Hashimoto's thyroiditis, Hashimoto's disease or chronic lymphocytic thyroiditis are medical terms reffering to a thyroid autoimmune disorder in which the body's own T-cells attack the folicular thyroid cells. Hashimoto's disease is the first documented autoimmune disease and it is considered to be the most common cause of hypothyroidism in the United States where almost 2 in 1000 people develop this disease. This disorder affects far more  women than men ( 20 :1), and its prevalence peaks between 45 and 65 years of age. In Europe a form of atrophic autoimmune thyroiditis is more frequent than Hashimoto's disease.


The underlying specific immune mechanisms of systemic destruction of the thyroidian cells has not been clearly determined. There has been documented the presence of various autoantibodies may be present against TSH receptors and thyroglobulin even though a small percentage of the people who develop the disease may not have these antibodies. Another small percentage of the general population may have these antibodies in their blood but without ever developing the disease. Many patients have a family history of thyroid disorder and the studies have shown that the incidence of the disease is increased in the people with chromosomial disorder, especially 21 trisomy (Down's syndrome), X trisomy , Klinefelter's syndrome, X monosomy (Turner Syndrome)



The disease has an insidious onset and it consists in a slow, constant destruction of the thyroid cells resulting in the gland's inability to produce sufficient thyroid hormone - hypothyroidism. During the course of the disease there may be periods when the thyroid function may spike, even leading to a temporary hyperthyroidism, followed invariably by returns to hypothyroidism. These variations and bouncing between hypothyroidism and hyperthyroidism is a characteristic feature of Hashimoto's disease. So, for example, periods specific to hyperthyroidism with symptoms such as anxiety, insomnia, diarrhea, weight loss may be followed by depression, fatigue, constipation and weight gain.

Many patients do not have any  symptoms and seek medical assistance just because of the specific sign of the disorder - the goiter.  The goiter (the gradual enlargement of the thyroid gland) is usually asymptomatic and painless, but in some cases the patients complain of a feeling of local pressure, voice changes (hoarseness) and dysphagia (pain or difficulty while swallowing).
In the early stages of the disease depression and anxiety may occur but an underlying depression may also be aggravated by Hashimoto's disease.



The disease leads to hypercolesterolemia (high colesterol levels) with consequent predisposition to heart disease but heart disease may be determined also by the impact of the low levels of thyroid hormones on the cardiac activity, leading to contraction and rhythm disorders.Other clinical features of the disease are dry brittle hair and nails, hair loss, osteoarticular pain, insomnia, fatigue and weight changes.

The severity of the disease may decrease during pregnancy and there have also been documented very few cases of thyroid disorders in pregnant women, due to the fact that the immune system is slightly depressed during pregnancy in order to protect the fetal development. However, during the postpartum period the disease may increase in severity in the post partum period. There should be known that hypothyroidism may affect fetal development, leading to an increased risk of miscarriage or malformations (such as cleft lip or cleft palate) or to an impaired psychomotor development and a lower IQ.