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Journalism of Courage
Recently actor Arjun Kapoor revealed his struggles with an autoimmune condition called Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, where the immune system mistakenly attacks the thyroid gland and upsets the hormones it produces. This results in a series of changes in your body, most apparent through sudden weight gain.
Named after Dr Hakaru Hashimoto, who first described it in 1912, this is a lifelong condition where your thyroid remains underactive and needs to be managed. In most cases, your thyroid can’t produce enough hormones for your body. This slows down your metabolism, a process of how your body transforms the food you consume into energy. As your calorie burn is slow, you can accumulate weight. This then affects every organ in your body.
The immune system fails to differentiate between foreign invaders and the body’s own cells, leading it to attack healthy tissues. In this case, immune cells produce antibodies that target the thyroid gland, leading to inflammation and gradual destruction of thyroid tissue. Over time, this damage reduces the thyroid’s ability to produce thyroid hormones.
It is believed to be a combination of genetic, environmental and hormonal factors. It can happen to anybody, anytime, though it primarily affects women and middle-aged individuals. Kapoor says it runs in his family. So those with a family history of thyroid disorders or other autoimmune diseases, such as rheumatoid arthritis, Type 1 diabetes, or lupus, have a higher risk of developing the condition. Environmental factors such as excessive iodine intake, radiation exposure, and viral infections may also trigger or worsen the disease. Hormonal changes, especially in women during pregnancy and menopause, can be a trigger too.
It may take years for symptoms to become noticeable. But patients complain of fatigue and weakness, weight gain, intolerance to cold, dry skin and brittle nails, hair loss, muscle and joint pain, depression or mood changes and constipation.
In some cases, the thyroid gland may get enlarged, resulting in neck swelling or tightness in the throat.
There is no cure as such. The primary treatment involves thyroid hormone replacement therapy, usually with a synthetic hormone like levothyroxine. This medication helps restore normal hormone levels. Regular monitoring of TSH (thyroid-stimulating hormone) levels and thyroid hormones T3 and T4 are essential to adjust the dosage and ensure that hormone levels remain within the normal range. In Hashimoto’s, TSH levels are typically elevated while T3 and T4 are low. Testing for thyroid peroxidase antibodies (TPO antibodies) can confirm the presence of autoimmune activity against the thyroid gland,
Other than that, eat a balanced diet, manage stress and get regular exercise. Some individuals may benefit from avoiding gluten.
(Dr Gupta is Internal Medicine specialist at Indraprastha Apollo Hospitals, New Delhi)
