iThei mdcdaelcinfd o c elllllrlllll tThe hlcinfd olsbdkpvouvIn Hashimoto’s, two types of self-reactive antibodies can be seen. More
than 90 percent of people with Hashimoto’s have thyroid peroxidase an-
tibodies (TPOAb), and about 80 percent of people with Hashimoto’s
have thyroglobulin antibodies (TgAb).1, 14
Prevalence
Hashimoto’s affects up to 10 percent of the population in the US, and
prevalence increases with age. Hashimoto’s predominantly affects wom-
en—at a rate of seven women for every one man with Hashimoto’s.
Hormonal fluctuation may contribute to the development of
Hashimoto’s, and peak effects are seen around puberty, pregnancy, and
menopauses. Up to 20 percent of women may have TPO antibodies
indicative of Hashimoto’s. There seems to be a higher incidence of this
condition in Caucasian and Japanese individuals as compared with in-
dividuals of African or Mexican descent.1, 14
Thyroid Changes in Hashimoto’s
If we were to examine the thyroid gland of a Hashimoto’s patient under
a microscope, we would observe thyroid cell destruction, a pooling of
white blood cells, and scarring of thyroid tissue. The thyroid cells are
slightly larger, while thyroglobulin—the usually present reservoir of thy-
roid hormones and raw materials for hormone production—is signifi-
cantly shrunken.
Ultrasound of the thyroid usually shows an enlarged gland with normal
texture and a characteristic picture with a low reflection of the ultrasound
waves (low echogenicity), which means the tissue has become less solid and
more rubbery. These changes are seen on the entire lobe or gland.^14
Symptoms of Hashimoto’s
People with Hashimoto’s may experience both hypothyroid and hyper-
thyroid symptoms because as the thyroid cells are destroyed, stored hor-
mones are released into the circulation, causing a toxic level of thyroid
hormone in the body—also known as thyrotoxicosis or Hashitoxicosis.
Eventually, the stored thyroid hormones may become depleted. Due to
thyroid cell damage, the person may no longer be able to produce suf-
ficient hormones. At this time, hypothyroidism develops.