Exploring a Vascular Hypothesis: The Thyroid Ima Artery as a Potential Contributor to Hashimoto's Thyroiditis

Hashimoto’s thyroiditis is the most common autoimmune thyroid disorder, yet the initial trigger that exposes thyroid antigens such as thyroid peroxidase (TPO) to the immune system remains unclear. This article proposes a novel anatomical hypothesis suggesting that the presence of the thyroid ima artery (TIA)—a rare vascular variant—may contribute to early mechanical disruption of thyroid tissue, allowing intracellular components like TPO to enter the bloodstream. We explore the potential role of TIA in increasing local vascular pressure or fragility in the thyroid isthmus, leading to microdamage in follicular cells. Such exposure may initiate or accelerate the autoimmune cascade in genetically predisposed individuals. A research methodology is proposed to test this hypothesis through imaging, histopathology, and population-based studies. If validated, this theory could provide a new perspective on the etiology of Hashimoto’s thyroiditis and the influence of vascular anomalies on autoimmune disease onset.