Encephalopathy caused by Hashimoto's disease: Symptoms, origins, and details
Hashimoto's Thyroiditis (HT) is an autoimmune disorder that affects the thyroid gland, leading to hypothyroidism. Symptoms of HT are largely related to thyroid hormone deficiency and immune dysfunction. Hashimoto Encephalopathy, a rare neurological condition, is associated with HT and is characterised by neuropsychiatric symptoms.
Common Symptoms of Hashimoto's Thyroiditis
Symptoms of Hashimoto's Thyroiditis typically develop over time as thyroid gland damage accumulates and hypothyroidism ensues. Early symptoms may be vague or fluctuate. Classic hypothyroid symptoms include extreme fatigue or exhaustion, moderate weight gain, hair loss, mood changes, menstrual irregularities, chronic muscular and joint pain, constipation, and gastrointestinal issues.
Causes of Hashimoto's Thyroiditis
Hashimoto's Thyroiditis is caused by an autoimmune reaction where the body produces antibodies that attack thyroid tissue. The exact cause remains unclear but involves genetic susceptibility and environmental factors such as prolonged stress, infections, and excessive iodine intake. Low vitamin D levels are frequently observed in HT and may contribute to immune dysregulation.
Treatment for Hashimoto's Thyroiditis
The cornerstone treatment for Hashimoto's Thyroiditis is thyroid hormone replacement therapy, often with levothyroxine, to normalize hormone levels and offset hypothyroidism. Adjusting therapy may involve combining levothyroxine and liothyronine therapy in some cases with persistent symptoms despite normal labs. Adjunct therapies to modulate the autoimmune response include selenium and vitamin D supplementation, dietary changes, optimizing gastrointestinal health, and emerging treatments like low-dose naltrexone. In very refractory cases, total thyroidectomy may be considered.
Hashimoto Encephalopathy
Hashimoto Encephalopathy is a rare, likely immune-mediated neurological condition associated with Hashimoto Thyroiditis. It is characterized by neuropsychiatric symptoms such as seizures, confusion, personality changes, hallucinations or delusions, schizophrenia, depression, cognitive impairment, and stroke-like episodes.
Doctors may use MRI scans, blood tests, and electroencephalogram (EEG) recordings to help diagnose Hashimoto Encephalopathy. They may first rule out dementia, Alzheimer's disease, Creutzfeldt-Jakob disease, stroke, and other neurological disorders before diagnosing Hashimoto Encephalopathy.
There is no cure for Hashimoto Encephalopathy, but treatment can help reduce its effects. Treatment typically involves a combination of medications such as anti-seizure drugs to reduce inflammation and manage symptoms. Doctors may recommend corticosteroids such as prednisone and methylprednisolone to reduce inflammation in the brain. In some cases, immunosuppressants like cyclophosphamide, azathioprine, and mycophenolate mofetil may be used. In IVIG therapy, a person receives large doses of antibodies from donor blood to target immune cells causing inflammation in the brain. Plasma exchange, where a doctor removes some of the person's blood, separates the red blood cells, and replaces the missing component with healthy donor plasma to reduce antithyroid antibody levels in the body, may also be used.
With proper treatment, a person with Hashimoto Encephalopathy can expect a typical life expectancy. Hashimoto Encephalopathy affects fewer than 1,000 people in the United States or 2.1 per 100,000 individuals. Following initial treatment, Hashimoto Encephalopathy frequently lapses into remission, and only 16% of participants had one or more relapses in a review. The exact cause of Hashimoto Encephalopathy is not known, but it may be due to an atypical immune system response to an infection or other trigger. Hashimoto Encephalopathy affects females more frequently than males and can affect children, but less frequently. Blood tests can detect antithyroid antibodies in individuals with Hashimoto Encephalopathy, but these antibodies are fairly common in the general population.
Hashimoto'sThyroiditis can result in mental health issues due to its neurological associations, such as Hashimoto Encephalopathy, which is characterized by neuropsychiatric symptoms. The treatment for Hashimoto's Thyroiditis often includes supplementation of vitamins D and selenium, aimed at modulating the immune system. Moreover, maintaining health-and-wellness through dietary changes and optimizing gastrointestinal health can also be beneficial for managing this autoimmune disorder and any associated medical-conditions.
