January is Thyroid Awareness Month and today we’re looking at the most common thyroid disease in the United States—Hashimoto's disease (a.k.a., Hashimoto’s thyroiditis, autoimmune thyroiditis or chronic lymphocytic thyroiditis). It is an autoimmune disorder in which the immune system damages cells in the thyroid gland and prevents it from producing enough thyroid hormone, which helps regulate metabolism, heartbeat, body temperature and other essential functions.
Hashimoto’s disease tends to run in families and often leads to hypothyroidism, a condition which causes fatigue, drowsiness, forgetfulness, weight gain, sore muscles, painful and stiff joints, constipation, a puffy face, dry skin and hair, depression and other symptoms.
Dr. Laurence Altshuler, an internist at our Tulsa hospital, says it is common for people who have papillary thyroid cancer to also have Hashimoto's disease.
“When thyroid cancers are removed at the time of surgery, the cellular changes of Hashimoto’s disease is often seen surrounding the thyroid cancer,” he notes.
It can take a number of years for symptoms of Hashimoto’s disease to become noticeable. Doctors make the diagnosis when their patients have an enlarged thyroid gland, symptoms of hypothyroidism and abnormal blood tests, including a TSH test and T4 test.
According to the American Association of Clinical Endocrinologists, Hashimoto's disease affects more than 10 million Americans and women are about seven times more likely than men to have the disease. Yet a recent study in the publication Otolaryngology-Head and Neck Surgery says women who have Hashimoto’s disease that develop papillary thyroid cancer may have an improved prognosis.
“Hashimoto's patients, especially women, may need regular screening and examinations for papillary thyroid cancer,” says Dr. Altshuler. “Patients with either or both conditions need to be on thyroid replacement medication for life, so they need a physician experienced in managing thyroid conditions. This impacts quality of life since it’s important to provide the specific dose and type of medication to eliminate symptoms of hypothyroidism.”
Dr. Altshuler says papillary thyroid cancer is typically responsive to treatment in the hands of good management. He recommends patients work with a team of doctors, including a head/neck surgeon, internist or endocrinologist, and a radiologist or radiation oncologist (certified in thyroid ablation). He also advises patients who need surgery (i.e., a thyroidectomy) to seek out an oncologic surgeon or a head and neck surgeon who specializes in thyroid surgery.
Learn more about thyroid cancer and treatment options.