Disease of the thyroid gland - chronic thyroiditis. Causes of acute thyroiditis. Treatment of thyroiditis in adults

Autoimmune thyroiditis is an autoimmune disease that is the main cause of hypothyroidism.

With this disease, the thyroid gland becomes significantly inflamed and the production of its hormones is low. This gradually leads to the development of hypothyroidism. This is an immune disease because it is the body's immune system that produces antibodies that attack the tissue. thyroid gland. It is impossible to cure autoimmune thyroiditis using traditional medicine methods, but treatment autoimmune thyroiditis folk remedies gives good result. Some people are completely cured of the disease, while others experience relief from symptoms, improved well-being, and increased years of life.

Causes of the disease

Autoimmune thyroiditis may be caused by the following factors:

The presence of chronic infections in the human body (sinusitis, caries).

An early viral (infectious) disease.

Any psychological trauma (stress, disappointment, loss).

Unfavorable environment.

Poor nutrition and living conditions.

Uncontrolled use of various medicines(self-medication).

Radiation or long stay in the open sun.

Diabetes mellitus.

Hereditary predisposition.

The disease is most often diagnosed in people in middle age (30-50 years). In women it is found several times more often due to a certain tendency. Depending on the stage of the disease, the symptoms vary. We will study the treatment of autoimmune thyroiditis with folk remedies below.

Let's look at the symptoms in more detail.

Early stage

Signs of autoimmune thyroiditis at an early stage are characterized by:

• pale skin;
• brittle nails;
• thinning hair;
• muscle pain;
• increase in body weight;
• fatigue;
• joint pain;
• constipation;
• cold intolerance;
• depression.

This is how autoimmune thyroiditis of the thyroid gland manifests itself at an early stage. Treatment with folk remedies will be most effective.

Late stage

Signs of autoimmune thyroiditis on late stage characterized by:

• decreased sense of taste and smell;
• dry skin;
• irregular periods;
• slow speech;
• swelling of the face, arms and legs;
• sore throat;
• eyebrow loss.

This is what happens at a late stage of autoimmune thyroiditis. Symptoms and treatment with folk remedies are often interrelated.

General symptoms regardless of stage

These signs distinguish autoimmune thyroiditis, regardless of the stage:

• loss of appetite;
• stiffness in the joints;
• muscle atrophy;
• muscle pain and cramps;
• dry hair;
• swelling in other parts of the body;
• drowsiness;
• hair loss;
• decreased coordination of body movements.

We looked at the main signs of a disease called "autoimmune thyroiditis of the thyroid gland." Treatment with folk remedies has been very popular lately.

Diagnosis of the disease

Autoimmune thyroiditis is defined by:

A general blood test to determine the level of lymphocytes.

Immunogram for the presence of antibodies to thyroglobulin.

Ultrasound of the thyroid gland.

A thyroid biopsy (fine needle) to identify a large number of lymphocytes, which may indicate the presence of the disease.

This way you can identify autoimmune thyroiditis and hypothyroidism.

Treatment with folk remedies must be long-term.

IN traditional medicine Hypothyroidism is treated with hormone replacement therapy - taking synthetic thyroid hormones for the rest of your life. This is due to the fact that the thyroid gland cannot fully produce hormones (T3 and T4), and the body really needs them.

The disease is most often characterized by:

• An increase in antibodies against the thyroid gland.
• Detection of an enlarged gland on ultrasound.
• Primary hypothyroidism.

If one of the criteria is missing, the diagnosis is probable, but not certain.

Diagnosis of this disease is not always reliable, and the results of several tests may differ. It happens that in the absence of a real disease, people are prescribed hormonal drugs. They drink them, thereby completely disrupting the functioning of the thyroid gland. That is, at first there was no disease, but now there is. And people are forced to take hormones throughout their lives. Treatment of autoimmune thyroiditis with folk remedies has a more gentle effect on the body.

If a person has already started taking hormonal drugs, it will be much more difficult to cure him. Unlike those who did not take these medications or those who were treated with traditional medicine. The usual drug treatment regimen assumes the impossibility of refusing them, this happens during therapy diabetes mellitus, high cholesterol, mental disorders and cancer.

Signs of autoimmune thyroiditis can be controlled naturally in several ways. In the absence of a specific treatment method that can completely rid a person of the disease, there are folk remedies. They help very well people who have been suffering from this disease for a long time.

Let's consider what the diagnosis of autoimmune thyroiditis with nodulation involves treatment with folk remedies.

Treatment of autoimmune thyroiditis with coconut oil

Coconut oil is one of nature's most powerful healers. It is necessary to enrich the diet of a person suffering from autoimmune thyroiditis or hypothyroidism with it every day. This will help relieve many symptoms and improve your well-being.

Coconut oil is saturated fat, it contains mainly medium-chain fatty acids or medium-chain triglycerides. They perfectly speed up metabolism, increase basal temperature body, reduce weight and increase energy.

Triglycerides are half composed of This is one of the most important fatty acids that creates and maintains the body's immune defense. It has an extremely positive effect on the thyroid gland.

Coconut oil is rich in other fatty acids, which are no less beneficial. They are able to maintain human health at the highest level.

Linoleic acid is often used in the production of weight loss medications. It is a polyunsaturated fatty acid and is sold as a dietary supplement in capsules. It is called It refers to necessary for the body fats that help reduce excess weight.

Don't forget about oleic acid. This is an omega-9 unsaturated fatty acid found in coconut oil and olive oil. It is also highly recommended for autoimmune thyroiditis. Oleic acid increases high-density lipoproteins, reduces lipoproteins with low density. These are good and bad cholesterol.

For this autoimmune disease, it is recommended to consume at least four tablespoons coconut oil per day. If this amount seems too large, you can start with two spoons. Then the dose must be gradually increased.

The diet of a person suffering from hypothyroidism or thyroiditis must be carefully thought out. Many foods worsen the condition, but if you eat only healthy food, then your health will noticeably improve. This is the treatment of autoimmune thyroiditis with folk remedies.

Let's take a closer look at what is healthy to eat.

Use of essential oils

For autoimmune thyroiditis, the following types of essential oils are recommended for use:

Peppermint;

Spearmint;

Carnation.

They can be applied to the surface of the skin, and you can also use a special preparation for evaporation (diffuser). With its help, you can regularly inhale the aromas of oils.

