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Health

Treatment of autoimmune thyroiditis

, medical expert
Last reviewed: 23.04.2024
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Since this form of chronic inflammation of the thyroid gland is the result of the pathological reaction of the human immune system, the currently practiced treatment of autoimmune thyroiditis can not restore the damaged iron ability to function normally and synthesize hormones necessary for the body and is aimed at compensating these hormones and fighting the symptoms of the disease.

Iodine in autoimmune thyroiditis

Autoimmune thyroiditis occurs regardless of the consumption of iodine, which, as is known in the body, is not produced. Most doctors believe that iodine in autoimmune thyroiditis (Hashimoto's hypothyroidism) intensifies manifestations of pathology. This opinion is partially confirmed by the more frequent manifestation of this disease in populations with increased iodine intake.

In addition, it is iodine that stimulates the synthesis and activity of the thyroid peroxidase enzyme thyroperoxidase (TPO), necessary for the production of thyroid hormones. And this enzyme is the target of an autoimmune attack in patients with autoimmune thyroiditis.

As the clinical practice shows, the proportion of those on whom the iodide potassium drug Jodomarin in the autoimmune thyroiditis acts negatively, significant. The main indications for using this medication are not the treatment of autoimmune thyroiditis, but the prevention of iodine deficiency in the body, as well as endemic, diffuse non-toxic or euthyroid goiter.

Containing potassium iodide and folic acid bioadditives Iodophil in autoimmune thyroiditis is also not prescribed; it is designed to prevent shortages of iodine and folic acid, including during pregnancy.

Scientific studies of the last decade found that, firstly, a sharp increase in iodine content in the body can cause reactive hypothyroidism. And secondly, that intolerance to high iodine content is associated with a deficiency of a trace element, such as selenium, and iodine acts synergistically with selenium. Therefore, a balanced intake of these elements is necessary: 50 μg of iodine and 55-100 μg of selenium per day.

Especially important is selenium in autoimmune thyroiditis induced by iodine: the results of numerous studies have shown a significant decrease in serum antibodies to thyroglobulin TgAb after administration of preparations containing selenium (at an average daily dose of 200 μg).

Medicamentous treatment of autoimmune thyroiditis

As a result of autoimmune inflammation of the thyroid gland, the production of thyroid hormones decreases and hypothyroidism occurs, therefore, drugs replacing the missing hormones are used. This treatment is called hormone replacement therapy, and it is life-long.

The main thyroid hormone thyroxine in autoimmune thyroiditis is practically not produced, and endocrinologists prescribe the drug Levothyroxine, L-thyroxine or L-thyroxine in autoimmune thyroiditis. The drug acts similarly to endogenous thyroxin and performs in the patient's body the same functions for regulating oxidative reactions and metabolism of basic substances, the work of the cardiovascular and nervous system. Dosage is determined individually - depending on the level of thyroid hormones in the blood plasma and taking into account the patient's body weight (0, 00014-0.00017 mg per kilogram); tablets are taken once a day (in the morning, half an hour before meals). The drug Eutiroks with autoimmune thyroiditis, as well as Eferox are just other trade names of Levothyroxine.

Since the development of protective antibodies against tissues of the thyroid gland in this pathology is increased, no immunomodulators with autoimmune thyroiditis - due to their inefficiency and uselessness - are not used. For this reason, the immunomodulatory anti-inflammatory drug Erbisol with autoimmune thyroiditis is not necessary.

Whether appoint or nominate a corticosteroid preparation Diprospan at an autoimmune thyroiditis? This drug has immunosuppressive, anti-allergic, anti-inflammatory and anti-shock properties that help when subacute or amiodarone-associated thyroiditis joins autoimmune thyroiditis, as well as the development of giant goiter or mucinous edema. However, all endocrinologists recognized the ineffectiveness of corticosteroids in standard therapy of thyroiditis Hashimoto - due to the ability of drugs of this group to aggravate hypothyroidism, in particular, to block the production of thyroid-stimulating hormone synthesized by the pituitary (TSH). In addition, significant doses of corticosteroids reduce the conversion of thyroxine (T4) to triiodothyronine (T3).

