Does Hashimoto's thyroiditis hurt?

Written by Chen Li Ping
Endocrinology
Updated on January 26, 2025
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Hashimoto's thyroiditis is a chronic lymphocytic thyroiditis. The typical manifestation of Hashimoto's thyroiditis is chronic diffuse goiter, but the patient is asymptomatic. The patient's thyroid will show diffuse, painless mild to moderate enlargement, firm texture, slight tenderness upon pressure, local compression in the neck, and generally not very pronounced systemic symptoms, often with discomfort in the throat. Thyroid pain or tenderness in Hashimoto's thyroiditis is still quite rare; if pain is present, differentiation from subacute thyroiditis is necessary.

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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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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.)

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Hashimoto's thyroiditis diagnostic indicators

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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Is Hashimoto's thyroiditis severe?

Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis, is a common type of autoimmune thyroid disease. Hashimoto's thyroiditis is the most common cause of hypothyroidism. If hypothyroidism caused by Hashimoto's thyroiditis is identified, long-term administration of levothyroxine can achieve good control. It is worth noting that the clinical manifestations of Hashimoto's thyroiditis are often atypical, or may coexist with other thyroid diseases, or other autoimmune diseases. Special attention needs to be paid to certain types of Hashimoto's thyroiditis. One such type is Hashitoxicosis, Hashimoto's pseudohyperthyroidism, or Hashimoto's thyroiditis accompanied by thyroid tumors, Hashimoto's encephalopathy, or Hashimoto's with proptosis. These special types require particular attention.

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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.