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Hashimoto's thyroiditis
What to do with Hashimoto's thyroiditis?
Hashimoto's thyroiditis is the most common clinical type of thyroiditis, with over 90% occurring in females. It is also the major cause of primary hypothyroidism. The onset of Hashimoto's thyroiditis is insidious and progresses slowly. Early clinical manifestations are often atypical. Therefore, the treatment of Hashimoto's thyroiditis should be tailored to different circumstances. If a patient with Hashimoto's thyroiditis has normal thyroid function, then no special treatment is needed, only regular follow-up is required. If the patient develops hypothyroidism, thyroid hormone replacement therapy should be administered using either thyroxine tablets or levothyroxine tablets until the maintenance dose is reached, to improve clinical symptoms and normalize thyroid function. Another category includes patients with Hashimoto's hyperthyroidism, who generally do not require treatment as they may go through phases of hyperthyroidism, normal thyroid function, and hypothyroidism. Transient hyperthyroidism can be managed symptomatically with β-blockers. For cases highly suspected of concurrent Hashimoto's thyroiditis with thyroid cancer or lymphoma, surgical treatment can be considered.
Hashimoto's Thyroiditis Clinical Symptoms
Hashimoto's thyroiditis is the most common clinical type of thyroiditis, with over 90% occurring in women. The typical clinical presentation involves middle-aged women with a long disease duration. The thyroid is diffusely, painlessly, and mildly to moderately enlarged, with a tough texture, slow development, possibly slight tenderness, local compression in the neck area, and no significant general symptoms, often accompanied by a feeling of discomfort in the throat. Thyroid enlargement is the most prominent clinical manifestation of Hashimoto's thyroiditis, usually of moderate size and diffuse, which can be asymmetrical. Therefore, thyroid enlargement can potentially compress the trachea, esophagus, and recurrent laryngeal nerve, although this is relatively rare. Thyroid pain and touch sensitivity are also rare. In the later stages, the condition may progress to primary hypothyroidism due to destruction of the thyroid. Most patients with Hashimoto's thyroiditis have normal thyroid function, but 20% of patients may show signs of hypothyroidism.
Can people with Hashimoto's thyroiditis eat lamb?
Currently, there is no evidence to suggest that patients with Hashimoto's thyroiditis cannot eat mutton, so it is permissible to eat mutton. Hashimoto's thyroiditis is a common autoimmune thyroid disease and the primary cause of hypothyroidism. Its onset is generally closely related to genetic factors, abnormal iodine metabolism, and immune function abnormalities. The pathological characteristics are mainly marked by significant infiltration of lymphocytes and plasma cells in the thyroid, as well as fibrosis of thyroid tissues. In terms of diet, patients with Hashimoto's thyroiditis need to strictly control their iodine intake.
How is Hashimoto's thyroiditis diagnosed?
Firstly, it is important to check thyroid function for Hashimoto's thyroiditis, which involves a specific antibody, the anti-thyroid peroxidase antibody (TPOAb). If this antibody is significantly elevated, it supports the diagnosis of Hashimoto's thyroiditis. Additionally, a thyroid ultrasound should be combined, and if there is severe enlargement, a thyroid fine-needle aspiration can be conducted to assist in treatment. After a confirmed diagnosis of Hashimoto's thyroiditis, it is also necessary to assess thyroid function to determine if there is concurrent hyperthyroidism or hypothyroidism. Treatment should then be administered based on the specific condition of the patient.
How to test for Hashimoto's thyroiditis?
Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis, is a common type of autoimmune thyroid disease and the main cause of primary hypothyroidism. Often, Hashimoto's thyroiditis may present no symptoms, having hidden onset and slow development. Typical symptoms include general fatigue, throat discomfort, localized pressure, or dull pain. Hashimoto's thyroiditis can lead to damage by the autoimmune system, causing permanent hypothyroidism. Diagnosis can be facilitated through thyroid function tests, iodine-131 uptake tests, anti-thyroid antibody tests, thyroid ultrasound, and thyroid nuclear scanning.
