blood test for T3, T4, TSH. According to their concentration and ratio, the doctor determines the degree and stage of the disease.
- one of the most important diagnostic methods, with its help, you can determine the size of the organ and how far the changes in its structure have gone.
Fine-needle biopsy can accurately determine the presence of lymphocytes. As a rule, this study is indicated in cases of suspicion of the degeneration of benign nodules into malignant ones. The most dangerous thing is when tumors form in the tissues.
Scintigraphy is a highly informative method that allows you to obtain a two-dimensional image of the affected organ by introducing radioactive isotopes into the body.

Based on the totality of data, the doctor will determine the echo structure of the gland, its shape and size, the ratio of the lobes of the thyroid gland and the shape of its isthmus.

Treatment

Measures for the treatment of autoimmune thyroiditis are possible only with the onset of hypothyroidism - the last stage of the disease. The most commonly used drugs are levothyroxine-based drugs. Their distinguishing feature is that they contain active ingredient, as close as possible in composition to the T4 hormone.

The main advantages of such drugs are that they have no contraindications even during pregnancy, breastfeeding, do not have side effects and do not contribute to an increase in body weight.

These funds should not be taken in conjunction with other medicines., they are always taken exclusively on an empty stomach 30 minutes before meals and washed down with plenty of water. All other medications can be taken no earlier than 4 hours after taking levothyroxine.

The best agents in this group are Eutirox and L-thyroxine. Despite the existing analogues, the best option there will be exactly these two drugs. Their effect will be the longest. The transition to analogs will require a consultation with a doctor to adjust the dosage and take blood tests every 2-3 months for the TSH level.

Nutrition with AIT

Proper nutrition is the key to a quick and successful recovery. The menu for the week should be designed in such a way that it necessarily includes:

a sufficient amount of fermented milk products, this is very important for the normalization of the intestines;
Coconut oil;
a large amount of fresh vegetables and fruits;
lean meat and broths from it;
any fish, seafood, seaweed;
sprouted cereals.

All of the above products have a positive effect on both the thyroid gland itself and the functioning of the immune system as a whole.

The following products should be banned: fast food, sweets (especially chocolate), flour products and bread, cereals.

If there is an excess of iodine in the body, foods with a high iodine content are excluded from the diet.

Definition

(synonym: lymphocytic thyroiditis, lymphatic goiter, Hashimoto's goiter) is a chronic autoimmune disease of the thyroid gland with gradual and prolonged destruction of thyrocytes and the development of a hypothyroid state. This is a fairly common disease, with a constant tendency to progression, occurs in 3-11% of the total population. Women get sick more often than men. The disease develops at any age, more often at 50-70 years. Autoimmune thyroiditis was described in 1912 by the Japanese surgeon Hashimoto, who, examining the histological structure of the removed thyroid glands in patients with goiter, discovered a triad of histological changes:

Diffuse plasmacytic infiltration with the formation of a large number of breeding centers;
Atrophy of thyroid follicles associated with the proliferation of connective tissue;
Severe oxyphilic cell metaplasia.

By 1960, about 200 cases of autoimmune thyroiditis were described in the literature. Now it is the main pathology of the thyroid gland.

Causes

Autoimmune thyroiditis is a genetically determined disease. In the hypertrophic form of thyroiditis, the antigen of the main histocompatibility complex, HLA-DR5, is most often detected, and in the atrophic form, HLA-B8. Thyroid damage is often found in the same family and is associated with other autoimmune diseases: pernicious anemia, primary autoimmune hypocorticism (Addison's disease), allergic alveolitis, chronic active hepatitis, vitiligo, Sjogren's disease, insulin-dependent diabetes, autoimmune oophoritis and orchitis, rheumatoid arthritis.

There is a great concordance of this disease in identical twins, while one of them may have autoimmune thyroiditis, and the other - a diffuse toxic goiter, confirming the same type of immunological defect in both diseases. Autoimmune thyroiditis is a multifactorial disease. The realization of the genetic predisposition to the disease occurs under the influence various factors environment: biological, physical and chemical. Under certain conditions, this interaction induces auto-aggression, which leads to a gradual but complete destruction of thyrocytes. The increase in the number of cases of autoimmune thyroiditis with age is explained by the accumulation negative impact environment and disorders in the mechanisms of immune self-regulation.

