Chronic Lymphocytic Thyroiditis: Most Effective Supplements

Chronic lymphocytic thyroiditis, commonly known as Hashimoto's thyroiditis, is a form of autoimmune thyroiditis where the immune system attacks the thyroid gland, gradually leading to inflammation and destruction of its functional cells. This pathology is the most common cause of acquired hypothyroidism in regions where iodine intake is adequate. The disease primarily affects middle-aged women, although it can also affect children and adolescents, especially in cases of genetic predisposition.

Pathophysiology

Hashimoto's thyroiditis is characterized by a progressive lymphocytic infiltration of the thyroid gland, resulting in the destruction of thyroid follicles. This process is initiated by an immune response directed against thyroid antigens, notably thyroid peroxidase (TPO) and thyroglobulin (TG), which are targeted by autoantibodies. This immune activation leads to the production of anti-TPO and anti-TG antibodies in 90% and 20-50% of cases, respectively. The immune attack causes destruction of thyrocytes, temporarily releasing thyroid hormones into the circulation, which may lead to a transient phase of hyperthyroidism before the onset of hypothyroidism. In the long term, chronic inflammation results in a progressive reduction of thyroid function, with a decrease in T3 and T4 production, and a compensatory increase in TSH.

Risk Factors

Genetic predisposition: Hashimoto's thyroiditis is often associated with a family history of autoimmune diseases, including type 1 diabetes, Graves' disease, and other autoimmune endocrine diseases. Environmental factors: Exposure to excess iodine, certain viral infections, and stress can trigger or worsen the disease in genetically predisposed individuals. Sex and age: The disease primarily affects women, with an increased prevalence starting at middle age.

Symptoms

Clinically, symptoms vary depending on the severity of the disease and the degree of thyroid impairment. In the initial phase, Hashimoto's thyroiditis is often asymptomatic or associated with subtle symptoms. The patient may present with a diffuse, painless goiter, firm or elastic in consistency, indicating thyroid inflammation. As the disease progresses, hypothyroidism sets in with typical symptoms such as: • Persistent fatigue. • Cold intolerance. • Unexplained weight gain. • Dry skin. • Constipation. • Cognitive disturbances and mild depression, sometimes associated. The onset of symptoms is generally insidious, which can delay diagnosis.

Evolution and Complications

Hashimoto's thyroiditis slowly progresses to permanent hypothyroidism. The initial phase may include transient hyperthyroidism caused by the release of stored hormones during the destruction of thyroid cells. This phase is generally brief and precedes the establishment of hypothyroidism. Possible complications include: • Progressive atrophy of the thyroid gland, with a reduction in its size. • In rare cases, thyroid lymphoma. For some patients, a residual goiter may persist despite the progression of the disease.

Treatment

The treatment of Hashimoto's thyroiditis primarily relies on hormone replacement therapy. Administration of levothyroxine, a replacement hormone, is the reference treatment to compensate for thyroid hormone deficiency and stabilize hypothyroidism symptoms. The dose is adjusted according to blood TSH levels, and treatment is generally lifelong. In the case of a transient phase of hyperthyroidism, no specific treatment is necessary, except for beta-blockers to relieve symptoms such as palpitations or tremors. Regular monitoring of thyroid hormones is essential to avoid complications related to overdosing or underdosing.