The next question on drugs: Wobenzym and autoimmune thyroiditis. In the list of indications for the use of Wobenzym - an enzyme preparation containing enzymes of animal and plant origin - along with other immune pathologies, autoimmune thyroiditis is indicated. In the official instruction to the preparation, the ability of a complex of enzymes to affect the immunological reactions of the organism and reduce the accumulation of antibodies in the affected tissues was noted. Domestic specialists appoint Wobenzym, but the American Food and Drug Administration does not consider this drug a medicine.

Also, endocrinologists recommend taking vitamins for autoimmune thyroiditis in the form of various multivitamin complexes, including those containing trace elements, especially selenium (see the section Iodine in autoimmune thyroiditis) and necessarily - vitamins B12 and D. As a vitamin, you can use rosehips for autoimmune thyroiditis - in the form of infusion.

Biologically active complex with folic acid, vitamins C, E, group B and iodine - Femibion with autoimmune thyroiditis is not prescribed, but is recommended for pregnant women for normal fetal development.

Antibacterial drug Metronidazole with autoimmune thyroiditis in the usual medical practice is not used, it is prescribed only with inflammation of the thyroid gland of a bacterial nature.

For the treatment of thyroiditis Hashimoto, homeopathy offers an antihomotoxic agent for injection and oral administration of Thyreoidea Compositum, consisting of 25 ingredients, including folate, iodine compounds, purgative extracts, cesspool, hemlock, bed-rock, mistletoe, etc.

According to the instructions, this homeopathic preparation activates immunity and improves thyroid function, and it is recommended to prescribe it for thyroid dysfunction and autoimmune thyroiditis.

Among the side effects noted exacerbation of existing hyperthyroidism, lowering blood pressure and body temperature, convulsions, an increase in lymph nodes, etc.

It should be borne in mind that surgical treatment of autoimmune thyroiditis - by thyroidectomy (removal of the thyroid gland) - can be used when the size of the gland rapidly increases or large nodes appear. Or when hypertrophic autoimmune thyroiditis is diagnosed in patients, causing compression of the larynx, trachea, esophagus, vessels or nerve trunks located in the upper mediastinum.

Alternative treatment of autoimmune thyroiditis

Genetically caused immune system failure makes the alternative treatment of autoimmune thyroiditis applicable, mainly as an aid to alleviating some of the symptoms of the disease (hair loss, constipation, joint and muscle pain, high cholesterol, etc.).

However, herbal treatment can be useful for stabilizing the thyroid gland. So, it is recommended to use the plant crawfish from autoimmune thyroiditis. There are many useful compounds in the roots of Potentilla alba (Potentilla alba), but for the thyroid gland the main medicinal qualities are the presence of iodine and selenium. From dried and crushed roots, you need to prepare an infusion: in the evening, a tablespoon of raw material is poured into the thermos, poured into 240 ml of steep boiling water and infused overnight (not less than 8-9 hours). During the week, take infusion in a day - 80 ml three times a day.

Alternative treatment of autoimmune thyroiditis with celandine (alcohol tincture) from the biochemical and pharmacodynamic point of view is not justified; moreover, the chelatedonine alkaloids and sanguinarine contained in this plant are poisonous. And the expediency of using blue-green algae (dried cyanobacterium Arthrospira) in the form of biologically active Spirulina in autoimmune thyroiditis has not been studied.

There are recipes in which "sea kale" and autoimmune thyroiditis are "combined". For example, some advise drinking a decoction of a mixture of kelp, plantain and kidney pine; others - must include in the diet of iodine-rich sea kale. Neither one nor the other do not need. Why, see above - section Iodine in autoimmune thyroiditis. And in South-East Asia, the widespread consumption of marine algae in large quantities often ends with thyroid cancer: this is the effect of this compound on laminar accumulation of arsenic, mercury and radioactive iodine.

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Physiotherapy with autoimmune thyroiditis

At once it is necessary to specify: physiotherapy at an autoimmune thyroiditis will not restore the destroyed cells shchitovidki and will not adjust a synthesis of thyroid hormones. Apply electrophoresis and massage with autoimmune thyroiditis is possible only to reduce the intensity of myalgia or arthralgia, that is, symptoms.

Ozone therapy with autoimmune thyroiditis is not applied, but oxygenation - to improve blood supply to organs and combat oxygen starvation of tissues - is prescribed quite often.