How is Hashimoto's thyroiditis caused?
Hashimoto's thyroiditis is a chronic autoimmune disease and is the most common type of thyroiditis clinically. Its etiology is primarily immunological, as Hashimoto's thyroiditis is an autoimmune disorder. Therefore, patients can detect a high concentration of anti-thyroid antibodies through blood tests, such as anti-thyroglobulin antibodies and anti-microsomal antibodies. Additionally, genetic factors are involved, with about 50% of patients with Hashimoto's thyroiditis having a family history. Environmental factors, including radiation, infections, excessive dietary iodine, and selenium deficiency, can also lead to Hashimoto's thyroiditis. In recent years, the incidence of Hashimoto's thyroiditis has notably increased.
Ultrasonic manifestations of Hashimoto's thyroiditis
Under ultrasound observation, Hashimoto's thyroiditis generally presents as a diffuse enlargement of the thyroid, often symmetrically, although there are cases of unilateral enlargement as well. Additionally, the surface of the thyroid appears irregular and nodular. The ultrasound often reveals uneven echogenicity in the gland, sometimes with nodular changes and unclear boundaries. However, the ultrasonographic characteristics of Hashimoto's thyroiditis are not particularly specific unless it's a typical case of the disease, which can be roughly diagnosed via ultrasound. For atypical or early cases of Hashimoto's thyroiditis, diagnosis typically requires thyroid function tests, known as the "thyroid function six-item test," which remains the gold standard for diagnosing Hashimoto's thyroiditis.
How is Hashimoto's thyroiditis treated?
After being diagnosed with Hashimoto's thyroiditis, treatment decisions should be made based on the size of the thyroid and the presence of symptoms. If the thyroid is relatively small and there are no significant compression symptoms, it is possible to follow up and observe without treatment. If the thyroid is significantly enlarged and there are compression symptoms, thyroid hormone preparations can be used to reduce thyroid swelling. If there is hypothyroidism, it is necessary to use thyroid hormone or levothyroxine for supplementary replacement therapy. In cases of Hashimoto's thyroiditis with hyperthyroidism, short-term treatment should follow the treatment for Graves' disease, using antithyroid treatments such as thioamides or thioureas. (Medications should be used under the guidance of a physician, and self-medication without guidance is strongly discouraged.)
Is Hashimoto's thyroiditis easy to treat?
Regarding whether Hashimoto's thyroiditis is easy to treat, it needs to be analyzed based on specific circumstances. Generally, after diagnosing Hashimoto's thyroiditis, the treatment decision depends on the size of the thyroid and whether there are any symptoms. For patients with a smaller thyroid who do not have noticeable compression symptoms, follow-up observation without immediate treatment is possible. However, for patients with significant thyroid enlargement and compression symptoms, treatment with levothyroxine can be adopted to reduce thyroid size. In some patients who develop hypothyroidism, thyroid hormone replacement therapy is used. Moreover, some patients with Hashimoto's thyroiditis may also develop thyroid nodules. It is necessary to dynamically track changes in the morphology of the thyroid nodules. Patients with obvious compression symptoms, significant local pain, progressive enlargement of the nodules, or suspected malignant changes should undergo surgical treatment.
Does Hashimoto's thyroiditis hurt?
Hashimoto's thyroiditis is a chronic lymphocytic thyroiditis. The typical manifestation of Hashimoto's thyroiditis is chronic diffuse goiter, but the patient is asymptomatic. The patient's thyroid will show diffuse, painless mild to moderate enlargement, firm texture, slight tenderness upon pressure, local compression in the neck, and generally not very pronounced systemic symptoms, often with discomfort in the throat. Thyroid pain or tenderness in Hashimoto's thyroiditis is still quite rare; if pain is present, differentiation from subacute thyroiditis is necessary.