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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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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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.

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Written by Chen Xie
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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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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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Can Hashimoto's thyroiditis breastfeed?

Patients with Hashimoto's thyroiditis can breastfeed. It is important for those in a hyperthyroid phase, especially when taking anti-thyroid medications, to switch to breastfeeding-safe medications beforehand and to regularly monitor thyroid function to ensure it remains within normal limits. Patients in a hypothyroid phase should also regularly monitor their thyroid function and adjust their replacement medication dosage accordingly. Newborns should have their thyroid function and related antibodies regularly tested from birth onwards. (Please medicate under the guidance of a physician.)