From the Guidelines
Hashimoto's thyroiditis is an autoimmune disorder where the immune system attacks the thyroid gland, leading to chronic inflammation and eventual hypothyroidism. This condition is characterized by the presence of antibodies against thyroid peroxidase (TPO) and thyroglobulin, which can be detected through blood tests 1. The primary screening test for thyroid dysfunction, including Hashimoto's, is the serum TSH test, which should be done over a 3- to 6-month interval to confirm or rule out abnormal findings 1.
Some key points to consider in the management of Hashimoto's thyroiditis include:
- The principal treatment for hypothyroidism is oral T4 monotherapy (levothyroxine sodium) 1
- Regular blood tests (every 6-8 weeks initially, then annually once stabilized) are necessary to monitor thyroid-stimulating hormone (TSH) levels and adjust medication dosage accordingly
- Optimal TSH levels typically range between 0.5-2.5 mIU/L
- Hashimoto's often requires lifelong treatment, as the condition progressively damages the thyroid's ability to produce hormones
- Patients with Hashimoto's may have increased risk for other autoimmune conditions, so maintaining overall health through proper nutrition, stress management, and regular medical check-ups is important
It is essential to note that while detection and treatment of abnormal TSH levels in asymptomatic persons is common practice, evidence that this clinical approach improves important health outcomes, such as cardiovascular- and cancer-related morbidity and mortality, as well as falls, fractures, functional status, and quality of life, is lacking 1. Therefore, treatment should be individualized and based on the patient's specific needs and health status.
From the FDA Drug Label
As pituitary thyroid-stimulating hormone (TSH) suppressants, in the treatment or prevention of various types of euthyroid goiters, including thyroid nodules, subacute or chronic lymphocytic thyroiditis (Hashimoto's) and multinodular goiter Hashimoto's is another term for chronic lymphocytic thyroiditis, a condition where the thyroid gland is inflamed. 2
From the Research
Definition and Causes of Hashimoto's
- Hashimoto's disease, also known as chronic autoimmune thyroiditis, is a condition where the immune system attacks the thyroid gland, leading to hypothyroidism 3, 4, 5.
- It is the most common cause of thyroid failure in areas with sufficient iodine intake 3.
- Hashimoto's disease is characterized by the presence of antibodies against thyroid peroxidase (TPO) and/or thyroglobulin, which can be detected in the blood 5.
Symptoms and Diagnosis
- The symptoms of Hashimoto's disease are non-specific and can include fatigue, weight gain, cold intolerance, dry skin, constipation, and voice changes 4, 6.
- Diagnosis is based on blood tests that measure thyroid-stimulating hormone (TSH) and free thyroxine (T4) levels, as well as the presence of antibodies against TPO and/or thyroglobulin 4, 6, 5.
- A diagnosis of Hashimoto's disease is often made in conjunction with a diagnosis of hypothyroidism, which is characterized by elevated TSH levels and low T4 levels 3, 4, 6, 5.
Treatment and Management
- Treatment for Hashimoto's disease typically involves levothyroxine replacement therapy, which aims to normalize TSH levels and alleviate symptoms 3, 4, 6, 5.
- The dosage of levothyroxine may need to be adjusted based on individual factors, such as age, weight, and the presence of other medical conditions 4, 6, 5.
- In some cases, patients with Hashimoto's disease may experience malabsorption of levothyroxine due to gastrointestinal disorders, such as gastroparesis and small intestinal bacterial overgrowth (SIBO) 7.
- Alternative formulations of levothyroxine, such as oral solutions, may be effective in patients with malabsorption or sensitivities to certain ingredients 7.