Why do you have a lump on your neck?
One morning, you’re getting dressed as you adjust your shirt, you notice that your neck seems swollen. It’s not hurting and your throat isn’t sore, so you decide to continue with your day. Over the next several weeks, you notice that your neck isn’t getting better, so you go to the doctor. Why is this happening? Can it be fixed?
Definition
Hashimoto’s disease is an autoimmune disorder, which means your immune system attacks part of your body resulting in inflammation of the area. In this case, it’s your thyroid (the small gland at the base of your neck) that’s affected. Your thyroid produces hormones (triiodothyronine—T3 and thyroxine—T4) that help regulate numerous body functions, so if it’s not working correctly, it can cause various symptoms. With Hashimoto’s, the inflammation in your thyroid results in it producing fewer hormones than usual. The disorder is the most common cause of hypothyroidism. What precipitates the condition isn’t known but thought to be related to a genetic flaw or a virus or bacterium triggers it. Certain individuals are at a higher risk of developing the syndrome, such as women, those who are middle-aged, if you have a family history of thyroid or other autoimmune disorders, or if you’ve been exposed to radiation.
Hashimoto’s develops slowly over time, so many people don’t realize that they have it. Besides swelling of your thyroid gland (goiter), symptoms include fatigue, sluggishness, constipation, hair loss, brittle nails, increased sensitivity to cold, pale/dry skin, puffy face, enlarged tongue, muscle aches/tenderness/stiffness/weakness, joint pain/stiffness, unexplained weight gain, excessive/prolonged menstrual bleeding, depression, decreased libido, and memory lapses. If the condition isn’t treated, it can lead to many complications. The goiter can become so large that it affects your ability to swallow or breathe. You can develop heart problems because your thyroid typically helps your body keep your low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol, lower. When your thyroid doesn’t do this, LDL builds up inside your arteries, placing you at increased risk for heart issues. For women with Hashimoto’s, they have a greater chance of having a child with birth defects. A rare, but life-threatening, condition is myxedema. This is caused by severe long-term hypothyroidism and triggered by exposure to cold, sedatives, infection, or other stress on your body. Its symptoms include drowsiness that progresses to lethargy and unconsciousness, which is why it requires immediate emergency medical treatment.
Treatment
The treatment of Hashimoto’s usually involves taking a synthetic thyroid hormone (levothyroxine) to replace the T4 that your body usually produces. Typically, your body will convert T4 into T3. The medication comes as a pill that needs to be taken daily. It’s vital not to skip doses or stop taking the drug without talking to your doctor. Your doctor will check your blood levels of T4 before you start taking the medicine and 6 -8 weeks after to see if there has been any improvement. Often it takes time to find the right dosage, and after each change, you’ll need to repeat blood work to look for any progress. Once you find the right level, you’ll need to have your thyroid level checked yearly.
Some individuals find that levothyroxine isn’t enough for them to feel “normal.” If this is the case, your doctor may recommend taking T3 either alone in the form of liothyronine or in combination with T4. It’s important to note that if you do take both, your body will likely end up having higher than normal levels of T3 since T4 is also converted into T3. You might end up having a fast heart rate, anxiety, and trouble sleeping as a result. Some individuals try products, like Armour Thyroid, that derive thyroid hormones from pigs. These products contain both T3 and T4. However, many doctors have concerns about them since the balance of the two hormones in animals isn’t the same as humans and the exact amount of either hormone in each batch can vary, which can result in unpredictable levels in your blood.
Prevention
There isn’t a way to prevent Hashimoto’s from occurring since the exact cause isn’t known yet. The important thing is to avoid complications from the disorder. The best way to do this is by being aware of how you’re feeling and going to the doctor if you notice anything abnormal.
Having Hashimoto’s can be a life-changing experience. Most people don’t notice a difference until they’ve gotten treatment and feel better. The good news is that the treatment is very simple. If you have any questions or concerns about Hashimoto’s disease, please speak with your doctor. If you would like more information, please visit the National Institute of Health’s National Institute Diabetes and Digestive and Kidney Diseases’ Hashimoto’s disease page at https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease