Hashimoto's thyroiditis diagnostic indicators

Written by Chen Xie
Endocrinology
Updated on September 23, 2024
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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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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 Chen Xie
Endocrinology
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Can Hashimoto's thyroiditis be cured?

Hashimoto's thyroiditis is an autoimmune thyroiditis in which the body itself has autoimmune antibodies, leading to the destruction of thyroid follicular cells and the release of a large amount of thyroid hormones, possibly resulting in hyperthyroidism. Some patients may experience hyperthyroidism for years or even decades, which requires anti-hyperthyroidism treatment. However, as the disease progresses, further destruction of thyroid function may occur, resulting in hypothyroidism. For patients with Hashimoto's thyroiditis, once hypothyroidism occurs, it is usually progressive. Therefore, once hypothyroidism occurs in patients with Hashimoto's thyroiditis, lifelong replacement therapy with levothyroxine is necessary, as Hashimoto's thyroiditis cannot be completely cured, but clinical remission can be achieved through replacement therapy.

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Written by Tang Zhuo
Endocrinology
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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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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.

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Written by Luo Juan
Endocrinology
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Does Hashimoto's thyroiditis require treatment?

Treatment depends on the case. Currently, there is no cure for Hashimoto's thyroiditis, and the main goal of treatment is to correct secondary thyroid dysfunction and reduce significantly enlarged thyroids. Generally, for patients with mild diffuse goiter without obvious compression symptoms and no thyroid dysfunction, no special treatment is needed; follow-up observation is sufficient. For patients with significant thyroid enlargement and compression symptoms, treatment with levothyroxine may be used to reduce thyroid swelling. If the patient has hypothyroidism, thyroid hormone replacement therapy can be administered. (Medication should be administered under the guidance of a doctor.)