General overview of the Risk factors, Pathogenesis, and Combined treatments for Hashimoto's Thyroiditis (HT)

  • Yash Srivastav Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.
  • Akhandnath Prajapati Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.
  • Meera Kumari Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.
  • Madhaw Kumar Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.

Abstract

In regions of the world where iodine is abundant, Hashimoto's thyroiditis, also known as Hashimoto's disease or autoimmune thyroiditis, is the most prevalent cause of hypothyroidism. It is a chronic inflammation of the thyroid gland. It is characterized by autoimmune-mediated thyroid gland destruction, which results in progressive thyroid failure, either with or without goiter formation. In young to middle-aged women, Hashimoto's thyroiditis typically starts as a painless, diffuse, firm thyroid gland enlargement that progresses to hypothyroidism. Many people don't initially exhibit hypothyroidism, and some don't even have a goiter or may have an atrophic thyroid gland. Hashimoto's thyroiditis (HT), also known as chronic autoimmune thyroiditis, is an inflammatory condition that is characterized by parenchymal atrophy, fibrosis, and diffuse lymphocytic infiltration. being the main source of primary hypothyroidism in regions with adequate iodine. With the help of various criteria, such as physical examination, blood tests for thyroid hormone levels (TSH is low, T3 and T4 are tall, for example), serum cholesterol and triglycerides, blood glucose, and radioactive iodine uptake, it is possible to distinguish between infections and clutter. According to estimates from several thyroid disease studies, 42 million persons in India are estimated to have the ailment. The pathogenesis causes, risk factors and combination therapy linked to Hashimoto's thyroiditis are discussed in this review study.

Keywords: Hashimoto's thyroiditis, Etiology, Epidemiology, Risk factors, Signs and Symptoms, Pathophysiology, Treatments

Downloads

Download data is not yet available.

Author Biographies

Yash Srivastav, Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.

Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.

Akhandnath Prajapati, Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.

Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.

Meera Kumari, Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.

Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.

Madhaw Kumar, Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.

Goel Institute of Pharmacy & Sciences (GIPS), Lucknow, Uttar Pradesh, India.

