How is Hashimoto's thyroiditis diagnosed?

Written by Li Hui Zhi
Endocrinology
Updated on May 28, 2025
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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.

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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.

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Written by Chen Li Ping
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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.)

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Written by Chen Xie
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What kind of salt should be consumed for Hashimoto's thyroiditis?

Hashimoto's thyroiditis is a type of autoimmune thyroiditis that can manifest as hyperthyroidism, hypothyroidism, or normal thyroid function during its progression. Therefore, there are different requirements for the type of salt to consume depending on the state of thyroid function. When Hashimoto's thyroiditis presents with hyperthyroidism, it is recommended to consume non-iodized salt. When thyroid function is normal in Hashimoto's thyroiditis, iodized salt can be consumed. When Hashimoto's thyroiditis is accompanied by hypothyroidism, there is no specific requirement for consuming iodized or non-iodized salt. Because at this stage, the thyroid has largely lost its ability to synthesize thyroid hormones, and treatment involves replacing them with levothyroxine to maintain thyroid function. Therefore, the intake of iodine does not matter, and one can freely choose to consume iodized or non-iodized salt. Thus, the choice of salt in Hashimoto's thyroiditis should be based on thyroid function testing.

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Can Hashimoto's thyroiditis patients eat iodized salt?

Hashimoto's thyroiditis is an autoimmune thyroid disease, which can manifest in three thyroid function states: hyperthyroidism, euthyroidism, and hypothyroidism. The dietary requirements for iodized salt vary depending on the thyroid state. When Hashimoto's thyroiditis coexists with hyperthyroidism, an iodine-restricted diet is necessary. When thyroid function is normal in Hashimoto's thyroiditis, iodine intake should still be limited, as excessive iodine can cause a thyroiditis that changes from euthyroid to dysfunctional. Therefore, iodized salt can be consumed, but the intake of iodine-rich foods such as kelp, seaweed, and seafood should be restricted. When Hashimoto's thyroiditis coincides with hypothyroidism, iodized salt can be consumed without specific restrictions; both iodized and non-iodized salt are acceptable. This is because, at this stage, thyroid function primarily requires hormone replacement therapy, so the consumption of iodized salt has no effect.

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Does Hashimoto's thyroiditis cause a sore throat?

Hashimoto's thyroiditis does not cause a sore throat; the type of thyroiditis that primarily causes a sore throat is subacute thyroiditis. Subacute thyroiditis is a viral infection and is a self-limiting disease. Its main clinical manifestations include sore throat, thyroid enlargement, as well as accompanying fever and elevated erythrocyte sedimentation rate. Meanwhile, Hashimoto's thyroiditis is an autoimmune disease, whose most common clinical manifestation is painless thyroid enlargement, progressing to hypothyroidism in later stages. Additionally, it involves thyroid antibodies, especially positive TPO antibodies. Because the treatments for each are different, it is important to note that Hashimoto's thyroiditis does not cause a sore throat.