From the Guidelines
To properly evaluate Hashimoto's thyroiditis, comprehensive lab testing is essential, including TSH, Free T4, Free T3, and thyroid antibodies (TPO and TgAb), with the goal of maintaining TSH between 0.5-2.5 mIU/L for most patients, as recommended by recent guidelines 1. The most important tests for Hashimoto's thyroiditis include:
- TSH (thyroid stimulating hormone)
- Free T4
- Free T3
- Thyroid antibodies (TPO and TgAb) Positive thyroid antibodies, particularly TPO antibodies, confirm the autoimmune nature of the condition. Additional helpful tests include:
- Complete Blood Count
- Comprehensive Metabolic Panel
- Vitamin D
- Vitamin B12
- Ferritin levels, as deficiencies are common in autoimmune thyroid disease, as noted in previous studies 1. For optimal monitoring, these labs should be checked every 3-6 months initially, then annually once stable. If medication is needed, levothyroxine (starting at 25-50 mcg daily, adjusted based on lab results) is typically prescribed, with the aim of maintaining TSH within the target range, as there is no role for imaging in the workup of hypothyroidism in adults, according to the most recent guidelines 1. Testing should be done in the morning before taking thyroid medication to ensure accurate results. Hashimoto's is an autoimmune condition where the immune system attacks the thyroid gland, gradually reducing its ability to produce hormones, which is why regular monitoring is crucial even when symptoms aren't present. The treatment of hypothyroidism, which is often caused by Hashimoto thyroiditis, is thyroid hormone replacement, and the most common etiology in the developed world is Hashimoto thyroiditis, also known as chronic lymphocytic thyroiditis, as stated in recent studies 1.
From the Research
Hashimoto's Labs
- Hashimoto's disease is an autoimmune disorder that affects the thyroid gland, leading to hypothyroidism 2, 3, 4, 5.
- The diagnosis of Hashimoto's disease requires a detailed medical history, sonography, and blood analysis of thyroid function and thyroid antibodies 4.
- Laboratory tests for Hashimoto's disease may include:
- Treatment of Hashimoto's disease typically involves levothyroxine (LT4) replacement therapy, with the goal of normalizing TSH levels and alleviating symptoms 2, 3, 4, 5.
- Some patients may require combination therapy with LT4 and triiodothyronine (T3) to achieve optimal thyroid hormone levels and symptom relief 6.