References

Invernizzi P, Gershwin ME. The genetics of human autoimmune disease. J Autoimmun [Internet]. 2009;33(3–4):290–9. Available from: http://dx.doi.org/10.1016/j.jaut.2009.07.008
2. Kawicka A, Regulska-Ilow B. Metabolic disorders and nutritional status in autoimmune thyroid diseases. Postepy Hig Med Dosw. 2015;69:80–90.
3. Borah K, Tiwari A, Chandrul DKK. Review on Miracle of Herbals in Treatment and Regulation of Thyroid. Int J Trend Sci Res Dev. 2019;Volume-3(Issue-4):368–72.
4. Soon TK, Ting PW. Thyroid Diseases and Diet Control. J Nutr Disord Ther. 2018;08(01).
5. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, et al. Guidelines for the treatment of hypothyroidism: Prepared by the American thyroid association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670–751.
6. Samuchiwal SK. Autoimmune diseases : backfiring of an otherwise unerring defense. 2018;6(6):251–2.
7. Shoenfeld Y, Zandman-Goddard G, Stojanovich L, Cutolo M, Amital H, Levy Y, et al. The mosaic of autoimmunity: Hormonal and environmental factors involved in autoimmune diseases - 2008. Isr Med Assoc J. 2008;10(1):8–12.
8. Kahaly GJ, Grebe SKG, Lupo MA, McDonald N, Sipos JA. Graves’ disease: Diagnostic and therapeutic challenges (multimedia activity). Am J Med [Internet]. 2011;124(6):S2–3. Available from: http://dx.doi.org/10.1016/j.amjmed.2011.03.001
9. Merrill SJ, Mu Y. Thyroid autoimmunity as a window to autoimmunity: An explanation for sex differences in the prevalence of thyroid autoimmunity. J Theor Biol. 2015;375:95–100.
10. Bjoro T, Holmen J, Kruger O, Midthjell K, Hunstad K, Schreiner T, et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The health study of Nord-Trondelag (HUNT). Eur J Endocrinol. 2000;143(5):639–47.
11. Hashimoto H. Hashimotoâ s Thyroiditis. Epidemiology. 2016;(June 2014):1–4.
12. Pyzik A, Grywalska E, Matyjaszek-Matuszek B, Roliński J. Immune disorders in Hashimoto’s thyroiditis: What do we know so far? J Immunol Res. 2015;2015.
13. Schreiber FS, Ziob T, Vieth M, Elsbernd H. Atypische Sprue bei einem Patienten mit Diabetes mellitus Typ 1 und Hashimoto-Thyreoiditis. Dtsch Medizinische Wochenschrift. 2011;136(3):82–5.
14. Rugge JB, Bougatsos C, Chou R. Screening and treatment of thyroid dysfunction: An evidence review for the U.S. preventive services task force. Ann Intern Med. 2015;162(1):35–45.
15. Gianfranco TR, Camila AA, Pilar HJ, Alejandro DF, Daniela AS. Development of nephrotic syndrome in a patient with Hashimoto’s Thyroiditis. Andes Pediatr. 2022;93(4):574–8.
16. Brent, Gregory A., and Anthony P. Weetman. “Hypothyroidism and thyroiditis.” Williams textbook of endocrinology . Elsevier, 2016. 416-448. 2016;2016.
17. Kasagi K, Kousaka T, Higuchi K, Iida Y, Misaki T, Alam MS, et al. Clinical significance of measurements of antithyroid antibodies in the diagnosis of Hashimoto’s thyroiditis: Comparison with histological findings. Thyroid. 1996;6(5):445–50.
18. Bello F. Hypothyroidism in adults: A review and recent advances in management. J Diabetes Endocrinol. 2012;3(5):57–69.
19. Fisher DA, Oddie TH, Johnson DE, Nelson JC. The Diagnosis of Hashimoto’s Thyroiditis. 2015;(May).
20. Saikia UK, Saikia M. Drug-induced thyroid disorders. J Indian Med Assoc [Internet]. 2006 Oct;104(10):583, 585—7, 600. Available from: http://europepmc.org/abstract/MED/17380824
21. Tagoe CE, Sheth T, Golub E, Sorensen K. Rheumatic associations of autoimmune thyroid disease: a systematic review. Clin Rheumatol. 2019;
