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I have a question.

What difference does it make if an underactive thyroid is caused by an autoimune disease? Does it get treated diferently? Does it indicate that it could be caused by Lupus?

Just wondering, bit confused as I have an underacitve thyroid but never asked why.
Diagnosed Discoid Lupus by dermo. awaiting apointment with rhumatologist.

Thanks
 

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Good question Primrose and one which I have often asked myself :hehe: I also have hypothyroidism and, like you, never really asked if there was an underlying autoimmune cause for it.

You prompted me to do some research on this. Lets see if I have this right....

Hashimoto's is a disease and hypothyroidism is a condition. The disease of Hashimotos can lead to the individual developing hypothyroidism. It is the condition that must be treated.

Hashimoto's typically involves a slow but steady destruction of the gland that eventually results in the thyroid's inability to produce sufficient thyroid hormone -- the condition known as hypothyroidism.
Hypothyroidism is most commonly caused by Hashimotos but to determine if it is Hashimotos, a number of thyroid antibody tests are performed. According to the link which I found it is typically diagnosed by

Hashimoto's disease is typically diagnosed by clinical examination that demonstrates one or more of the following findings:
  • Enlargement of the thyroid, known as a goiter (not in everyone)
  • High levels of antibodies against thyroglobulin (TG) and thyroid peroxidase (TPO), detected via blood test
  • Fine needle aspiration of the thyroid (also known as a needle biopsy), which shows lymphocytes and macrophages
  • A radioactive uptake scan, which would show diffuse uptake in an enlarged thyroid gland
  • Ultrasound, which would show an enlarged thyroid gland
I have only ever had my thyroid function tested and this showed hypothyroidism for which I am medication. I've never had any of the other tests.

Except in the case of a goiter, most endocrinologists and conventional physicians will not treat Hashimoto's disease, as diagnosed by elevated antibody levels, unless other thyroid function tests such as TSH are outside the normal range.
I am unsure if there is an underlying autoimmune cause to my hypothyroidism but I guess the chances are high given my diagnosis of SLE. My TSH levels are outside normal range and I get my levels checked about twice a year to make sure they are okay. Even with medication they are still a little bit under what is considered normal so I may have to consider increasing my medication dosage. (And given the fact that I have been complaining of a sore throat (no evidence of infection) and a feeling of a lump in my throat for about eight weeks now I guess I should just go and get checked out!)

http://thyroid.about.com/cs/hypothyroidism/a/hashivshypo.htm

I would be interested if anyone had a more comprehensive (or even simpler:hehe:) explanation...

Cheers
Joan:rose:
 

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Wow! Great post Joan :)

I only knew that Hypothyroid was caused by the thyroid not producing enough hormones while Hyperthyroid was producing too much. Specifying that both are a condition but not a disease makes sense, I hadn't heard it put that way before. It also makes sense that these conditions can be caused by an autoimmune disease such as SLE, but can probably be unrelated as well. I do know it seems to be fairly common among us with SLE (Myself included) where Hashimoto's is thyroid specific.

That's just my 2 cents worth. All I really wanted to say was what a nice job you did on that post. :)
 

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Hi there,

I was diagnosed with an underactive thyroid years ago. That showed up in a routine blood test. I was then sent immediately to do the specific test that shows whether it is caused by hashimotos (which it was). The treatment is the same but the docs still say that it is important as a distinction, though I don't really know why. Maybe because it means that they will keep an eye out for any other auto-immune conditions.

Katharine
 

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Don't forget about the tests, T-4 and T-3.

If the thyroid gland does not produce sufficient T4 (due to thyroid dysfunction or to insufficient TSH), then the affected patient experiences symptoms of hypothyroidism such as weight gain, dry skin, cold intolerance, irregular menstruation, and fatigue. If the thyroid gland produces too much T4, the rate of the patient’s body functions will increase and cause symptoms associated with hyperthyroidism such as increased heart rate, anxiety, weight loss, difficulty sleeping, tremors in the hands, and puffiness around dry, irritated eyes.
My T-4 is on the low side and my doctor has been doing labs and raising my thyroid meds in hopes that it raises and I feel better.

The most common causes of thyroid dysfunction are autoimmune-related. Graves’ disease causes hyperthyroidism and Hashimoto’s thyroiditis causes hypothyroidism. Both hyper- and hypothyroidism can also be caused by thyroiditis (thyroid inflammation), thyroid cancer, and excessive or deficient production of TSH. The effect of these conditions on thyroid hormone production can be detected and monitored by measuring the total T4 (includes bound and free portion) or the free T4 (only unbound).
I never knew I was tested for it until my new doctor told me about it. He told me 3 years ago it was on the low side. He has tested it twice so far. I need to get back in there and get it retested again. (if this wonderful weather would let me)

http://www.labtestsonline.org/understanding/analytes/t4/sample.html

I hope this helps.
Take care,
Lyn
 

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Sorry I couldn't get this added. This is what T-4 is all about.

What is being tested?
This test measures the amount of thyroxine, or T4, in your blood. T4 is one of two major hormones produced by the thyroid gland (the other is called triiodothyronine, or T3). The thyroid is a small, butterfly-shaped gland located just below the Adam's apple. This gland plays a vital role in controlling the rate at which your body uses energy.
 
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