Chronic lymphocytic thyroiditis: the most effective dietary supplements

Chronic lymphocytic thyroiditis, commonly called Hashimoto's thyroiditis, is a form of autoimmune thyroiditis in which the immune system attacks the thyroid gland, progressively causing inflammation and destruction of its functional cells. This condition 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 progressive lymphocytic infiltration of the thyroid gland, leading to destruction of the 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 can produce a transient hyperthyroid phase before hypothyroidism appears. In the long term, chronic inflammation leads to a progressive reduction in thyroid function, with decreased production of T3 and T4 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 disorders. 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 mainly affects women, with increased prevalence from middle age onward.

Symptoms

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

Progression and complications

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

Treatment

Treatment of Hashimoto's thyroiditis is mainly based on hormone replacement. Administration of levothyroxine, a replacement hormone, is the standard treatment to compensate for thyroid hormone deficiency and stabilize hypothyroid symptoms. The dose is adjusted according to blood TSH (thyrotropin) levels, and treatment is generally lifelong. In the case of a transient hyperthyroid phase, no specific treatment is usually required, apart from beta-blockers to relieve symptoms such as palpitations or tremors. Regular monitoring of thyroid hormones is essential to avoid complications related to over- or under-dosing.