Application of Bach colors

Symptoms of autoimmune thyroiditis and hypothyroidism are controlled through treatment with flower essences. The three most commonly used are the following:

• Essence wild rose. You only need a couple of drops of essence to mix with a small amount of water. This composition must be drunk once a day. At regular use fatigue will pass and depression, which are associated with autoimmune thyroiditis.
• Elm essence. You also just need to mix a couple of drops with water. Then drink this composition. The essence is used once a day, no more often. This perfectly restores well-being in this disease.
• Essence of wild apple. Good for cleansing the body. The recipe is the same - two drops of wild apple essence and water. Drink during the day.

Milk thistle

You can make tea from milk thistle. The plant is also called milk thistle. Used to relieve intoxication of the body. Toxins are eliminated thanks to daily consumption one cup of this tea. Especially if a person has chronic autoimmune thyroiditis. Treatment with folk remedies will be very helpful.

Apples and pears for thyroiditis

Using pears you can control the level of hormones in the body. This was noticed back in ancient China. Pears have a good effect especially on the female half of humanity. Apples also balance hormonal levels. They are best consumed together in the form of pear and apple puree or freshly squeezed juice.

We looked at autoimmune thyroiditis of the thyroid.

Treatment with folk remedies is not limited to this. There are a large number of recipes that can help with this disease.

The term thyroiditis includes diseases in which inflammation of the thyroid gland occurs. These diseases differ in symptoms, features of occurrence and course. Before treating thyroiditis, it is worth understanding what form of the disease the patient and the doctor are faced with.

Treatment for these diseases will also vary depending on the degree of dysfunction of the thyroid gland. Different techniques correction will require violations that do not relate to the endocrine system.

Before starting treatment, an examination will be required. Which should accurately determine the type of disease, because only after this the treatment will be as effective and safe as possible. Currently, there are several types of thyroiditis.

Table No. 1. Main thyroiditis and their features:

Important: treatment this violation is carried out only after examination, as prescribed and under the supervision of an endocrinologist, since self-medication can aggravate the patient’s condition

How to treat thyroiditis of the thyroid gland will be decided by the attending physician. Depending on the type of thyroiditis, treatment is aimed at one or another factor contributing to the development of thyroiditis (etiological and pathological therapy), as well as correction hormonal levels that arose during the underlying disease.

Medications for the treatment of thyroiditis

Conservative methods of treating thyroid disorders are carried out using several groups of drugs, each group is aimed at relieving a particular problem.

Thyroid drugs

Representatives:

• L-thyroxine.
• Levothyroxine.
• Euthyrox.
• Triiodothyronine.
• Thyroidin.
• Thyrotome.
• Novotiral

They carry a dose of thyroid hormones. Hormone replacement therapy is the main way to treat autoimmune thyroiditis at the stage.

At first, minimal doses are prescribed, and the dosage is increased every three weeks. The size of the individual dose depends on many factors that determine whether the drug will be lifelong.

Glucocorticosteroids

Representative - Prednisolone. Contains adrenal hormones. Works as a powerful anti-inflammatory agent that helps prevent the formation of antibodies to the thyroid gland.

Allows you to relieve intoxication of the body, relieve pain, and affect the functioning of metabolic processes in the body. Treatment begins with a high dose, and gradually, every six days, the dosage is reduced to a maintenance level. The drug should not be discontinued abruptly; the dose and number of uses are reduced gradually.

Antibiotics

Representatives:

• Cephalosporins.
• Penicillin drugs.
• Other agents with antibiotic activity.

The wide range of effects of these groups makes it possible to destroy the pathogenic pathogen that provokes the development of acute purulent form of thyroiditis.

Nonsteroidal anti-inflammatory drugs

Representatives:

• Methindol.
• Indomethacin.
• Indovis.
• Indotard.
• Indobene.

Fights inflammatory processes in the tissues of the thyroid gland. Reduces the likelihood of developing antibodies to the thyroid gland, relieves pain in the thyroid gland area if present pain syndrome. The standard course of treatment is 5 days, the maximum allowable is 7 days.

Local painkillers

Representative – Diclofenac ointment. Compresses on the thyroid area will help relieve inflammation and eliminate pain.

Beta blockers

Representatives:

• Propranolol.
• Inderal.
• Anaprilin.
• Obzidan.

The drugs help eliminate arrhythmia, reduce arterial pressure, reduce tremors, eliminate headaches. Normalize heart rhythms and improve blood supply to the vessels of the head.

For patients suffering from thyroiditis, they help cope with heart problems, increased heartbeat and other heart problems due to hypothyroidism. Reception begins with small doses, gradual increase is possible.

Immunomodulators

Representatives:

• Levamisole;
• Decaris.

Modulate work immune system, stop producing antibodies to your own thyroid gland. They have the effect of generally strengthening the immune system.

Antihistamines

Representatives:

• Tavegil;
• Diazolin;
• Loratadine.

The drugs help relieve tissue swelling, which helps to quickly cure inflammation of the affected thyroid gland. Depending on the instructions, they can be taken once or twice a day. Photos and videos in this article will demonstrate the variety of drugs for the treatment of thyroiditis.

Treatment of thyroiditis

Important: with timely treatment of autoimmune thyroiditis, the prognosis is quite favorable.

Treatment for each disease will be carried out according to its own scheme, depending on the main point of damage. The stage of the disease at which treatment was started is also important, for example, the answer to the question - how to cure autoimmune thyroiditis will depend on the stage of the disease.

Table No. 2. Types of disease and possible treatment regimen:

Important: synthetic thyroid hormones prescribed for insufficient functioning of the gland provoke a lot of side effects, menstrual irregularities in young women, problems with the cardiovascular system in people over 45 years of age.

Surgical methods for treating thyroiditis

Important: replacement therapy does not solve the problem - it does not restore the functioning of the organ; over time, the patient needs to increase the dosage.

Surgery may be required if various states thyroid gland.

Opening and draining the abscess

Manipulation is required for acute purulent thyroiditis with the formation of an abscess. Performed using local anesthesia. Damaged tissue are completely removed. The outflow of purulent masses is ensured by installing drainage. Produced local administration antiseptic drugs.

Thyroidectomy or removal of the thyroid gland

Removal surgery is performed for the following indications:

• with a combination of chronic thyroiditis and second-degree hypertrophy of the gland, surgical intervention is sometimes the only method to treat chronic thyroiditis;
• with pressure from the altered gland on the trachea or esophagus;
• if therapy does not show adequate results and the growth of the affected thyroid gland continues;
• when particularly large nodular formations are detected on the body of the gland or there is a possibility of degeneration of formations from benign to malignant.