22. Al-sofy RA, Hussein TA, Brakhas SA. Estimation of Free T3 , free T4 and TSH Levels in a Sample of Iraqi Autoimmune Urticarial Patients. 2022;21(2):688–92.
23. Mori K, Yoshida K. Viral infection in induction of Hashimoto’s thyroiditis: A key player or just a bystander? Curr Opin Endocrinol Diabetes Obes. 2010;17(5):418–24.
24. Wiersinga WM. Clinical relevance of environmental factors in the pathogenesis of autoimmune thyroid disease. Endocrinol Metab. 2016;31(2):213–22.
25. Eschler DC, Hasham A, Tomer Y. Cutting edge: The etiology of autoimmune thyroid diseases. Clin Rev Allergy Immunol. 2011;41(2):190–7.
26. Li D, Cai W, Gu R, Zhang Y, Zhang H, Tang K, et al. Th17 cell plays a role in the pathogenesis of Hashimoto’s thyroiditis in patients. Clin Immunol. 2013;149(3 PB):411–20.
27. Song H, Fang F, Tomasson G, Arnberg FK, Mataix-Cols D, De La Cruz LF, et al. Association of stress-related disorders with subsequent autoimmune disease. JAMA - J Am Med Assoc. 2018;319(23):2388–400.
28. Champion BR, Page KR, Parish N, Rayner DC, Dawe K, Biswas-Hughes G, et al. identification of a thyroxine-containing self-epitope of thyroglobulin which triggers thyroid autoreactive T cells. J Exp Med. 1991;174(2):363–70.
29. Amano T, Fujio H. Antigenic determinants of lysozyme. Tanpakushitsu Kakusan Koso. 1968;13(2):129–36.
30. Mikosch P, Aistleitner A, Oehrlein M, Trifina-Mikosch E. Hashimoto’s thyroiditis and coexisting disorders in correlation with HLA status—an overview. Wiener Medizinische Wochenschrift. 2023;173(1–2):41–53.
31. Brix TH, Hegedüs L, Gardas A, Banga JP, Nielsen CH. Monozygotic twin pairs discordant for Hashimoto’s thyroiditis share a high proportion of thyroid peroxidase autoantibodies to the immunodominant region A. Further evidence for genetic transmission of epitopic “fingerprints.” Autoimmunity. 2011;44(3):188–94.
32. Unnikrishnan A, Menon U. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. 2011;15(6):78.
33. Bagcchi S. Hypothyroidism in India: More to be done. Lancet Diabetes Endocrinol [Internet]. 2014;2(10):778. Available from: http://dx.doi.org/10.1016/S2213-8587(14)70208-6
34. Murphy ED, Roths JB. A y chromosome associated factor in strain bxsb producing accelerated autoimmunity and lymphoproliferation. Arthritis Rheum. 1979;22(11):1188–94.
35. Pierdominici M, Maselli A, Colasanti T, Giammarioli AM, Delunardo F, Vacirca D, et al. Estrogen receptor profiles in human peripheral blood lymphocytes. Immunol Lett [Internet]. 2010;132(1–2):79–85. Available from: http://dx.doi.org/10.1016/j.imlet.2010.06.003
36. CN, STEEM et al. "Gender Differences in Autoimmune Diseases.
37. Selmi C, Brunetta E, Raimondo MG, Meroni PL. The X chromosome and the sex ratio of autoimmunity. Autoimmun Rev [Internet]. 2012;11(6–7):A531–7. Available from: http://dx.doi.org/10.1016/j.autrev.2011.11.024
38. Shelly S, Boaz M, Orbach H. Prolactin and autoimmunity. Autoimmun Rev [Internet]. 2012;11(6–7). Available from: http://dx.doi.org/10.1016/j.autrev.2011.11.009
39. Tsatsoulis A. The role of stress in the clinical expression of thyroid autoimmunity. Ann N Y Acad Sci. 2006;1088:382–95.
40. Blum, Susan. The Immune System Recovery Plan: A Doctor’s 4-step Program to Treat Autoimmune Disease . Simon and Schuster, 2013. 2013;2013.
41. Becker KL, Ferguson RH, McConahey WM. The Connective-Tissue Diseases and Symptoms Associated with Hashimoto’s Thyroiditis. N Engl J Med [Internet]. 1963;268(6):277–80. Available from: https://doi.org/10.1056/NEJM196302072680601
