How To Diagnose Hashimoto's Disease?

Do you feel swelling in your neck or thyroid area? Maybe you're having symptoms of fatigue. Or maybe you got some thyroid lab results back and you're wondering how to diagnose Hashimoto's Disease. In this video we're gonna look at that question, what specific lab tests you need to diagnose Hashimoto's and some of the different ways it can present itself. To give you a better understanding of how we actually make the diagnosis.

Okay, so in this video we're gonna look at how to diagnose Hashimoto's Disease, also known as Hashimoto's thyroiditis. So if you don't know, Hashimoto's Disease is also known as chronic lymphocytic thyroiditis, and it's those lymphocytes. Those are types of white blood cells that are inflaming the thyroid gland.

It is by nature an autoimmune disorder, so those lymphocytes are attacking the thyroid gland. In the US and other developed nations, this is the most common cause of hypothyroidism or underactive thyroid. The thyroid gland is a small butterfly shape gland that sits. Right in the neck here, and it produces thyroid hormones like T3 and t4. So when we want to diagnose Hashimoto's thyroiditis or Hashimoto's disease, we need to look at both the thyroid function and the autoimmune activity.

Now, it's also important to look at certain signs and symptoms in the body. So we do want to do a thorough intake and understand what kind of symptoms the person may be having. I did do a separate video on symptoms of Hashimoto's.
Physical exam and signs, well, a lot of that's gonna be done through the blood test, which we're gonna discuss in a second. But sometimes you can also feel nodules along the thyroid gland as well, and that may be an indicator that you have something going on with the thyroid and might have Hashimotos as well.

So the test we do to look at the thyroid functionality is both the T S H, which is also known as thyroid stimulating hormone, and T3 and t4, which are the thyroid hormone output from the thyroid gland.

Most of what the thyroid produces is t4, so that's one of the more important ones to get a measurement of. But both T3 and T4 can be low, and so it's good to measure both. You also want to measure the free or bioavailable versions of these tests, because that's gonna give you a more of an indicator of what the active amount of thyroid is.

So high levels of T s H and low levels of either T3 or T4 can be an indicator of hypothyroidism, and this is really common with Hashimotos. The presence of the high T s H or low T3 and T4 isn't really enough though to diagnose Hashimotos. You can have hypothyroidism without Hashimotos. While we're on the note of hypothyroidism, depending on how high that T S H is and how low that T3 and T4 are,

is gonna determine how we move forward with treatment. And I also discuss that in another video Thyroid lab. So now onto the autoimmune part of diagnosing Hashimotos. So when you're looking at lab tests for the diagnosis of the autoimmune part of this, you wanna be looking at something known as antithyroid peroxidase or anti T P O antibody, which is the most commonly used to diagnose Hashimotos.

And then sometimes we'll also. Antithyroglobulin. Now, the anti T P O antibody is the most common because that's actually interfering with the production of the thyroid hormone itself, or the antithyroglobulin has more to do with the transport of the thyroid hormone, but both are indicators of autoimmune disease, so they need to be above a certain level in order to make that diagnosis.

Some of us have little bits of this in our body, even though we don't. Enough of it to actually trigger a positive test result. But when they are high above that threshold, that's when you're said to have Hashimoto's thyroiditis. Now, it's also possible for you to have Hashimoto's antibodies in your blood and not have hypothyroidism.

Meaning the levels of Tssh, t3, and T4 all look really good. Not even close They just looked really. Still, if you have the autoimmune component, meaning those auto antibodies are present still means your immune system is interfering with the production of that thyroid hormone and because that interference is inconsistent or not constant all the time. It can be fluctuating, and that means the level of thyroid hormone that your body's producing can also be fluctuating so that when you actually check your blood, you may have different levels.

Then a day later, when perhaps those levels are lower or even higher. So if your symptoms seem to fluctuate a lot, it may be important to get multiple serial tests before you make a decision on what's going on in terms of starting thyroid hormone.

An ultrasound can also be used to image the thyroid basically bouncing some sound waves up the thyroid and gives you a better understanding of whether or not there's nodules there for one.
So how do we diagnose Hashimoto's disease?