Does Hashimoto's thyroiditis require medication?

Written by Chen Xie
Endocrinology
Updated on September 04, 2024
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Hashimoto's thyroiditis refers to the destruction of thyroid tissue by autoimmune cells. Therefore, during the course of the disease, three states of thyroid function can be manifested: hyperthyroidism, euthyroid state, and hypothyroidism. When the patient presents with hyperthyroidism, it is possible to treat with anti-thyroid drugs, but the dosage of the anti-thyroid drugs should be reduced. When thyroid function is normal, no special treatment is needed, and regular thyroid function testing is sufficient. When there is concurrent hypothyroidism, thyroid hormone replacement therapy is required to achieve clinical healing.

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Written by Chen Xie
Endocrinology
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Hashimoto's thyroiditis diagnostic indicators

Hashimoto's thyroiditis is a type of autoimmune thyroiditis, which can present in various phases regarding thyroid function, manifesting as hyperthyroidism, hypothyroidism, or normal thyroid function. Therefore, for patients with Hashimoto's thyroiditis, it is necessary to check thyroid function to understand its status. Since Hashimoto's thyroiditis is an autoimmune thyroiditis, the thyroid peroxidase antibodies and thyroglobulin antibodies are generally elevated. Additionally, it is necessary to perform thyroid ultrasound to assess the thyroid's condition. For some difficult-to-distinguish patients, a further examination such as a 131I uptake test can be conducted, where the uptake rate in Hashimoto's thyroiditis is reduced. Even further, a fine needle aspiration biopsy of the thyroid can be performed, where we can observe significant lymphocyte infiltration.

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Can Hashimoto's thyroiditis be cured?

Hashimoto's thyroiditis is an autoimmune thyroiditis where the body itself has autoantibodies that lead to the destruction of thyroid follicular cells, resulting in the failure of thyroid cells. Therefore, Hashimoto's thyroiditis can manifest as hyperthyroidism, euthyroidism, and hypothyroidism. Ultimately, Hashimoto's thyroiditis may develop into hypothyroidism. Hypothyroidism is proliferative and generally cannot be completely cured, but clinical remission can be achieved through oral administration of levothyroxine. However, Hashimoto's thyroiditis cannot be completely cured and requires lifelong replacement therapy.

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Endocrinology
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Does Hashimoto's thyroiditis cause fever?

Hashimoto's thyroiditis belongs to autoimmune thyroiditis, where the body's own antibodies destroy the thyroid follicular cells, leading to apoptosis of thyroid cells. As the disease progresses, it may lead to hypothyroidism. Generally, Hashimoto's thyroiditis does not cause fever. If a patient with Hashimoto's thyroiditis experiences a fever, it is necessary to exclude other infectious diseases. If a patient with Hashimoto's thyroiditis has a fever, especially if there is significant tenderness in the thyroid area, it is necessary to exclude the possibility of concomitant subacute thyroiditis. If Hashimoto's thyroiditis is accompanied by subacute thyroiditis, small doses of hormones can be used for treatment. (Please use medication under the guidance of a doctor.)

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Is the ESR high in Hashimoto's thyroiditis?

Hashimoto's thyroiditis belongs to autoimmune thyroiditis, which is caused by the presence of autoantibodies that destroy the thyroid follicular cells, leading to the failure of thyroid cells. For patients with Hashimoto's thyroiditis, the erythrocyte sedimentation rate (ESR) generally does not increase. However, if a patient experiences neck discomfort or sore throat, and the ESR increases, even accompanied by fever, it is necessary to rule out whether subacute thyroiditis is present. If the patient has subacute thyroiditis, it indicates that a viral infection has caused the destruction of the thyroid cells, which might increase the ESR.

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Written by Chen Xie
Endocrinology
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Is Hashimoto's thyroiditis hereditary?

Hashimoto's thyroiditis is an autoimmune thyroid disease and is not hereditary. However, it tends to cluster in families, meaning if one's parents have a history of Hashimoto's thyroiditis, their offspring have a relatively higher risk of developing the disease. However, this is not absolute heredity; it simply indicates a familial clustering tendency. Treatment for Hashimoto's thyroiditis is relatively effective. If hypothyroidism occurs, one only needs to take lifelong replacement therapy with levothyroxine to maintain thyroid function within the normal range, which has minimal impact on the body. Therefore, there is no need for excessive worry.