Among the chemical factors for the induction of autoimmune thyroiditis, iodine is most often considered. It should be realized that physiological doses of iodine do not induce autoaggression processes in the thyroid gland. This induction is possible in the case of exposure to significant doses of iodine, thousands of times greater than physiological. It is also worth noting that most reports on the induction of autoimmune thyroiditis by iodine are based on experimental data. As you know, in experiments, pure lines of animals are used, which are characterized by a high activity of autoimmune processes (independent, without significant influence of external factors). Autoaggression against the thyroid gland due to radiation exposure is realized by the following mechanisms: firstly, the release of autoantigens from destroyed thyrocytes and, secondly, the death of lymphocytes with regulatory properties. This explains the significant increase in the number of autoimmune thyroiditis diseases among people affected by ionizing radiation (in particular, those affected by the Chernobyl disaster).

The influence of biological factors on the development of autoimmune thyroiditis is evidenced by an increase in the number of cases of it after seasonal exacerbations respiratory diseases... Rubella and Epstein-Barr viruses are the most important viruses. The existence of related thyroiditis epitopes in viral and bacterial proteins is suggested. The formation of an immune response on them leads to a cross-reaction and the emergence of auto-aggression.

Normally, a certain amount of autoaggressive lymphocytes is formed in the bone marrow. Passing through the retrosternal gland, they are inactivated - the central mechanism of immunological tolerance is realized. In the absence of certain antigens in the retrosternal gland, lymphocytes leave it and react with their own antigens on the periphery, becoming anergic - peripheral mechanisms of tolerance are realized. In autoimmune thyroiditis, the mechanisms of immunological tolerance are impaired. Partial deficiency of T-suppressors allows the survival of forbidden (phorbid) T-lymphocyte clones. They interact with thyrocyte antigens, causing a local immune response by a delayed-type reaction mechanism. T-helpers interact with B-lymphocytes, prompting them to transform into plasma cells and produce antibodies to thyroglobulin and microsomal fraction (thyroperoxidase). Circulating antibodies interact on the surface of thyrocytes with killer T cells, causing cytotoxic effects and destruction of thyrocytes. The number of thyrocytes gradually decreases and the functional state of the thyroid gland decreases. According to the feedback mechanism, the incretion of thyrotropin by the pituitary gland increases. The end result is an enlargement of the gland and the development of a goiter. A hypertrophic form of autoimmune thyroiditis occurs behind such mechanisms. Due to the regenerative capacity of the thyroid gland, this process takes decades.

In addition to regeneration, thyrocytes are protected from destruction by the expression on their surface of certain proteins, which turn autoaggressive lymphocytes into anergic ones. The duration of the course of autoimmune thyroiditis is explained by which of the mechanisms - protection or destruction - prevails.

The development of an atrophic form of autoimmune thyroiditis is due to the presence of blocking antibodies to thyrotropin. During laboratory research antibodies to many components of the thyrocyte are determined in large titers: thyroglobulin, peroxidases, colloidal antigen, thyroid hormones.

The state of euthyroidism, thyrotoxicosis or hypothyroidism is determined by the presence and titers of antibodies involved in this condition. Thyrotoxicosis (hashitoxicosis) occurs when there are high titers of thyroid-stimulated antibodies and low or no antibodies to thyrotropin at all.

So, the chronic inflammatory process in the thyroid gland, the deployment of the processes of destruction of thyrocytes is provided by antigen-specific antibodies and is supported by antigen-specific mechanisms due to the release of cytokines from destroyed thyrocytes.

Symptoms

Autoimmune thyroiditis develops gradually and does not bother patients for a long time. Most often, the disease is diagnosed in patients with goiter. Often, patients are worried about the nodes in the thyroid gland, a feeling of discomfort and compression of the neck. On palpation, the thyroid gland is unevenly enlarged, tuberous, slightly painful. The gland can be enlarged all over and is very dense on palpation, but there may be separate compacted areas in it. Patients may also be bothered by pain and aches in the joints without signs of inflammation in them. In general, the complaints of patients are nonspecific, varied and are due to the originality of the subjective sensation and functional state thyroid gland.