Before surgery, a comprehensive examination is necessary. If necessary, treatment is carried out before surgery cardiovascular problems, glucose levels are normalized when they deviate from the norm.

Removal of the gland can be of several types:

• partial removal of the gland– hemithyroidectomy;
• subtotal removal– it preserves the upper parts of the gland;
• total removal of all tissue– strumectomy.

Important: after total removal of the organ, the patient will undergo lifelong hormone replacement therapy due to persistent hypothyroidism.

The thyroid gland is removed in accordance with the following steps:

• the patient is given general anesthesia;
• the doctor makes a transverse incision in the neck;
• the gland is exposed and the surgeon decides on the volume of manipulation;
• blood vessels and skin are sutured;
• The extracted tissues of the damaged gland are sent for histological examination.

Important: the use of traditional medicine is not recommended for the treatment of endocrine diseases.

Thyroiditis and folk remedies

Many patients, fearing classical treatment methods, begin to wonder whether autoimmune thyroiditis can be cured using traditional medicine. The remedies used in home treatments can provide very strong influence to hormonal exchanges.

It is quite difficult to determine the correct dosage of herbs from which compresses and lotions are made. Active components home medicine if used incorrectly, they can aggravate the disease and worsen the patient’s condition or negate all progress from traditional treatment.

Therefore, it is not recommended for use in the treatment of thyroid disease. traditional methods. Cost of use unconventional method treatment is too high. Launching pathological process Using an unprofessional approach, you can deprive the patient of the possibility of recovery and the ability to lead a full life.

Diet for thyroiditis

Proper nutrition is one of the components of successful treatment. A special diet is what can be used to treat thyroiditis of the thyroid gland, along with a well-chosen medication regimen.

Compliance therapeutic diet will help:

• improve the patient’s condition, a lighter diet eliminates unnecessary stress on the digestive organs;
• To bring recovery and normalization of the condition closer, a balanced diet will allow medications to be better absorbed by the body, providing maximum impact.

The basis of the diet for thyroid problems is the presence in the diet of vitamins necessary to normalize hormonal regulation and improve the well-being of the thyroid gland. So the patient’s food should be saturated with iodine, essential vitamins, calcium and fiber of plant origin.

Must be supported normal level protein while reducing the content of fats and carbohydrates in the diet. In this case, the daily calorie content should be maintained at least 2000 kcal.

Sufficient water consumption is important; it should be at least two liters per day. Diet may have individual characteristics and instructions that their presence should be consulted with the treating endocrinologist before treating thyroid aitis or any other form of this disease.

You can create a healthy diet using the following products:

• seafood, but you need to make sure that there is no excess cholesterol content;
• seaweed;
• meat products with low fat content (turkey, rabbit, veal);
• products with bran;
• cereals;
• fruits and vegetables prepared by any method other than frying;
• dairy products;
• juices with high content vitamins, freshly squeezed.

Prevention of recurrence of the disease

Most people think about the quality of their lifestyle only after receiving a diagnosis or after completing serious treatment. Preventive actions for the prevention of endocrinological diseases are no different from standard rules healthy lifestyle.

There is nothing complicated about them, but by following them you can protect yourself from a large number of health problems with your own hands and prolong your life.

So, you can protect yourself from the primary or recurrent occurrence of thyroiditis by the following actions:

1. Compliance with the rules of a healthy diet and adequate physical activity.
2. Maintaining sleep and wakefulness.
3. Prevention and timely treatment of respiratory and colds. Vaccinations and seasonal intake of vitamin complexes.
4. Quitting habits that harm the body. Elimination of promiscuity and prevention of sexually transmitted diseases.
5. If you feel unwell or have any complaints, you should contact a specialist and not self-medicate. Uncontrolled use of iodine preparations, antibiotics, and drugs that affect the immune system can provoke the development of a serious disease.
6. It is necessary to protect your body from being in potential hazardous areas. Avoid places where radiation spreads and where air, water and food are heavily polluted.
7. Preventive examination of all organs and systems. The use of iodine-containing drugs only after they have been prescribed by an endocrinologist.

Any person after undergoing treatment for such a serious disease as thyroiditis needs to consult a specialist. The doctor should issue individual instructions on the recommended lifestyle, based on the amount of therapy performed and the likelihood of relapse of the condition.

Thyroiditis is a condition that requires constant attention on the part of the patient to the function of his thyroid gland. If you suspect it, you should definitely visit an endocrinologist to find out how to treat thyroiditis.

Thyroid thyroiditis is a concept that includes a group of disorders associated with. The group of diseases is based on thyroid abnormalities. Previously it was believed that thyroiditis was associated with a lack of iodine in food and water, but it has now been proven that it is of genetic origin.

Classification of thyroiditis

The disorder is classified depending on the characteristics of clinical manifestations and type of development.

Types of illness:

• spicy;
• subacute (lymphocytic, pneumocystis, granulomatous);

In addition, thyroiditis is divided into forms:

Causes of the disease and its clinical manifestations

The cause of acute forms thyroiditis endocrine gland may become used for treatment radiation therapy, irradiation, mechanical injury or hemorrhage into the thyroid gland. Often the cause of the disease is an infection, viral or bacterial.

The long-dormant chronic form begins to manifest itself after viral diseases, radiation or abuse medicines, appeared nodular goiter sharply reduces the quality of life.

Clinical manifestations of thyroiditis depend on the form of the disease.

Symptoms of thyroiditis in acute, purulent form:

Symptoms of thyroiditis in acute, non-purulent form:

• rapid pulse;
• weight loss;
• tremor;
• sweating;
• lethargy, drowsiness;
• swelling;
• dry hair and skin;
• discomfort in the gland area, pain when touched.

Symptoms of the subacute form:

A disease such as chronic thyroiditis (Riedel's goiter) may not manifest itself for a long time; the first symptoms of the disorder are a lump in the throat, difficulty swallowing. Over time, the voice becomes hoarse and breathing becomes impaired. Appeared diffuse goiter can be easily felt.

IN further patient The following manifestations begin to worry:

• headache;
• noise in the hearing organs;
• vision problems;
• arrhythmia.