Most endocrinologists cleanse the blood, that is, therapeutic plasmapheresis in autoimmune thyroiditis is recognized as useless, since it does not affect the cause of the pathology, and autoantibodies in the blood after the procedure reappear.

By the way, about cosmetic procedures. Neither injections of hyaluronic acid, nor injections of silicone, nor botox with autoimmune thyroiditis are unacceptable.

As for physical therapy, light aerobics are most suitable for maintaining mobility of the musculoskeletal system, as well as treatment of autoimmune thyroiditis with yoga - breathing exercises for training the diaphragm and pectoral muscles and feasible exercises to strengthen the muscular corset.

The way of life in autoimmune thyroiditis

In general, as you already understood, habitual for a healthy lifestyle with autoimmune thyroiditis varies somewhat ...

As the apparent symptoms of Hashimoto's hypothyroidism, such as weakness, joint and muscle pains, cardiac disruptions, blood pressure instability, the question of whether it is possible to play sports, do not arise anyway, especially since doctors in this condition advise patients to exercise physical activity to minimize . Some doctors say that for people who have serious thyroid dysfunctions and an irresistible feeling of fatigue, it is better to give up muscle loads altogether for a while. In addition, the violation of metabolic processes in the body can be accompanied by increased traumatism - dislocations, sprains and even fractures.

Limitations in autoimmune thyroiditis can affect the sphere of intimate relationships, as there is often a persistent decline in libido.

Important questions for patients - sun and autoimmune thyroiditis, as well as

Sea and autoimmune thyroiditis - the specialists give the following recommendations:

  • Ultraviolet irradiation for any problems with the thyroid gland should be minimal (no lying on the beach);
  • seawater, rich in iodine, can harm if the level of thyrotropic hormone (TSH) in the blood is elevated, so only your doctor (after passing the appropriate analysis) can give a specific answer to this question. Also keep in mind that you can not swim longer than 10 minutes and at the hottest time of the day, and after sea bathing you should immediately take a fresh shower.

Diet and nutrition with autoimmune thyroiditis

To manage the disease, diet and nutrition with autoimmune thyroiditis are of paramount importance.

First, a violation of the total metabolism requires a slight reduction in the calorie of the daily diet - see Diet in case of thyroid disease.

This is the answer to the question of how to lose weight with autoimmune thyroiditis: in fact, despite weight gain, no diet for weight loss with this disease can not be adhered to - in order to avoid deterioration.

But the main question - what can not be eaten with autoimmune thyroiditis?

Experts of the Journal of Clinical Endocrinology and Metabolism (USA) advise:

  • Stay away from sugar and caffeine, since both products can raise the production of adrenaline and cortisol (stress hormones), and this will negatively affect the functioning of the thyroid gland.
  • To stop the growth of goiter, it is necessary to exclude the "striogenic factor" - to minimize or even stop using the inhibitory movement of iodine ions in the thyroid gland goitrogens (goitrogens) contained in cruciferous vegetables, that is, in all cabbage, swede and radish - fresh form. Thermal cooking inactivates these compounds.
  • For the same reason, reduce the consumption of soy and soy products, peanuts, millet, horseradish, flaxseed, spinach, pears, strawberries and peaches.
  • With celiac disease, gluten (gluten) - vegetable proteins of cereals: wheat, rye, oats and barley - should be discarded. The molecular structure of gluten is almost identical to the molecular structure of the thyroid tissue, which provokes the production of antibodies.

But what should include a diet for autoimmune thyroiditis:

  • animal protein (helps to increase the production of endogenous thyroxine and triiodothyronine);
  • carbohydrates (without them will increase memory loss, hair loss and cold allergy);
  • healthy fats (fatty unsaturated acids) - vegetable oil, fish oil, liver, bone marrow, egg yolks;
  • selenium (55-100 μg per day, found in walnuts, cashew, sea fish, pork, lamb, chicken and turkey fillet, asparagus, white mushrooms and shiitake, brown rice, etc.)
  • Zinc (11 mg per day, is contained in beef, sunflower seeds and pumpkin, beans and lentils, mushrooms, buckwheat, walnuts, garlic).

As the leading experts of the American Association of Clinical Endocrinology (AACE) say, autoimmune thyroiditis is more than just a disease of the thyroid gland. Therefore, the treatment of autoimmune thyroiditis is more than a medical problem.

trusted-source[5], [6]

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