What should I do about Hashimoto's thyroiditis?

Written by Gan Jun
Endocrinology
Updated on December 25, 2024
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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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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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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.

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How to cure Hashimoto's thyroiditis?

Hashimoto's thyroiditis is characterized by autoimmune antibodies destroying the thyroid gland, leading to a gradual decline in thyroid function and manifesting symptoms of hypothyroidism. Currently, this disease is incurable. Treatment mainly includes restricting iodine intake to keep it within a safe range to prevent the progression of autoimmune destruction of the thyroid. Patients who only have thyroid swelling without hypothyroidism generally do not require treatment. However, once hypothyroidism occurs, it can be treated with levothyroxine to alleviate the symptoms of hypothyroidism. Nevertheless, current levothyroxine treatment cannot stop the progression of the disease. When the thyroid swells rapidly with local pain or compressive symptoms, treatment with glucocorticoids can be considered. However, if the symptoms do not improve or the compressive symptoms are significant, surgical treatment may be considered, although the likelihood of developing hypothyroidism post-surgery is higher.

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Hashimoto's thyroiditis should be seen in which department?

Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis, should be seen by an endocrinologist as it is an autoimmune disease. How do we know if it's Hashimoto's thyroiditis? It is typically identified during routine physical examinations that include a thyroid function test. Hashimoto's thyroiditis is characterized by a specific antibody, the anti-thyroperoxidase antibody, also known as Tpoab. Many people may have elevated levels of this antibody, yet their thyroid function, such as free T3, T4, and TSH levels, remains normal. In such cases, it is advisable to initially observe the condition dynamically and to regularly recheck thyroid function, as some individuals may gradually develop reduced thyroid function. Thus, regular monitoring of thyroid function is very important.

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Can Hashimoto's thyroiditis heal itself?

Hashimoto's thyroiditis is an autoimmune disease that varies in severity. If a patient merely has elevated antibodies but normal thyroid function, there is no need for treatment; regular thyroid function monitoring is sufficient. If a patient has Hashimoto's thyroiditis combined with reduced thyroid function, they should visit an endocrinology specialist and timely supplement thyroid hormones. Therefore, it cannot be categorically stated whether it can be cured or not; it depends on the severity of the condition. Some patients, if their thyroid function is normal, need only monitor their thyroid function.