Lymphocytic thyroiditis in chronic course It is almost impossible to identify before the first symptoms appear:

Diagnosis of thyroiditis

Since the disease in its chronic form does not produce pronounced symptoms, the endocrinologist pays attention to the family history. If family members suffer from autoimmune diseases, such as Riedel's thyroiditis, then the doctor advises the patient to undergo a complete laboratory examination, including the following procedures:

• Biopsy of gland tissue.
• Ultrasound to determine the tissue structure, shape and size of the gland. Ultrasound allows you to determine the presence of diffuse changes in the gland using special echo signs.
• Blood test for thyroid hormones.
• Immunogram.

Treatment of thyroiditis

Treatment is selected depending on the form and complexity of the disease. If the thyroid gland is hyperfunctional, thyreostatics, such as Thiamazole or Mercazolil, are prescribed to reduce negative influence For cardiac drug therapy, patients are prescribed beta-blockers.

Taking anti-inflammatory non-steroidal drugs reduces the production of antibodies that destroy gland tissue.

Non-steroidal anti-inflammatory drugs:

• Indomethacin;
• Voltaren;
• Methindol.

• low-grade fever;
• pain in the area of ​​the endocrine gland;
• weakness;
• pain when turning the neck and swallowing.

The acute phase of illness lasts up to seven weeks, while laboratory research blood show a high level of thyroid hormones and a decrease in thyrotropin, the uptake of radioactive iodine is also very low. Signs of the disease disappear as T3 and T4 levels normalize in the blood. A sign such as an enlarged and swollen gland can bother you for a long time.

The recovery phase is characterized by a picture of hypothyroidism with a decrease in T4, an increase in thyrotropin and an increase in iodine uptake. Hypothyroidism has been bothering me for about six months.

Therapeutic measures to relieve the symptoms of subacute thyroiditis in children consist of therapy with salicylic or pyrazolone drugs. Patients are prescribed anti-inflammatory drugs: Indomethacin, Naproxen. In severe cases, glucocorticoids and adrenergic blockers are used to relieve the clinical manifestations of the disease.

Children with subacute thyroiditis are advised to eat a diet that includes pureed and liquid products. Children's nutrition should be rich in protein and iodine. Children need dairy and dairy products, rich in calcium. Meals are fractional, in small portions.

Patients in the acute phase of the disease are advised to reduce physical activity to a minimum; ideally, patients should remain in bed.

Thyroiditis is a group of inflammatory diseases of the thyroid gland of various origins and pathogenesis.

In modern times, thyroiditis is the most common endocrine diseases in the world after diabetes mellitus, and autoimmune thyroiditis is the most common autoimmune disease. Scientists suggest that almost half of the population on Earth has one or another pathology of the thyroid gland, although not everyone can be treated. But there are no official statistics on thyroiditis in Russia and in the world due to the impossibility of conducting reliable studies of the endemicity of this pathology.

A little history

Thus, the famous surgeon E. T. Kocher was the first to operate on the thyroid gland and provided evidence of the effectiveness of iodine in the treatment of goiter (enlarged thyroid gland), for which he received the Nobel Prize in 1909. Although Kocher already had patients in whom iodine therapy did not give a positive result.

In 1912, Japanese surgeon Hakaru Hashimoto, while performing operations to remove the thyroid gland in people living in Japan, the country richest in iodine, saw the first inflammatory changes in the thyroid gland. This suggested that goiter may not only be the result of iodine deficiency. These assumptions were confirmed in 1930 - 1932. O. A. Grochem, and in 1956 E. Vitebsky and N. Rose created an experimental animal model of Hashimoto's disease and proved the autoimmune etiology of thyroid diseases, accompanied by its enlargement. The path to research into thyroiditis has been long and continues in our times.

• Excess iodine as proven by scientists, plays a significant role in the development of autoimmune thyroiditis.
• Thyroiditis is more common young people, children and adolescents, while the incidence among women is higher, but men suffer the disease more severely.
• Effect of radiation. Following the Chernobyl disaster, there was an increase in cases of autoimmune thyroiditis among those affected by the accident. Scientists have proven that this fact occurred due to massive and unjustified prophylaxis with non-radioactive iodine, which was carried out in areas of radiation, and not due to the effects of radiation itself.
• State of the environment directly affects the condition of the human thyroid gland.
• Timely treatment thyroiditis leads to a favorable outcome.
• Thyroid hormones and reproductive health. Thyroid dysfunction can cause decreased fertility, infertility and miscarriage in women, as well as impaired sperm production in men. After restoration of the hormonal levels of the thyroid gland, fertility in men and women is restored.
• Lack of thyroid hormones during pregnancy increases the risk of developing autism in children, and can also lead to deafness and mental, intellectual and mental retardation physical development child.

Anatomy of the thyroid gland

Structure of the thyroid gland

Sections of the thyroid gland:

• left lobe,
• right lobe,
• isthmus.

Thyroid size
Each lobe has a length from 2 to 4 cm (can reach 6 cm), and a width of up to 2 cm (sometimes up to 4 cm). The weight of the gland also ranges from 15 to 25 g (can weigh up to 60 g). Normal sizes and the mass of the thyroid gland depend on many factors (gender, adolescence, menstruation in women, age, etc.).

Histology of the thyroid gland

1. Follicular vesicle (follicle):
   • epithelial follicular cells (thyrocytes),
   • colloid (contains hormone).
2. Capillary network around the follicle.
3. Gland stroma– connective tissue around the follicle.
4. Islands of interfollicular epithelium, which may be underdeveloped thyrocytes and contribute to the proliferation of thyrocytes.
5. C cells located singly between thyrocyte cells.

1. Iodinated (thyroxine or T4, triiodothyronine or T3) produced by thyrocytes from the thyroglobulin protein, bind to iodine (form iodides) in the follicle colloid.

   Functions of thyroxine and triiodothyronine:

   • Effect on tissue growth (bone, muscle and other tissues).
   • Effect on metabolic processes in the body: protein, lipid, carbohydrate, water, electrolyte, vitamin and basal metabolism.
   • Effect on the central nervous system : brain development, differentiation of nerve centers.
   • Effect on the autonomic nervous system (nervous system internal organs).
   • Regulation of other endocrine organs (sex glands, thymus, pituitary gland, adrenal cortex)
   • Participation in the blood coagulation system (affects platelets and other blood clotting factors).
2. Thyrocalcitonin (calcitonin) produced by C-cells of the thyroid gland, takes part in phosphorus-calcium metabolism, its level normally increases with an increase in blood calcium levels and during breastfeeding. Is counteracting parathyroid hormone (a parathyroid hormone that affects calcium metabolism).

