iThei mdcdaelcinfd o c elllllrlllll tThe hlcinfd olsbdkpvouvComplications
One quarter of patients experience physical symptoms such as chest pain
or joint pain. Hypothyroidism also puts people at an increased risk of
heart disease.
Hashimoto’s patients are three times more likely to develop thyroid can-
cer compared to people without the condition.
Pregnancy
Sadly, women with positive TPO antibodies have an increased risk of
miscarriage, and women who have an underactive thyroid during preg-
nancy are at risk of delivering an intellectually disabled child.16,17,18
Thyroid screening is not a routine test performed until later in life, so
many women don’t discover they have Hashimoto’s until they have expe-
rienced recurrent miscarriages.
Remission of Hashimoto’s with loss of goiter, hypothyroidism, and se-
rum antibodies has been reported in pregnancy, with a relapse after
delivery. Usually, the antibodies decrease during pregnancy. Pregnancy
has also been identified as a trigger for Hashimoto’s and can cause a
condition known as postpartum thyroiditis, which is self-limiting in 80
percent of cases but develops into Hashimoto’s in 20 percent of cases.
Risk Factors
There is a genetic predisposition to developing Hashimoto’s, and the con-
dition tends to run in families. Thus, relatives of those with Hashimoto’s
are at risk. Hashimoto’s thyroiditis can occur in two varieties: 1) an organ
wasting form (atrophic) associated with HLA-DR3 gene inheritance and
2) enlarged thyroid (goiterous form) through HLA-DR5 inheritance.
These genes are common in the Caucasian population.
Well-established environmental triggers for developing Hashimoto’s in
those who are genetically predisposed include iodine intake, bacterial and
viral infections, hormonal imbalances, toxins, and therapy with certain
types of medications. Cigarette smoking, surprisingly, has been associated
with a reduced risk of Hashimoto’s.
In people with Hashimoto’s, only 50 percent of their identical twins pre-
sented with thyroid antibodies, meaning genes alone are not the single
defining factor and environmental triggers play a critical role.^1