What is autoimmune thyroid disease (AITD)?
Find out all you need to know about autoimmune thyroid conditions.
Thyroid conditions can be complex and vary from temporary to lifelong. In many cases, the cause of a thyroid condition may be autoimmune in nature. So, how do you know if an autoimmune reaction is to blame for your thyroid condition? And are there factors that could leave you more at risk of developing autoimmune thyroid disease?
In this blog, we discuss:
- What is autoimmune thyroid disease?
- What is Hashimoto’s disease?
- What are the symptoms of Hashimoto’s disease?
- What is Graves’ disease?
- What are the symptoms of Graves’ disease?
- How are autoimmune thyroid conditions diagnosed?
- What are the risk factors for autoimmune thyroid disease?
- Are Hashimoto’s and Graves’ disease curable?
- How do you treat Hashimoto’s disease?
- How do you treat Graves’ disease?
- Where can I get support for an autoimmune thyroid condition?
What is autoimmune thyroid disease?
Autoimmune thyroid disease (AITD) is any thyroid condition that's caused by certain antibodies attacking the thyroid gland.
There are several types of autoimmune thyroid disease, including [1]:
The two most common autoimmune thyroid diseases are Hashimoto’s disease and Graves’ disease.
What is Hashimoto’s disease?
Hashimoto’s disease is one of the most common causes of hypothyroidism (an underactive thyroid). In its early stages, it’s possible for Hashimoto’s thyroiditis to cause temporary hyperthyroidism (an overactive thyroid), but this is uncommon [2].
Hashimoto’s disease develops when the immune system makes thyroid antibodies that attack the thyroid gland, causing it to become damaged and unable to make enough thyroid hormones. This, in turn, can cause unwanted symptoms.
What are the symptoms of Hashimoto’s disease?
In the early stages, it’s common for Hashimoto’s to have no symptoms. But, as the disease progresses, you are more likely to develop symptoms.
Symptoms of Hashimoto’s disease include [3]:
- Constipation
- Dry skin and hair
- Fatigue
- Fertility problems
- Irregular menstrual cycle
- Joint and muscle pain
- Slower heart rate
- Weight gain
What is Graves’ disease?
Graves’ disease is the most common cause of hyperthyroidism (an overactive thyroid). As it’s an autoimmune disease, the body creates antibodies that attack the thyroid gland. Unlike Hashimoto’s disease, the attack on the thyroid gland causes an increase in thyroid hormones – speeding up many functions in the body and causing several unwanted symptoms [4].
What are the symptoms of Graves’ disease?
With Graves’ disease, your symptoms may come and go over time and will differ from person to person.
Symptoms of Graves’ disease include [4]:
- Problems with your eyes and skin
- Weight loss, despite an increased appetite
- Increase in heart rate
- Palpitations (a noticeably rapid, strong, or irregular heartbeat)
- Mood swings, including an increase in anxiety
- Insomnia
- Shaky hands
- Muscle weakness
- Frequent bowel movements
- Goitre (swelling of the thyroid gland)
How are autoimmune thyroid conditions diagnosed?
The first step in testing for autoimmune thyroid disease is a blood test. Initially, your doctor may only test your thyroid hormones to check how your thyroid is functioning. If your doctor suspects an autoimmune thyroid condition, they may test for specific thyroid antibodies, including:
Thyroid antibodies often indicate an autoimmune condition is at play. However, it is possible to have normal thyroid antibodies and still have Graves’ or Hashimoto’s. This is why your blood test results will be considered alongside your medical history, risk factors, and any other test results (such as an ultrasound).
What are the risk factors for autoimmune thyroid disease?
Certain factors may leave you more at risk of developing autoimmune thyroid disease.
Risk factors include:
- Being female
- Having a family history of Graves’ or Hashimoto’s
- Having another autoimmune condition, such as coeliac disease or type 1 diabetes
- Smoking
Are Hashimoto’s and Graves’ disease curable?
As Hashimoto’s and Graves’ disease are both autoimmune conditions, neither are curable. However, they can be treated to restore hormones to normal levels. Many people with Hashimoto’s and Graves’ disease lead long and healthy lives once their condition is well controlled.
How do you treat Hashimoto’s disease?
Hashimoto's disease develops slowly over many years. Initial blood tests may only show minor changes in your thyroid hormone levels. For that reason, your doctor might choose to monitor your blood test results for a while rather than start treatment right away.
As Hashimoto's disease ultimately causes overt hypothyroidism, you'll likely develop some symptoms and need treatment in the form of replacement hormones (levothyroxine).
As well as medication, it's important to look after yourself with a balanced (thyroid-friendly) diet and regular exercise.
How do you treat Graves’ disease?
The most effective treatment for Graves' disease is either medication, radioiodine therapy, or in some cases, surgery. Treatment for Graves’ disease often causes hypothyroidism, which may need to be corrected with levothyroxine.
As with Hashimoto’s, a healthy lifestyle including a thyroid-friendly diet and regular exercise can help to manage your symptoms.
Where can I get support for an autoimmune thyroid condition?
As well as causing physical symptoms, thyroid conditions often affect your mental health too. This is partly due to abnormal thyroid hormone levels, but it can also be a result of the difficulties and adjustments of living with a long-term condition. Thankfully, there are lots of sources of support:
- Thyroid Hub – find answers and actionable advice on a range of topics including the early warning signs of thyroid problems and how thyroid conditions can affect fertilty and pregnancy.
- Thyroid UK – a charity that aims to help you through your thyroid journey. Whether you are undiagnosed or diagnosed, it offers plenty of support and information.
- British Thyroid Foundation – a charity that helps people who have been diagnosed and are living with a thyroid disorder.
References
- Franco JS, Amaya-Amaya J, Anaya JM. Thyroid disease and autoimmune diseases. In: Anaya JM, Shoenfeld Y, Rojas-Villarraga A, et al., editors. Autoimmunity: From Bench to Bedside [Internet]. Bogota (Colombia): El Rosario University Press; 2013 Jul 18. Chapter 30. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459466/
- Shahbaz, A. et al. (2018) ‘ prolonged duration of Hashitoxicosis in a patient with Hashimoto’s thyroiditis: A case report and review of literature’, Cureus [Preprint]. doi:10.7759/cureus.2804.
- Hashimoto’s disease - NIDDK (no date) National Institute of Diabetes and Digestive and Kidney Diseases. Available at: https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease#:~:text=for%20Hashimoto’s%20Disease-,What%20is%20Hashimoto’s%20disease%3F,the%20front%20of%20your%20neck (Accessed: 31 May 2023).
- Graves’ disease - niddk (no date) National Institute of Diabetes and Digestive and Kidney Diseases. Available at: https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease#:~:text=Graves’%20disease%20is%20an%20autoimmune,the%20way%20your%20heart%20beats (Accessed: 31 May 2023).