Hashimoto’s Thyroiditis is an “auto-immune” disease of the thyroid similar in many ways to Rheumatoid Arthritis. Essentially, an immune reaction occurs within one’s body that allows antibodies to be produced against the patient’s own thyroid gland. This causes an inflammatory reaction within the thyroid. Although initially, there may be transient hyperthyroidism (due to release of thyroid hormone stored within the thyroid gland), over time the patient develops hypothyroidism as the inflammation leads to progressive destruction and scarring of the thyroid gland. This usually results in the need for the patient to take thyroid hormone orally for many years if not for life.
Not all cases of Hashimoto’s Thyroiditis follow this pathway and the course can be extremely variable. Some patients have enlarged, and others normal or small scarred thyroid glands with this disease. As inflammation and scarring occur within the gland, some patients experience discomfort such as a tightening around the lower neck, difficulty swallowing or compressive symptoms when they lie down. Interestingly, about 1/3 of patients found to have thyroid cancer will also have some element of thyroiditis. That does not mean that if you have thyroiditis that you will develop thyroid cancer. However, the relationship does deserve special scrutiny by your thyroid specialist. Surgery is rarely necessary with Hashimoto’s Thyroiditis, unless thyroid cancer or enlarging nodules are found associated with it.