What are autoimmune thyroid disorders

Autoimmune thyroiditis (also named after the person who first described it, Hashimoto's thyroiditis) is the most common disease in adults that leads to hypothyroidism. The cause is a disorder of the immune system. Proteins (antibodies) are formed in the blood, which lead to an inflammatory reaction in the thyroid gland and to a disruption of thyroid hormone production. In some patients, the thyroid gland enlarges, in others the thyroid becomes smaller over time. It is not yet known in which people the disease is accompanied by a smaller organ and in whom the thyroid function is permanently impaired. The antibodies in the blood typical for Hashimoto's thyroiditis are the antibodies against thyroid peroxidase (TPO-AK) and the antibodies against thyroglobulin (Tg-AK). Thyroid function and antibody levels are not always linked. So high antibody levels do not necessarily mean severe hypofunction and vice versa. The antibody values ​​are often very changeable over the course of the disease and higher values ​​do not automatically mean that the disease is getting worse. There are a large proportion of patients with normal thyroid hormone levels and elevated antibody levels that do not require treatment. In these people, however, the TSH value (it represents the thyroid hormone function) should be measured once or twice a year so that the onset of hypofunction is not overlooked. If the disease is not recognized early, the typical symptoms of hypothyroidism can occur. Treatment aims to replace the loss of thyroid hormone. If thyroid hormone production fails, lifelong thyroid hormone intake is usually necessary. There is a familial accumulation, but there is no clear inheritance. Hashimoto's thyroiditis can be linked to one or more autoimmune diseases. Some patients also suffer from white spots on the skin (vitiligo), a vitamin B12 deficiency (the cause is autoimmune damage to a certain type of cell in the stomach), gluten intolerance (celiac disease, local sprue), an underactive adrenal gland (Addison's disease), or already have developed type 1 diabetes mellitus in childhood or young adulthood. If several of these autoimmune diseases are present, one speaks of a so-called polyglandular ("multi-gland") autoimmune syndrome.

Postpartum thyroiditis (autoimmune thyroiditis after childbirth)

In Germany, an autoimmune disease of the thyroid gland is expected to develop in around 7% of cases after the birth of children. This thyroid disease, which occurs after birth (postpartum), more often affects women in whom thyroid antibodies were previously detectable. Occasionally, at the onset of the disorder, the thyroid gland becomes overactive, as the inflammation releases preformed thyroid hormone from destroyed thyroid cells. The lack of post-production can lead to temporary or permanent hypothyroidism. The disease is often diagnosed late, as the disorders (fatigue, exhaustion, depressive mood) in primipara in particular are associated with the general situation of the young mother and not with the thyroid gland.