Disturbances in the level of thyroid hormones (thyroxine and triiodothyronine)

Factors	Excess hormones (hyperthyroidism)	Lack of hormones (hypothyroidism)
Children		Dwarfism, cretinism, behavioral disorders, delayed puberty.
Pregnancy	Miscarriage	Fading of pregnancy, disruption of the physical and neuropsychic development of the child.
Metabolism	Acceleration of metabolism (weight loss, reduction of liver glycogen reserves).	Metabolic slowdown (excess weight gain).
Function of the nervous system	Increased nervous system arousal: emotionality, exhaustion (“burnout”) of the nervous system, psychosis, tachycardia (increased heartbeat), increased intestinal motility (diarrhea), increased sweating, violation of thermoregulation (increase in body temperature), exophthalmos (bulging of the eyeballs).	Suppression of the nervous system: drowsiness, malaise, bradycardia (slow heart rate), decreased intestinal motility (constipation), decreased sweating, decrease in body temperature
Disruption of other endocrine organs	Disorders of the menstrual cycle, decreased fertility.	Decreased fertility, infertility, menstruation disorders in women.
Photo of a patient with thyroid dysfunction	N.K. Krupskaya (1869 - 1939) - revolutionary, famous political and cultural figure of the USSR, wife of V.I. Lenin, suffered from Graves' disease.	A child with cretinism.

Regulation of the thyroid gland

The work of the thyroid gland is carried out under the regulation of the central nervous system, or rather - hypothalamic-pituitary system.

The hypothalamus and pituitary gland are brain structures that perform endocrine function. The hypothalamus, located in the brain, produces thyrotropin-releasing hormone (thyrotropin-releasing hormone), which in turn affects the anterior pituitary gland (adenohypophysis). In the adenohypophysis, under the influence of TRH, thyroid-stimulating hormone (TSH) is formed. TSH stimulates the production of thyroxine (T4) and triiodothyronine (T3) by thyroid cells.

There is also an inverse negative relationship between the regulation of thyroid function. Thus, the level of hormones T3 and T4 influence the production of thyroid-stimulating hormone and thyrotropin-releasing hormone. With insufficient iodine levels in the body, the production of T3 and T4 decreases, which contributes to an increase in the production of TSH and TRH. In turn, the hormones of the pituitary gland and hypothalamus begin to stimulate the thyroid gland, while the gland itself gradually increases in size. Thus, a cyclical cascade process is launched, which cannot be interrupted until the level of iodine in the thyroid gland is normalized.

Also, the process of production of thyroid hormones is influenced by other hormonal substances (glucocorticoids, estrogens, dopamine and many other factors), which explains the mutual influence of the thyroid gland on other endocrine organs.

Causes and types of thyroiditis

Symptoms of thyroiditis

• symptoms of hypothyroidism,
• symptoms of hyperthyroidism,
• symptoms of compression by an altered thyroid gland,
• general symptoms of inflammation.

Symptoms of hypothyroidism

Degrees of hypothyroidism:

• Latent hypothyroidism – no visible clinical symptoms
• Manifest hypothyroidism – hypothyroidism with clinical manifestations. Happens compensated and decompensated .
• Complicated hypothyroidism (heart failure, polyserositis (effusion in the cavity), cretinism in children, pituitary tumors, myxematous coma).

Symptoms of hyperthyroidism

• Light degree: moderate loss of body weight, tachycardia from 90 to 100 beats per minute, no damage to other endocrine organs.
• Average degree: pronounced weight loss, tachycardia from 100 to 120 per minute, changes heart rate, disorders of the digestive system and adrenal glands.
• Severe hyperthyroidism: severe changes in the functioning of individual systems and organs of the body.
• Complicated hyperthyroidism: manifests itself as a thyrotoxic crisis.

Symptoms of compression by an altered thyroid gland

• 0 tbsp. – The enlargement of the thyroid gland is not detected during examination.
• 1 tbsp. – enlargement of the thyroid gland is determined by palpation, but is not visually detected.
• 2 tbsp. – enlargement of the gland is visible upon examination and palpation.

Complaints regarding changes in the thyroid gland:

• Pain in the thyroid gland, which can radiate to the neck, ear, jaw, tongue and intensify when swallowing. The pain is associated with the presence of inflammation in the gland, which is accompanied by swelling and a local increase in temperature.
• Voice change . A rough voice is associated with pressure from an enlarged gland on the vocal cords.
• Compression of neighboring organs may be accompanied by pain when swallowing, choking on food, a feeling of a lump in the throat, and difficulty breathing.
• Compression syndrome (compression of mediastinal organs): when the vessels of the neck are compressed, headaches, tinnitus, decreased vision, etc. may develop.

General symptoms of inflammation:

• General intoxication : weakness, aching joints, increased body temperature, headache; associated with an infectious process in the body, the ingress of toxic waste products of bacteria.
• Enlarged lymph nodes : enlarged lymph nodes of the neck, painful on palpation, possible formation of lymphadenitis (purulent inflammation of the lymph node, accompanied by pain, redness of the skin over it, an increase in size of more than 10 mm). The reaction of lymph nodes is associated with the body’s attempts to destroy the infection through the lymphatic system.

Symptoms of thyroiditis depending on the type

Diagnosis of thyroiditis

Laboratory research

• TSH – norm from 0.4 to 4 mU/l,
• T3 – norm from 2.6 to 5.7 pmol/l,
• T4 – norm from 9 to 22 pmol/l,
• microsomal antibodies to thyroid peroxidase (AT TPO) – norm up to 18 U/l,
• antibodies to thyroglobulin (AT TG) – norm up to 5.6 U/l,
• second colloidal antigen and antibodies to thyroid hormones.

1. Acute thyroiditis – deviations in thyroid hormone levels TSH, T3 and T4, as well as antibodies to thyroglobulin and thyroid pyroxidase are most often not detected. Changes in the form of increased TSH from normal values T3 and T4 appear with latent hypothyroidism, and an increase in TSH in combination with a decrease in the levels of T3 and T4 with manifest hypothyroidism.


