How is Hashimoto's thyroiditis treated?

Written by Chen Li Ping
Endocrinology
Updated on March 10, 2025
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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.)

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Written by Tang Zhuo
Endocrinology
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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.

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Written by Gan Jun
Endocrinology
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What should I do about Hashimoto's thyroiditis?

Hashimoto's thyroiditis is an autoimmune inflammatory thyroid disease caused by the diffuse enlargement of thyroid follicular cells, and may present with transient hyperthyroidism during different clinical stages. During the period of normal thyroid function as well as the eventual phase of reduced thyroid function, appropriate anti-hyperthyroidism medications can be administered symptomatically when the patient is clinically hyperthyroid. When the patient is hypothyroid, it is necessary to timely supplement with thyroid hormones for treatment, and it is essential to dynamically monitor the individual’s thyroid hormone levels, thyroid hormone antibodies, and thyroid ultrasound to make a comprehensive assessment. It is always important to maintain a low iodine diet and avoid consuming foods that are high in iodine.

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Written by Chen Xie
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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Written by Li Hui Zhi
Endocrinology
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Does Hashimoto's thyroiditis affect pregnancy?

Hashimoto's thyroiditis, it is a type of autoimmune disease. Some people might have normal thyroid function, while others may develop hypothyroidism. Therefore, if someone with Hashimoto's thyroiditis plans to become pregnant, it is essential to test thyroid function before pregnancy. For patients with Hashimoto's thyroiditis, we recommend that the thyroid-stimulating hormone (TSH) should be controlled below 2.5 mIU/L before suggesting pregnancy, as this can prevent potential impacts on the fetus's intelligence.

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Written by Li Hui Zhi
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Can you get pregnant with Hashimoto's thyroiditis?

Hashimoto's thyroiditis can lead to pregnancy, but the prerequisite is that you must visit an endocrinology specialist before pregnancy to check your thyroid function, ensuring that the TSH (thyroid-stimulating hormone) is controlled below 2.5. This situation is suitable for pregnancy because if TSH is greater than 2.5, it is likely to have a certain impact on the fetus's intelligence. Therefore, if you have Hashimoto's thyroiditis and are planning to conceive, you first need to check the thyroid function. If this indicator is normal, then you can consider pregnancy.