More often (20% of cases), autoimmune thyroiditis is diagnosed in a state of hypothyroidism. Patients are worried about overweight, yellowness of the skin, dryness, slow motion, drowsiness, constipation, hearing and memory impairment, women - uterine bleeding such as menorrhagia and metrorrhagia, galagorrhea. These bleeding increases the anemia inherent in hypothyroidism. Tachycardia is often observed against its background. This masks hypothyroidism and makes it difficult to diagnose. More often, the symptoms of hypothyroidism are not very pronounced and the diagnosis is established only according to the results of laboratory tests (an increase in the content of thyrotropin in the blood plasma).

In 1-2% of patients, autoimmune thyroiditis begins with thyrotoxicosis (hashitoxicosis). Patients are worried about tachycardia, sweating, hand tremors. Sometimes manifestations of ophthalmopathy and pretibial edema are observed.

The state of thyrotoxicosis can occur against the background of the euthyroid course of autoimmune thyroiditis or even hypothyroidism, if the functional epithelium is preserved in the gland. An increase in the functional activity of the gland is observed after respiratory infections, during pregnancy, after childbirth or abortion. Changes in the course of autoimmune thyroiditis are caused by the expression of thyroid-stimulating antibodies or depression of antibodies that block thyrotropin receptors.

Endocrine ophthalmopathy in patients with autoimmune thyroiditis often occurs independently of the function of the gland. It can be both with thyrotoxicosis and with euthyroidism or hypothyroidism. The timing of ophthalmopathy is also not related to the diagnosis or treatment of autoimmune thyroiditis. Ophthalmopathy may be the only symptom that forced the patient to seek help, and autoimmune thyroiditis may be diagnosed during the examinations. Sometimes ophthalmopathy progresses as the clinical manifestations of autoimmune thyroiditis develop.

Autoimmune thyroiditis in children develops gradually. A state of euthyroidism has been observed in them for a long time. Usually, the diagnosis of thyroiditis is made during examinations for goiter. In half of cases, goiter is caused by autoimmune thyroiditis. More often the thyroid gland in children is enlarged evenly, soft palpation. The atrophic form of the disease is not typical for children. Often, autoimmune thyroiditis in children is diagnosed against the background of thyrotoxicosis, therefore, it must be differentiated from diffuse toxic goiter in order to avoid therapeutic errors.

Asymptomatic (silent) thyroiditis- This is a rare form of autoimmune thyroiditis that occurs without any clinical signs. The thyroid gland is normal in size or slightly enlarged. During the examination, high titers of antibodies to peroxidase (microsomal fraction) are determined, in puncture biopsy - lymphoid infiltration... The concentration of thyrotropin, thyroxine, triiodothyronine is within normal limits. Women with asymptomatic thyroiditis are more likely to be diagnosed with postpartum thyroiditis.

Postpartum thyroiditis. The disease occurs in the first months after childbirth. It starts predominantly with thyrotoxicosis, definition high content free thyroxine, triiodothyronine, decrease in thyrotropin levels. The titers of antibodies to thyroglobulin and peroxidase are significant. Within 2-3 months. the thyrotoxic state changes to euthyroid.

Postpartum thyroiditis occurs against the background of an asymptomatic form of the disease. Therefore, in pregnant women with an enlarged or reduced thyroid gland, it is necessary to determine the titers of antibodies to thyroglobulin and peroxidase.

Classification

There is no generally accepted classification of autoimmune thyroiditis. A.P. Kalinin and T.P. Kiseleva (1992) suggested the following classification autoimmune thyroiditis.

I. According to nosological characteristics:

independent disease;
combination with other endocrine diseases;
syndrome of another autoimmune disease.

II. By form:

hypertrophic;
atrophic.

III. By the activity of the thyroid gland:

euthyroid;
hypothyroid;
thyrotoxic.

