NHS pages state "autoimmune hypothyroidism may be present with a goitre (hashimoto's disease) . . .

[bertiesmum]

The NHS site goes on to say . . . or without a goitre (atrophic thyroiditis).

I discovered this whilst looking for NHS recommendations for Hashimotos, which my GP informed me I have. But I do not have a goitre. Perhaps that is what he is waiting to see before treating me?

The page is healthguides.mapofmedicine....

[helvella Administrator]

In his original work Hakaru Hashimoto investigated people with goitres. And found evidence of lymphocytic infiltration - which was destroying the thyroid.

Later, it was demonstrated that autoimmune attack also occurs in others who do not have a goitre. This somehow tended to be called autoimmune thyroiditis or autoimmune thyroid disease even though Hashimoto's and Graves would both qualify under that as a description. (Though in earlier days it was sometimes called Ord's Thyroiditis.)

More recently it has been shown that the lymphocytic infiltration is common to both forms - that is, whether or not there is a goitre.

So there seems to be little reason to perpetuate two separate names. And it would be a pretty confident doctor who could readily, accurately and honestly say at the point of diagnosis "You do not have and never have had even the smallest goitre."

But some doctors continue with the distinction. Seems more common to avoid the term "Hashimoto's" in the UK than, for example, the USA.

[Lymphocytic infiltration is where lymphocytes - a special form of white blood cell - attacks other cells.]

Rod

[bertiesmum]

Thank you for your reply. And obviously from a well informed person.

My surprise was that the source of my info was the NHS. It is a link for NHS health professionals and guides them through the referral procedures. Have you read this? I should be interested in your thoughts on this. Kind regards.

[helvella Administrator in reply to bertiesmum]

Yes - I think I have. It does seem odd that the professionals continue with the distinction.

I feel that one of the things NICE (or someone) could very usefully caretake is a dictionary of definitions.

We could then actually discuss the definitions in a way that could improve things. At present, it appears that each institution (whether that is a hospital, a Royal College, or international organisation) can, more or less, choose their own definitions. One that in my view is in urgent need of clarification is "subclinical hypothyroidism" - half the world say it only exists when patient has no symptoms and blood tests in range; the other half allows symptoms but in range. And the third half allows any blood test result so long as there are no symptoms.

Until then, the person who wrote that is free to choose their own medical language.

Rod