42. Baker BA, Gharib H, Markowitz H. Correlation of thyroid antibodies and cytologic features in suspected autoimmune thyroid disease. Am J Med. 1983;74(6):941–4.
43. Neupane N, Kaur M, Prabhakar PK. Treatment of Hashimoto’s thyroiditis with herbal medication. Int J Green Pharm. 2017;11(3):S343–7.
44. Hall RCW, Popkin MK, Devaul R, Hall AK, Gardner ER, Beresford TP. Psychiatric manifestations of Hashimoto’s thyroiditis. Psychosomatics [Internet]. 1982;23(4):337–42. Available from: http://dx.doi.org/10.1016/S0033-3182(82)73397-3
45. Piechaczyk M, Pau B, Kazatchkineo MD. specificity of anti-thyroglobulin autoantibodies in. 1991;811–4.
46. Martin A, Davies TF. T cells and human autoimmune thyroid disease: Emerging data show lack of need to invoke suppressor T cell problems. Thyroid. 1992;2(3):247–61.
47. Giordano C, Richiusa P, Bagnasco M, Pizzolanti G, Di Blasi F, Sbriglia MS, et al. Differential regulation of Fas-mediated apoptosis in both thyrocyte and lymphocyte cellular compartments correlates with opposite phenotypic manifestations of autoimmune thyroid disease. Thyroid. 2001;11(3):233–44.
48. Lumachi F, Basso S. Apoptosis: Life through planned cellular death regulating mechanisms, control systems, and relations with thyroid diseases. Thyroid. 2002;12(1):27–34.
49. Lorini R, Gastaldi R, Traggiai C, Perucchin PP, Sack J, Laron Z. Hashimoto’s thyroiditis. Pediatr Endocrinol Rev. 2003;1(SUPLL. 2):205–11.
50. Kumar N, Ray C, Jain S. Aspiration cytology of Hashimoto’s thyroiditis in an endemic area. Cytopathology. 2002;13(1):31–9.
51. Yoshida H, Amino N, Yagawa K, Uemura K, Satoh M, Miyai K, et al. Association of serum antithyroid antibodies with lymphocytic infiltration of the thyroid gland: Studies of seventy autopsied cases. J Clin Endocrinol Metab. 1978;46(6):859–62.
52. Ren Y, Kyriazidis N, Faquin WC, Soylu S, Kamani D, Saade R, et al. The Presence of Hürthle Cells Does Not Increase the Risk of Malignancy in Most Bethesda Categories in Thyroid Fine-Needle Aspirates. Thyroid. 2020;30(3):425–31.
53. Cannon J. The Significance of Hürthle Cells in Thyroid Disease. Oncologist. 2011;16(10):1380–7.
54. Iodine R. Radioactive Iodine Uptake in Hashimoto ’ s Thyroiditis. 2015;
55. Parvathaneni, Arvin, Daniel Fischman, and Pramil Cheriyath. “Hashimoto’s thyroiditis.” A New Look at Hypothyroidism . IntechOpen, 2012. 2012;2012.
56. Li Y, Bai Y, Liu Z, Ozaki T, Taniguchi E, Mori I, et al. Immunohistochemistry of IgG4 can help subclassify Hashimoto’s autoimmune thyroiditis. Pathol Int. 2009;59(9):636–41.
57. Mizokami T, Li AW, El-Kaissi S, Wall JR. Stress and thyroid autoimmunity. Thyroid. 2004;14(12):1047–55.
58. Ds C. Antithyroid drugs.
59. Moon JH, Yi KH. The Diagnosis and Management of Hyperthyroidism in Korea: Consensus Report of the Korean Thyroid Association. Endocrinol Metab. 2013;28(4):275.
60. Intidhar LS, Chaabouni AM, Kralem T, Attia N, Gritli S, et al. (2006) Нyroid carcinoma and Hashimoto thyroiditis. Ann Otolaryngol Chir Cerviofac 123: 175-178. 2006;2006.
61. Baron-Faust, R BJ. Нe autoimmune connection. New York McGraw-Hill.
62. Nazarpour S, Ramezani Tehrani F, Simbar M, Azizi F. Thyroid autoantibodies and the effect on pregnancy outcomes. J Obstet Gynaecol (Lahore) [Internet]. 2016;36(1):3–9. Available from: http://dx.doi.org/10.3109/01443615.2014.968110
63. Myers DA. The Autoimmune Solution: Prevent and Reverse the Full Spectrum of Inflammatory Symptoms and Diseases. 2015;400. Available from: https://books.google.com/books/about/The_Autoimmune_Solution.html?id=OvAYBAAAQBAJ&pgis=1
