Q. I have what I am told is Hashimoto's thyroiditis and have recently moved. Do I need a specialist, or will a family doctor be OK?
A. Thyroiditis is inflammation of the thyroid gland, the small but important endocrine gland located just below the Adam's apple. It produces several thyroid hormones that regulate functions of most cells of the body.
Thyroiditis may be caused by a viral infection or by the body's own immune system attacking the thyroid gland (known as an autoimmune reaction). As a result of the inflammation, the gland may produce too much but usually too little thyroid hormone.
It occurs at all ages and is six times more frequent in women than in men. It's often associated with other endocrine gland disorders such as diabetes, and immune system disorders such as pernicious anemia and lupus.
Symptoms of low thyroid include depression and chronic fatigue. Sometimes dry mouth and eyes are seen. One of the symptoms of low thyroid levels is a slowing down of many bodily functions such as heart rate and general metabolism.
Hashimoto's thyroiditis, also called chronic lymphocytic thyroiditis, is the most common form of thyroiditis, and probably the most common thyroid disorder.
Hashimoto's is a type of thyroiditis that is caused by an autoimmune reaction that creates antibodies that attack the thyroid gland. It occurs most often in older women and tends to run in families.
It often begins with a painless enlargement of the thyroid gland (goiter). At the beginning, a person may have an increase in thyroid hormone.
Most people with this disorder continue to produce normal amounts of thyroid hormones, but many do gradually develop hypothyroidism, or underactive thyroid function. This condition is usually permanent.
Diagnosis of Hashimoto's is based on symptoms, results of a physical exam and of blood tests to look for antibodies.
There is no specific treatment for the inflammation in Hashimoto's thyroiditis. Hypothyroidism, however, should be tested for over time and treated if it occurs. This requires long-term supplementation of thyroid hormone.
When selecting doctors in a new community, it makes general good sense to select those with the same specialty as you were using before you moved, especially if you don't see any major changes in your health profile.
In terms of your Hashimoto's thyroiditis, if you're seeing a doctor just for checkups and testing for thyroid and antibody blood levels, a good family practice physician or internist would certainly be sufficient for your needs.
In any event, it's a good idea to establish a relationship with a family practice/internal medicine physician as a starting point for all health concerns. They can always refer you to a specialist if required. Also, many health plans require that a referral to a specialist be initiated by a family practice/internal medicine physician.
Write to Dr. Douma in care of the Chicago Tribune, Room 400, 435 N. Michigan Ave., Chicago, IL 60611.