2. Subacute thyroiditis. At the II euthyroid stage, with the appearance of hyperthyroidism, an increase in T3 and T4 levels and a decrease in TSH levels are specific. At the third hypothyroid stage, TSH levels increase and/or T3 and T4 levels decrease. When the thyroid follicles are destroyed, antibodies to thyroid peroxidase and thyroglobulin may increase.


3. At chronic autoimmune thyroiditis AT TG, AT TPO, a second colloidal antigen and antibodies to thyroid-stimulating hormone appear. When hypothyroidism occurs, TSH levels increase and/or T3 and T4 levels decrease.


4. At Immunological and hormonal changes are often absent. In the presence of concomitant autoimmune thyroiditis, a low titer of antibodies to thyroglobulin, peroxidase, thyroid-stimulating hormones, and a second colloidal antigen may appear. As symptoms of hypothyroidism increase, TSH levels increase and/or T3 and T4 levels decrease.

Instrumental studies of the thyroid gland

• sizes,
• location,
• structure,
• condition of the parathyroid glands, regional lymph nodes, blood flow condition (Doppler ultrasound),
• control of puncture biopsy of the thyroid gland

Ultrasound – signs of thyroiditis, depending on the type:

• Acute purulent thyroiditis – the dimensions are normal or slightly enlarged, the echo structure is heterogeneous, foci of reduced echogenicity (abscesses) can be detected.


• Acute non-purulent thyroiditis – the sizes are not increased or diffusely increased, spots with reduced echogenicity; when examining Doppler ultrasound, there is an increase in blood supply.


• Subacute de Quervain's thyroiditis – the size of the gland is enlarged, foci of reduced echogenicity; when examining Doppler ultrasound, there is an absence or decrease in the blood flow of the gland.


• Chronic autoimmune thyroiditis Hashimoto's – diffusely reduced echogenicity of the thyroid gland, the presence of foci of increased echogenicity. With atrophic autoimmune thyroiditis, the volume of the gland decreases (up to 3 times), with hypertrophic thyroiditis it increases (up to 3 times), and the size of the gland may also remain unchanged. Doppler ultrasound shows increased blood filling and vascular deformation.


• Chronic fibrous thyroiditis – diffuse decrease in echogenicity of the thyroid gland, increased parenchyma density, with Doppler ultrasound – decreased blood flow.

Using scintigraphy, you can determine the location of the gland, its size, the presence of nodes, and developmental anomalies.

For thyroiditis this method uninformative, rarely used. It is important to use scintigraphy when making a differential diagnosis of thyroiditis and gland tumors (presence of cold and hot nodes).

Computed and magnetic resonance imaging (CT and MRI) allows you to fully assess the condition of the thyroid gland and surrounding organs and tissues. However, not all CT and MRI machines have the ability to examine the thyroid gland. MRI has advantages over CT due to the lack of radiation exposure.

Fine needle biopsy of the thyroid gland– an invasive diagnostic method, which is carried out for further cytological examination of gland tissue. It is carried out under ultrasound control or without it by inserting a needle into the parenchyma of the gland and collecting material.

A biopsy is performed for almost all diseases of the thyroid gland; the method is very informative and will allow diagnosing diseases and neoplasms of the gland at an early stage.

Cytological diagnostic method for thyroiditis.

Cytological examination for thyroiditis, it is carried out more often than histology due to the fact that material for cytology can be taken during a fine-needle biopsy, and for histology - only as postoperative material ( surgical treatment used infrequently for thyroiditis).

Cytology is microscopic examination biopsy cells are inferior in information content to histological examination. However, it often remains the method on the basis of which the diagnosis of thyroiditis is made.

Cytological picture depending on the type of thyroiditis:

• Acute purulent thyroiditis . Cytological examination of the aspirate reveals pus: neutrophils, necrosis. If these changes are detected, it is necessary bacteriological examination– culture for microflora, which will allow you to determine the type bacterial pathogen, as well as sensitivity to antibiotics.
• Acute non-purulent thyroiditis characterized by aseptic inflammation, neutrophils are not detected in the preparation, a large number of leukocytes (eosinophils, lymphocytes, monocytes) are detected; when inoculating this material, the pathogen is not determined.
• Subacute thyroiditis characterized by the presence in the preparation of normal follicular cells alternating with altered (mutated). Also in the preparation, inflammatory cells are determined: lymphocytes, giant multinucleated cells, epithelioid granulomas (it is by the predominance of these cells that subacute thyroiditis is divided into giant cell, granulomatous and lymphocytic).
• Chronic autoimmune thyroiditis. In the cytological preparation, many cells are detected, among which there is no colloid, and there are practically no thyrocytes. The cells are represented by a variety of immune cells: lymphocytes, plasma cells, eosinophils, giant cells of B lymphocytes and others.
• At chronic fibrous thyroiditis in the preparation the number of cells is very meager, a large number of fibroblasts (precursor cells of fibrosis), destroyed inflammatory cells (leukocytes, lymphocytes, plasma cells and others) are determined, a small amount of dystrophically changed follicular cells, thyrocytes.

Treatment of thyroiditis

Drug treatment for thyroiditis

• Antibiotic therapy. A broad-spectrum antibiotic (cephalosporins or protected penicillins) is prescribed, and when culture results with antibiotic sensitivity are obtained, treatment is adjusted.
• Antihistamines.
• Vitamin therapy.
• Surgery in the presence of thyroid abscesses.

• Antibiotic therapy usually not performed, since there is no thyroiditis with this type infectious agent, but with reduced immunity, antibiotics are prescribed as prophylaxis.
• Sedatives (soothing tinctures).
• Non-steroidal anti-inflammatory drugs.
• Vitamin therapy.

• is the main treatment for de Quervain's thyroiditis.
• Nonsteroidal anti-inflammatory drugs prescribed at the beginning of treatment for pain relief. A short course is administered orally and in the form of applications to the thyroid gland for 10 days.
• Thyroid e a drug s recommended 1 - 1.5 months from the start of hormonal therapy in the presence of symptoms of hypothyroidism, prescribed for 1 month. But if persistent symptoms of hypothyroidism persist, thyroid medications are prescribed for life.
• Vitamin therapy.
• Beta blockers How symptomatic therapy prescribed in the presence of tachycardia.

• Thyroid drugs apply long time for several months and years.
• Glucocorticosteroid therapy orally for 3 months. and locally through the skin in the form of physiotherapy (electrodraging).
• Immunomodulatory drugs prescribed for low effectiveness of thyroid and hormonal drugs.
• Maybe surgery.