64. Vita R, Saraceno G, Trimarchi F, Benvenga S. A novel formulation of l-thyroxine (l-T4) reduces the problem of l-T4 malabsorption by coffee observed with traditional tablet formulations. Endocrine. 2013;43(1):154–60.
65. Colucci P, Yue CS, Ducharme M, Benvenga S. A review of the pharmacokinetics of levothyroxine for the treatment of hypothyroidism. Eur Endocrinol. 2013;9(1):40–7.
66. Samuchiwal, S. K. “Autoimmune disease: backfiring of an otherwise unerring defence.” MOJ Autoimmune Disease 2.00008 (2017). 2017;00008:2017.
67. Ballantyne, Sarah. The Paleo approach: reverse autoimmune disease and heal your body . Victory Belt Publishing, 2014. 2014;2014.
68. Jabri B, Kasarda DD, Green PHR. Innate and adaptive immunity: The Yin and Yang of celiac disease. Immunol Rev. 2005;206:219–31.
69. Thomas CM, Versalovic J. Probiotics-host communication modulation of signaling pathways in the intestine. Gut Microbes. 2010;1(3):1–16.
70. Lee BJ, Bak YT. Irritable bowel syndrome, gut microbiota and probiotics. J Neurogastroenterol Motil. 2011;17(3):252–66.
71. Pflughoeі K, Versalovic J (2012) Human microbiome in health and disease. Annual Reviews Pathology 7: 99-122. 2012;2012.
72. Fasano A. Leaky gut and autoimmune diseases. Clin Rev Allergy Immunol. 2012;42(1):71–8.
73. Bron PA, Van Baarlen P, Kleerebezem M. Emerging molecular insights into the interaction between probiotics and the host intestinal mucosa. Nat Rev Microbiol [Internet]. 2012;10(1):66–78. Available from: http://dx.doi.org/10.1038/nrmicro2690
74. IJsselmuiden CB, Faden RR. The New England Journal of Medicine Downloaded from nejm.org on January 31, 2011. For personal use only. No other uses without permission. Copyright © 1992 Massachusetts Medical Society. All rights reserved. 1992;326.
75. Stansbury J, Saunders P, Winston D. Promoting Healthy Thyroid Function with Iodine, Bladderwrack, Guggul and Iris. J Restor Med. 2013;1(1):83–90.
76. Wu J, Xia C, Meier J, Li S, Hu X, Lala DS. The hypolipidemic natural product guggulsterone acts as an antagonist of the bile acid receptor. Mol Endocrinol. 2002;16(7):1590–7.
77. Panda S, Kar A. Gugulu (Commiphora mukul) induces triiodothyronine production: Possible involvement of lipid peroxidation. Life Sci. 1999;65(12):137–41.
78. Develhar, M., Y. H. Ousman and KDB. “Hypothyroism.” Endocrinol Metab Clin North Am 363 595-615. 2007;вы12у(235):245.
79. Noge K, Becerra JX. Germacrene D, A common sesquiterpene in the genus Bursera (Burseraceae). Molecules. 2009;14(12):5289–97.
80. Yan X, Chuda Y, Suzuki M, Nagata T. Fucoxanthin as the major antioxidant in hijikia fusiformis, a common edible seaweed. Biosci Biotechnol Biochem. 1999;63(3):605–7.
81. Jiménez-Escrig A, Jiménez-Jiménez I, Pulido R, Saura-Calixto F. Antioxidant activity of fresh and processed edible seaweeds. J Sci Food Agric. 2001;81(5):530–4.
82. Tripathi, Yamini B., O. P. Malhotra and SNT. “Thyroid stimulating action of Z-guggulsterone obtained from Commiphora mukul.” Planta medica 5001 (1984): 78-80. 1984;13(3):576.
Published
18-09-2023
Statistics
245 Views | 137 Downloads
Citatons
How to Cite
Srivastav, Y., A. Prajapati, K. Meera, and K. Madhaw. “General Overview of the Risk Factors, Pathogenesis, and Combined Treatments for Hashimoto’s Thyroiditis (HT)”. World Journal of Current Medical and Pharmaceutical Research, Vol. 5, no. 5, Sept. 2023, pp. 175-89, doi:10.37022/wjcmpr.v5i5.290.
Section
Review Articles