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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Written by Li Hui Zhi
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Can you get pregnant with Hashimoto's thyroiditis?

Hashimoto's thyroiditis can lead to pregnancy, but the prerequisite is that you must visit an endocrinology specialist before pregnancy to check your thyroid function, ensuring that the TSH (thyroid-stimulating hormone) is controlled below 2.5. This situation is suitable for pregnancy because if TSH is greater than 2.5, it is likely to have a certain impact on the fetus's intelligence. Therefore, if you have Hashimoto's thyroiditis and are planning to conceive, you first need to check the thyroid function. If this indicator is normal, then you can consider pregnancy.

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Written by Luo Juan
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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 Xie
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Does Hashimoto's thyroiditis cause fever?

Hashimoto's thyroiditis belongs to autoimmune thyroiditis, where the body's own antibodies destroy the thyroid follicular cells, leading to apoptosis of thyroid cells. As the disease progresses, it may lead to hypothyroidism. Generally, Hashimoto's thyroiditis does not cause fever. If a patient with Hashimoto's thyroiditis experiences a fever, it is necessary to exclude other infectious diseases. If a patient with Hashimoto's thyroiditis has a fever, especially if there is significant tenderness in the thyroid area, it is necessary to exclude the possibility of concomitant subacute thyroiditis. If Hashimoto's thyroiditis is accompanied by subacute thyroiditis, small doses of hormones can be used for treatment. (Please use medication under the guidance of a doctor.)

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Written by Chen Xie
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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 Li Hu Chen
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Ultrasonic manifestations of Hashimoto's thyroiditis

Under ultrasound observation, Hashimoto's thyroiditis generally presents as a diffuse enlargement of the thyroid, often symmetrically, although there are cases of unilateral enlargement as well. Additionally, the surface of the thyroid appears irregular and nodular. The ultrasound often reveals uneven echogenicity in the gland, sometimes with nodular changes and unclear boundaries. However, the ultrasonographic characteristics of Hashimoto's thyroiditis are not particularly specific unless it's a typical case of the disease, which can be roughly diagnosed via ultrasound. For atypical or early cases of Hashimoto's thyroiditis, diagnosis typically requires thyroid function tests, known as the "thyroid function six-item test," which remains the gold standard for diagnosing Hashimoto's thyroiditis.