There is no role for surgery to treat prostate & # 39; Hashimoto & # 39; s thyroiditis & # 39;? – Harvard Medical Letters


& # 39; autoimmune & # 39; occurs when the immune system attacks its cells, mistakenly feeling they are foreign. When the body attacks the thyroid gland, it is called Hashimoto & # 39; s thyroiditis, named after Japanese doctors. Haruko Hashimoto, who first described the disease in 1912. The condition is also known as & # 39; lymphocytic thyroiditis or autoimmune thyroiditis & # 39 ;.

Hashimoto thyroid disease is the most common cause of hypothyroidism in the world. It is also the most common autoimmune disorder in humans. It occurs in males and females as well as small and large. But it is more common in women, is more likely to occur in the age group, and is more common in those with a family history of thyroid disease or another autoimmune disease.

Hashimoto & # 39; s thyroiditis and hypothyroidism

Thyroid & # 39; thyroid & # 39; it is part of the endocrine system. It regulates many important functions in the body, affecting the level of every cell, tissue, and organ in your body – from your muscles, bones, and skin to your digestive tract, brain, and your heart – their work. It does this primarily by secreting the hormones that regulate how quickly and in which cells convert energy nutrients – a chemical activity called metabolism.

Your doctor may be suspicious of Hashimoto & # 39; s thyroiditis if you have low thyroid hormone levels, thyroid gland, or, in some cases, recurrent misdiagnosis. Diagnosis is usually confirmed by blood tests that look for cells in the thyroid gland.

Over time, Hashimoto's thyroid disease can cause damage to the thyroid gland that causes hypothyroidism (thyroid hormone insufficient to meet the body's needs). Hypothyroidism can cause various symptoms related to metabolism. Symptoms include fatigue, cold tolerance, loss of appetite, weight loss, depression, dry skin, hair loss, constipation, heavy menstruation, and high cholesterol.

Hypothyroidism is not the only problem associated with Hashimoto's thyroid disease. For some, the condition can be caused by goiter. The bigger the strap, the more likely it is to see. Goiter, especially large, can also cause symptoms such as difficulty swallowing. When this occurs, surgery may be necessary to remove all or part of the goiter.

Routine treatment of Hashimoto & # 39; s thyroiditis

Once diagnosed, the disease is known as & # 39; Hashimoto & # 39; s thyroiditis & # 39; it is usually treated by observation alone. In the event of hypothyroidism that develops (even in mild cases of pregnancy), it is treated with thyroid hormone (thyroid hormone combination).

The study explores the potential role of surgery

In 2019, a well-designed, randomized trial was performed at Telemark Hospital in Norway compared with the benefits of thyroiditis in patients with Hashimoto & # 39; s thyroiditis in thyroid cancer alone.

Participants in the study were between 18 and 79 years old, had antibiotic levels that were sensitive to at least 10 or more above normal limits, and were treated with thyroid medication. Although they have normal thyroid hormone levels (most likely with thyroid medication), the study participants reported symptoms that interfered with their lifestyle parameters including fatigue, physical and social functioning, resilience, and emotions. and mental health, and physical pain.

Of the 147 enrollees who completed the 18-month study, 73 underwent surgery. Those who do not continue with the surgery are only treated with medication.

The results of those who performed the surgery were incredible. Antibody levels decreased as usual. The quality of life has improved. Fatigue has improved since compared with ordinary Norwegians.

Expect hope, but more research is needed

This study raises the possibility of a surgical role for patients with & # 39; Hashimoto & # 39; s thyroid & # 39; who continue to feel poorly despite good treatment with thyroid hormone.

However, the study, while well-conducted, is scarce. We need long-term follow-up and verification with more studies in different populations.

It is also important to consider that thyroid surgery in patients with thyroid disease & # 39; Hashimoto & # 39; s thyroiditis & # 39; it's difficult. Problems levels, including damage to nerve roots (which control voice) and lymph nodes & # 39; parathyroid & # 39; (which maintains normal calcium levels), is increased. What is more, when the tube is removed, the body will not be able to make thyroid hormone, and the patient should take thyroid medication for the rest of their lives.

Therefore, until further confirmation studies are performed, surgery for patients with prostate cancer & # 39; Hashimoto & # 39; should only be considered when thyroid enlargement causes symptoms such as difficulty in swallowing.

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