IV. According to the clinical course:

explicit;
latent.

V. By morphological characteristics (the prevalence of the process in the thyroid gland):

diffuse;
local.

There is an attempt to identify clinical variants of autoimmune thyroiditis (R. Volpe, 1989): Hashimoto's thyroiditis, lymphocytic thyroiditis in children and adolescents, postpartum thyroiditis, chronic thyroiditis (fibrous variant), idiopathic myxedema, atrophic thyroiditis.

Pathomorphologists distinguish diffuse, focal, peritumoral and juvenile forms of autoimmune thyroiditis.

Diagnostics

Examination of the patient to establish the diagnosis of autoimmune thyroiditis is carried out in the presence of goiter, especially if the gland is significantly compacted, with an uneven bumpy surface, and has multiple seals. Single nodular seals are also the reason for testing for autoimmune thyroiditis due to the presence of focal forms of thyroiditis. The cause of idiopathic hypothyroidism, especially in people of mature and old age, is also mainly thyroiditis. In all cases of galactorrhea, dysmenorrhea, meno- and metrorrhagia, anemic conditions, hypercholesterolemia, dyslipoproteinemia, hypothyroidism and, as its cause, autoimmune thyroiditis should be suspected.

Ultrasound of the thyroid gland is valuable for screening and diagnosing autoimmune thyroiditis. The main ultrasound signs of this disease are:

Inhomogeneity of the structure of the gland, in which hypoechoic (hydrophilic) and hyperechoic (connective tissue) areas alternate. They can be of different sizes: from small to large hydrophilic and fibrotic, with the formation of constrictions of connective tissue, which divide the gland into small particles and mimic pseudo-nodes in it.
Decrease in the echogenicity of the thyroid gland from a slight pre-expressed degree.
Availability of additional ultrasound signs- indistinctness of the contour of the gland and the compaction of its capsule.
The size of the gland depends on the shape of the thyroiditis. It is increased in the hypertrophic form and decreased in atrophic processes in the gland.

With Doppler ultrasonography of the thyroid gland, the vascular pattern in it is enhanced (increased vascularization) and deformed.

Ultrasound signs inherent in autoimmune thyroiditis

Echogenicity	Reduced due to existing hypoechoic (hydrophilic) areas different sizes from 1 to 6 mm.
Echo structure	Inhomogeneous as a result of the alternation of hypoechoic and hyperechoic (connective tissue) layers, which sometimes provide the gland with a racemose structure
Additional ultrasound signs	Sealing the capsule. Fuzzy contour
Color Doppler	Diffuse increased blood filling of the gland tissue, deformation of the vascular network

Cytological examination of thyroid aspirate is one of the methods that can characterize autoimmune thyroiditis, but this is not the leading diagnostic method. In the classical variant of the disease, a large number of cells are determined in the punctate, practically without colloid - these are lymphoid elements of various degrees of maturity, with impurities of immunoblasts, plasma cells, macrophages, in the cytoplasm of which the remains of cells and their nuclei are visible. The presence of giant eosinophilic cells (B cells) is characteristic. There are few thyrocytes in the preparation.

The fibrous variant is characterized by depletion of punctata. A small number of lymphoid and plasma mature cells are observed, stromal cells, thyrocytes are very few, mostly flat cubic or flattened cylindrical; colloid is extremely rare.

In scintigraphic examination of the thyroid gland, an increase or decrease in its size can be detected, the absorption of a radioactive isotope can be normal, increased or decreased, it is distributed unevenly in the gland, from intense absorption in some areas to its absence in others.

Thyroid scintigraphy for the diagnosis of autoimmune thyroiditis is not very informative. Given the radioactive contamination of most of the territory of Ukraine due to the Chernobyl disaster, use with diagnostic purpose thyroid scintigraphy is not advisable.

