In Hashimoto’s disease, the entire thyroid may swell and enlarge. This swelling (goiter) is may be detected during health check-ups, leading to diagnosis of Hashimoto’s disease.
The size of goiters varies from a nearly normal-sized thyroid to one that is easily visible. Basedow’s disease also causes thyroid swelling, but Hashimoto’s disease goiters tend to be relatively hard and have bumpy surfaces.
■ Normal thyroid gland■ Diffuse goiter due to Hashimoto’s disease
Symptoms due to hypothyroidism
Hypothyroidism is a condition characterized by insufficient levels of thyroid hormones in the blood. Since thyroid hormones regulate metabolism, their lack can causes a variety of symptoms (detailed below). Symptoms improve with appropriate treatment. Patients with Hashimoto’s disease who have normal thyroid function do not develop the following symptoms from their thyroid gland.
(1) Edema
Edema is a condition in which excess fluid is trapped in the body’s tissues. A characteristic of edema is when the skin is depressed with a finger returns to an original state. Edema may be present in any part of the whole body, but it tends to appear in the hands and face when waking up in the morning and slightly improves around noon. If there is edema of the lips, tongue, or mucosa deep in the throat, a patient’s voice may become low, making it difficult to speak.
■ Healthy state (normal thyroid function)■ State of edema (reduced thyroid function)
(2) Skin symptoms
Since metabolism is slowed, the skin dries and becomes rough. Sweating is reduced and patients may suffer hair loss.
(3) Sensitivity to cold
A slower in metabolism results in less heat production in the whole body, leading to sensitivity to cold.
(4) Lack of appetite accompanied by weight gain
The worsening of gastrointestinal function reduces appetite, causing people to eat less. At the same time, however, metabolism is slowed and edema occurs, resulting in weight gain. In addition, patients tend to feel bloated and suffer from constipation.
(5) Slow pulse
Heart movement is reduced, resulting in a slow and weak pulse. If hypothyroidism is severe, fluid may accumulate in the sac covering the heart (pericardium), causing heart enlargement.
(6) Sluggishness
Patients find that they lack motivation and spirit to do things, and they may become forgetful or inactive. Some patients suffer frequent drowsiness, slurred speech, or speak slowly.
(7) Muscle symptoms
Muscle strength may decrease and shoulder stiffness may worsen.
(8) Menstrual disorders
Heavy or prolonged menstrual bleeding may occur (menorrhagia).