Treatment of chronic fibrous thyroiditis:

• Surgery – the main method of treating fibrous thyroiditis.
• Thyroid drugs are recommended for life as replacement therapy for persistent hypothyroidism.

Types of surgical treatment for thyroiditis

Removal of the thyroid gland (thyroidectomy)

Indications for chronic thyroiditis:

• hypertrophy of the thyroid gland 2 degrees (chronic thyroiditis),
• compression of the trachea and esophagus by an enlarged gland,
• growth of the thyroid gland against the background of adequate therapy,
• the presence of large nodes in the gland, suspicion of malignant formations.

Types of operations on the thyroid gland for chronic thyroiditis:

• partial resection thyroid gland(hemithyroidectomy),
• subtotal resection(with preservation of the upper parts of the gland),
• total extirpation of the thyroid gland(strumectomy, removal of the entire gland).

Traditional medicine and thyroiditis

Compresses on the thyroid area
Pour 200 g of hot pork lard into 200 g of dry wormwood, leave for 20 minutes, apply warm to the neck area overnight. Recommended daily use within 14 days. Compresses are effective for chronic thyroiditis.

Infusion with seaweed
50 g seaweed, 25 g pine buds, 3 plantain leaves, pour 1 liter of boiling water and put on water bath for 15 minutes, then add 10 g of honey and 2 grated lemons. Continue simmering the mixture in a water bath for another 15 minutes. Take 1 tbsp. l. 3 times a day for 20 – 30 minutes. before meals for one month. Effective for autoimmune thyroiditis.

Tincture of pine buds.
Fill 2 packs of crushed pine buds with vodka to a volume of 500 ml, leave in a warm, dark place for 21 days, then strain. Rub this tincture onto the thyroid gland 3-4 times a day until recovery. Effective for autoimmune thyroiditis.

Nutrition for thyroiditis

• seafood,
• seaweed,
• lean meat,
• bran,
• porridge,
• wholemeal bread,
• vegetables fruits,
• dairy products (cheese, cottage cheese, yogurt, kefir, etc.),
• vitamin juices daily.

Prevention of thyroiditis

• Healthy image life and nutrition ( physical exercise, healthy eating, refusal bad habits, walks in the air).
• Prevention of infectious and viral diseases (hardening, taking vitamins, preventive vaccination).
• Treatment of lesions chronic infection respiratory tract, oral cavity.
• Prevention of HIV and other sexually transmitted diseases.
• Refusal to self-medicate and take medications (antibiotics, immunomodulators and immunostimulants).
• Timely contact a doctor if any complaints appear for further examination.
• Reducing exposure to radiation.
• Adequate consumption of foods that contain iodine.
• Timely periodic preventive examination.

What is autoimmune thyroiditis? Hashimoto's thyroiditis, what is it?

Features of autoimmune thyroiditis:

• The most common thyroid disease.
• It is often hereditary (family) in nature.
• Postpartum autoimmune thyroiditis may develop due to immunosuppression during pregnancy.
• Children often get sick adolescence and young people.
• It is characterized by a long asymptomatic course.
• It can manifest itself as either an enlargement of the thyroid gland or a decrease in it.
• It almost always manifests itself as a lack of thyroid hormones (hypothyroidism).
• Complications of autoimmune thyroiditis can be persistent hypothyroidism (lifelong hormonal therapy is required), “malignancy” (degeneration into a cancerous tumor), transition to fibrous form chronic thyroiditis (often requires extirpation of the gland).
• With timely long-term treatment the prognosis is favorable.

• Determination of antibodies to own cells thyroid gland: microsomal antibodies to thyroid peroxidase (AT TPO), antibodies to thyroglobulin (AT TG), second colloid antigen and antibodies to thyroid hormones. When these antibodies appear, we can talk about the presence of autoimmune thyroiditis in the patient.
• Determination of thyroid hormones thyroxine and triiodothyronine (T3 and T4), as well as thyroid-stimulating hormone (TSH) in the patient’s blood. In Hashimoto's thyroiditis, hormone levels may be normal at the onset of the disease. When hypothyroidism occurs, TSH levels first increase, followed by a decrease in T3 and T4 levels.
• Ultrasound of the thyroid gland with autoimmune thyroiditis, it may indicate a decrease or increase in its size, the presence of foci of increased or decreased echogenicity, the presence or absence of nodes, deformation of blood vessels and an increase in blood supply to the gland.
• For fine needle biopsy of the thyroid gland (invasive method) it is possible to reliably confirm the presence of autoimmune thyroiditis and exclude oncological pathology.

How to treat thyroiditis during pregnancy?

It is very important to promptly detect the disease or its relapse by full examination thyroid gland. To do this, you need to see an endocrinologist, undergo a blood test for TSH, T3 and T4, antibodies to the thyroid gland, and an ultrasound of the thyroid gland. If there are changes in these studies, you should be re-examined every three months. If the diagnosis of thyroiditis is confirmed, then treatment is mandatory to prevent miscarriage, stillbirth and damage to the baby’s nervous system, and to prevent persistent hypothyroidism in the mother in the future.

To treat thyroiditis during pregnancy, L-thyroxine (contains thyroid hormone), iodine preparations (iodomarin), calcium and vitamin D3 preparations (calcium D3) are used. Treatment should be continued until delivery and for at least another 6 months after delivery. In case of thyroiditis, a cesarean section is more often performed, but this issue will be decided by the obstetrician-gynecologist together with the endocrinologist individually. Breastfeeding while taking medications is possible and necessary for the normal development of the baby.

At adequate treatment probability of giving birth full-term healthy child very high, the prognosis is favorable. It is very important for mothers to continue treatment after childbirth until full recovery under the supervision of an endocrinologist.

The term “thyroiditis” refers to a wide group of diseases that can be described as inflammation of the thyroid gland. If left untreated, thyroiditis becomes chronic, causing hyperthyroidism, and subsequently hypothyroidism, which especially often occurs with Hashimoto's thyroiditis.

The causes of thyroiditis are inflammation of the thyroid tissue

The causes of thyroiditis of the thyroid gland may be different, as well as their mechanism, but this wide group of diseases has one thing in common - the presence of an inflammatory focus in the thyroid tissue.

Classification:

There are several forms of this disease. So, depending on the nature of the course and clinical features, the following are distinguished:

• spicy;
• subacute;
• chronic thyroiditis.