Determination of titers of antibodies to thyroglobulin and microsomal fraction (antiperoxidase antibodies) in the blood plays a significant role in confirming the diagnosis of autoimmune thyroiditis. An increase in the titer of antibodies to thyroglobulin is observed in 30-70% of patients with autoimmune thyroiditis. Negative results may indicate the presence of thyroglobulin-antibody immune complexes that do not react with thyroglobulin. More probable are studies of antibodies to the microsomal fraction, which are found in 90-100% of patients. An indirect sign of an increase in the level of antibodies is the content of immunoglobulin G in the blood.

Diseases	Abody,%
Diseases	To thyroglobulin	To the microsomal fraction	To thyrotropin receptor

Diffuse toxic goiter
Healthy faces

Since none of the diagnostic tests can absolutely indicate autoimmune thyroiditis, it is proposed to use several significant criteria for diagnosis, among which are:

the presence of a goiter with an uneven surface;
uneven accumulation of the radiopharmaceutical during the scan of the thyroid gland;

an increase in the titer of antibodies to thyroglobulin or thyroperoxidase;
an increase in thyrotropin content in response to thyroliberin stimulation;
the presence of cytological or morphological features Hashimoto's goiter;
release from the thyroid gland of more than 10% of iodine-131 accumulated in it under the influence of potassium perchlorate.

The combination of at least 3 of these signs in one patient indicates autoimmune thyroiditis.

Differential diagnosis

For differential diagnosis, it must be borne in mind that autoimmune thyroiditis can be part of other endocrine and non-endocrine diseases, the basis or pathogenesis of which is an autoimmune component.

Endocrine diseases	Non-endocrine autoimmune diseases	Other diseases
A pronounced enlargement of the gland in size, the formation of nodes in it should alert the presence of malignant tumors. Ultrasound, cytological studies allow early diagnosis of thyroid cancer. In cases of hypothyroidism against the background of autoimmune thyroiditis, patients are treated with thyroid hormone preparations. In patients with autoimmune thyroiditis, L-thyroxine performs not only a substitutional role, but also immunomodulatory therapy, reducing the stimulation of the thyrotropin gland, the release of thyroglobulin from it, as a result of which the titers of antithyroid antibodies decrease. When prescribing L-thyroxine, one must always be prepared for the appearance of thyrotoxicosis. On the one hand, it can be caused by changes in the ratio between antibodies that block receptors to thyrotropin, and thyroid-stimulatory antibodies with the expression of the latter, on the other hand, thyrotoxicosis occurs due to the autonomy of nodes in the thyroid gland. If the content of thyrotropin is within normal limits and the patient is not disturbed discomfort, there is no need to prescribe L-thyroxine. The use of means and measures of immunomodulatory effects, glucocorticoids, NSAIDs does not affect the course of the disease. The use of prednisolone does not stop the autoimmune process and does not prevent destructive changes in the thyroid gland. If the patient has signs of thyrotoxicosis, ß-blockers, prednisolone are prescribed, in case of significant manifestations - mercazolil. Antithyroid drugs (mercazolil, metizol, tyrosol, propylthiouracil) are prescribed in low or medium therapeutic doses. Against the background of the use of thyrostatics, thyrotoxicosis is quickly compensated, the euthyroid state changes to hypothyroid. Therefore, the use of thyrostatics requires special vigilance. Surgical treatment for autoimmune thyroiditis is the exception rather than the rule. Indications for surgical intervention are: significant size of the goiter; Specialization: Endocrinologist Gulnaz: 06/13/2014 Good afternoon! Before pregnancy, I was diagnosed with primary hypothyroidism, honey compensated. The doctor prescribed me eutirox at a dose of 50 mg. from the moment of taking the hormone TTG, the norm is 2.65. When I found out that the pregnant woman raised the dose to 75mg. Now I have a pregnancy at 9-10 weeks, I half a dose of up to 100 mg (the doctor told me to double it and prescribed additional tests), here is the result: T4 free-13.5, TSH-0.332, AT to thyroid peroxidase (TPO) -378. Tell me, can I reduce the dose of the medicine, since TSH is in such a small result. And how dangerous it is for the child and my illness, I am very afraid. Now sometimes the feet sweat a lot, there is no swelling, there is no hair loss either, but in the morning there is a strong heart rhythm.