Hashimoto's Thyroiditis Chronic lymphocytic thyroiditis  Hashimoto's Thyroiditis is the most common form of thyroid disease in the United States, and it is also the most common form of Thyroiditis. It tends to run in families, and is much more common in women than men. In this condition, the thyroid gland typically becomes enlarged, causing the patient to develop Hypothyroidism. Treatment is usually with thyroid hormone replacement. The thyroid gland is typically enlarged all over, not just in one area. It is usually firm and not tender to touch. In some cases, the thyroid gland may actually shrink. If the thyroid enlarges, it may put pressure on other structures in the neck. Most often, people with Hashimoto's Thyroiditis suffer from symptoms of Hypothyroidism (fatigue, lethargy, decreased metabolic rate). In the case of acute severe infection, the thyroid gland may suddenly release its store of thyroid hormone, temporarily causing symptoms of Hyperthyroidism (Subacute Thyroiditis). Others may develop Grave's Disease , which also causes Hyperthyroidism. People with Hashimoto's disease may also suffer from chronic fatigue, dry eyes, dry mouth, and/or Depression. Others may have a mild form of Myasthenia Gravis, which causes the muscles of the eye to become weak. Some of these symptoms may continue even after the Hashimoto's disease has been treated. Many may have this disease and never have any symptoms at all. The disease is due to the patient's immune system attacking the thyroid gland. It is not clear why the immune system does this. Certain medications, such as GCSF (immune system modulator), Amiodarone, Interleukin-2, and Alpha Interferon tend to increase the chance of the immune system attacking the thyroid. Also, Hashimoto's Thyroiditis is seen more frequently in people taking extra iodine in their diets. Hashimoto's Thyroiditis is seen more often in people with Hepatitis C, Inflammatory Bowel Disease, Turner's Syndrome, and Celiac Disease. Most people with Hashimoto's Thyroiditis have increased levels of antithyroglobulin antibodies and antithyroid peroxidase antibodies. Depending on whether the patient is hypo- or hyperthyroid, the TSH (thyroid stimulating hormone) may be increased, decreased, or normal. Most often, T4 and T3 uptake is usually low. A Nuclear scan with radioactive iodine may be high. If the diagnosis is uncertain, and if there is any suspicion of cancer, a biopsy of the thyroid gland is advised. Treatment for Hashimoto's Thyroiditis -- if the patient is hypothyroid, or if they have an enlarged Goiter (swelling in the front part of the neck, aka "struma"), Levothyroxine (a thyroid hormone replacement) is administered. If the patient is not hypothyroid and the thyroid is not enlarged, he may be monitored without medication, but will need to have his thyroid hormone levels followed. Close follow-up with the doctor is advised as eventually Hypothyroidism may develop. Long-term prognosis is very good. Most people with the disease can be easily treated. Riedel's lobe (Thyroiditis struma) Subacute Thyroiditis Thyroid Cancer Suppurative Thyroiditis Goiter Grave's Disease Special Information Hashimoto's Thyroiditis may be associated with Addison's Disease, hypoparathyroidism, diabetes, pernicious anemia, biliary Cirrhosis, or Vitiligo. It is important that people with this disease be evaluated for these other disorders. If only part of the thyroid gland is enlarged, cancer and Lymphoma must be ruled out. If the thyroid gland is allowed to become enlarged, it may cause paralysis of the vocal cords, and difficulty swallowing and breathing.