Depending on the conditions and causes of occurrence, there are:

1. Autoimmune thyroiditis
2. Syphilitic
3. Tuberculous

Acute thyroiditis affects either the entire gland or parts of it

May be:

1. Diffuse

2. Ochagovym

Diffuse spreads to the entire gland or entire lobe. Focal partially affects the thyroid lobe. The inflammatory process in this form of the disease can be purulent or occur without suppuration.

This type of disease is distinguished by:

1. prevalence.
2. clinical forms.

In the first case, it can be focal or diffuse. In the second, there are 3 types of thyroiditis: pneumocystis and lymphocytic.

Chronic thyroiditis develops only due to untimely treatment

This is a group of thyroiditis, which includes the following varieties of this form of the disease:

1. Autoimmune thyroiditis of the thyroid gland or Hashimoto's thyroiditis.
2. Fibrous-invasive goiter of Riedel.
3. Specific thyroiditis of different etiologies (syphilitic, tuberculous, septomycosis).

Riedel's goiter and the purulent form of acute thyroiditis are extremely rare.

The main symptom is enlarged lymph nodes

The acute purulent form develops after pneumonia, tonsillitis and other infectious diseases, in which the causative agents of these diseases enter the tissues through the hematogenous method.

Acute non-purulent form occurs after hemorrhages in the thyroid tissue, as well as after radiation and traumatic damage.

Subacute de Quervain's thyroiditis. The second name for this form is Granulomatous thyroiditis. It is based on viral damage. Viruses, measles, influenza, adenoviruses and causative agents of other infections affect the cells of the thyroid gland, which is 5-6 times more common in women aged 20 to 50 years. Clinical signs subacute thyroiditis become noticeable a few weeks after the infectious disease. Outbreaks of infection directly depend on periods of viral activity. This form It is ten times less common than autoimmune thyroiditis and is characterized by reversible disturbances in the functioning of the gland. The cause of subacute thyroiditis, as a rule, is genetic factors and chronic nasopharyngeal infections.

Riedel's goiter or fibrous thyroiditis compresses the structures of the neck due to a significant proliferation of connective tissue. However, its etiology has not been fully elucidated. Some experts consider this disease to be the result of Hashimoto's thyroiditis after damage to the gland by autoimmune processes.

The development of Riedel's goiter is more common among patients with endemic goiter who have undergone surgery on the thyroid gland and in persons with allergic and autoimmune diseases, as well as those with a hereditary predisposition.

Symptoms of thyroiditis depend on stage C and the complexity of inflammation of the nodes

Thyroiditis manifests itself as painful sensations and pressure in the neck. Other symptoms of thyroiditis include hoarseness and difficulty swallowing. Acute inflammation provokes the formation of an abscess. Further development thyroiditis causes in the thyroid gland diffuse changes, which, as the disease progresses, lead to disruption of its functions.

The purulent form of this disease is distinguished by the presence inflammatory process, in which the thyroid gland is infiltrated, and subsequently the formation of an abscess is observed in it.

Purulent thyroiditis

It is characterized by acute development, beginning with chills and temperature up to 40°C. The patient experiences sharp pains in the area of ​​the front of the neck, while there is an increase in pain when moving the head, coughing and swallowing, their displacement in the jaw, back of the head, tongue, ears. The symptoms of general intoxication are rapidly increasing: tachycardia, weakness appear, the patient experiences weakness, aching joints and muscles, and a severe headache occurs.

Often the patient has a serious condition.

Acute thyroiditis, non-purulent form

Leaks with less severe symptoms and is characterized by aseptic inflammation of the thyroid tissue.

Subacute thyroiditis

May have clear signs of inflammation. The course of this form of thyroiditis is characterized by pain in the anterior cervical surface, weakness, temperature of 38°C and above, severe intoxication with increasing severity. With this form of thyroiditis, the duration of the acute initial stage of thyrotoxicosis is observed from 4 to 8 weeks, and after treatment of thyroiditis, it ends with recovery with restoration of the function and structure of the gland.

Chronic fibrous thyroiditis

Its course may not cause any disturbances in well-being for a very long time. An early manifestation of fibrous chronic thyroiditis is a feeling of a “lump in the throat” and difficulty swallowing. Next, hoarseness of the voice, disturbances in swallowing, breathing, speech, and choking while eating develop. The thyroid gland is painless, its functional activity is reduced. Chronic thyroiditis causes compression of adjacent structures in the neck.

Compression syndrome occurs with visual impairment, headache and tinnitus. In the chronic form there is pulsation cervical vessels, the patient complains of breathing problems and difficulty swallowing.

Autoimmune thyroiditis or Hashimoto's thyroiditis

Chronic autoimmune thyroiditis was first described in detail by physician Hashimoto from Japan. Autoimmune thyroiditis develops when the body mistakes its own proteins for foreign ones, which causes an autoimmune reaction in the thyroid gland - infiltration of lymphocytes. Chronic autoimmune thyroiditis develops slowly and causes destructive processes in the thyroid gland.

Hashimoto's thyroiditis is most often observed in women over 40-50 years of age, although it can occur among younger children and adolescents. Treatment of autoimmune thyroiditis is complicated by the fact that at first, its symptoms are almost invisible, and the diagnosis is not always timely.

Symptoms of autoimmune thyroiditis may not appear for a long time, then an enlargement of the gland and a change in its structure are noted. The thyroid gland is compacted and bumpy to the touch. Initially, a patient with Hashimoto's thyroiditis complains of malaise and swelling in the neck, experiences discomfort, and pain begins in the area of ​​the thyroid gland, especially when swallowing. Pain also occurs when chewing solid food, when turning, or tilting the head.

There may be an excess of thyroid-stimulating hormones. But more often, chronic autoimmune thyroiditis causes hypothyroidism - a decrease in hormones.

Treatment is carried out with the help of medications

To properly treat chronic autoimmune thyroiditis, the endocrinologist clarifies the condition of the gland and prescribes the following tests:

• immunological blood test;
• blood test for hormones.

Treatment options for autoimmune thyroiditis include medication replacement therapy with constant monitoring of the patient. Sometimes chronic autoimmune thyroiditis requires surgical intervention, and for very serious indications, complete removal of the gland is performed.

If the disease is detected on time, treatment of autoimmune thyroiditis gives good results and the prognosis is favorable.