{
  "schemaVersion": 2,
  "eyebrow": "Endocrinology",
  "title": "Hashimoto Thyroiditis",
  "summary": "Diagnose Hashimoto thyroiditis by integrating TSH/free T4 status with TPO or thyroglobulin antibodies and, when needed, ultrasound; treat thyroid hormone deficiency rather than antibody positivity, optimize levothyroxine administration before escalating dose, and intensify surveillance during pregnancy and postpartum.",
  "seoDescription": "Physician guide to diagnosing Hashimoto thyroiditis, interpreting thyroid tests and antibodies, using levothyroxine, and monitoring pregnancy.",
  "clinicalQuestion": "How should clinicians confirm Hashimoto thyroiditis, decide when to replace thyroid hormone, and monitor patients over time?",
  "specialty": "Endocrinology",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "Hashimoto thyroiditis",
    "chronic autoimmune thyroiditis",
    "TPO antibodies",
    "thyroglobulin antibodies",
    "subclinical hypothyroidism",
    "levothyroxine"
  ],
  "keyTakeaways": [
    "Use TSH and free T4 to determine the treatment state; TPOAb and TgAb support autoimmune etiology but do not by themselves require thyroid hormone treatment. [17][10]",
    "Overt primary hypothyroidism—elevated TSH with low free or total T4—requires levothyroxine replacement. [17]",
    "For mild subclinical hypothyroidism, immediate levothyroxine is not universal; monitor TSH once or twice yearly when treatment is deferred. [17]",
    "Before increasing levothyroxine for an elevated TSH, verify fasting administration and separation from iron, calcium, aluminum hydroxide, and proton-pump inhibitors. [10]",
    "Pregnancy and the 2- to 6-month postpartum interval can substantially change autoimmune thyroid activity and thyroid hormone requirements. [15]"
  ],
  "sections": [
    {
      "id": "confirm-diagnosis-and-function",
      "eyebrow": "Initial assessment",
      "heading": "Confirm autoimmune thyroiditis and define the functional state",
      "intro": "The immediate decision is not antibody status; it is whether thyroid hormone deficiency is present.",
      "paragraphs": [
        "Order serum TSH and free T4 when Hashimoto thyroiditis is suspected clinically or from thyroid enlargement. Elevated TSH with low free T4 establishes overt hypothyroidism and warrants replacement. Elevated TSH with normal free T4 is subclinical hypothyroidism; normal TSH and free T4 indicate euthyroid autoimmune thyroiditis if antibodies or imaging support the diagnosis. [17][10]",
        "Measure TPO antibodies as the principal serologic marker and add Tg antibodies when the diagnostic picture remains uncertain. TPO antibodies are present in approximately 80% to 90% of patients with autoimmune thyroid disease, while a clinically or ultrasonographically diagnosed antibody-negative phenotype occurs in about 5% of patients. A negative antibody result therefore lowers, but does not eliminate, the probability of Hashimoto thyroiditis. [2][16]",
        "Use thyroid ultrasound selectively when the gland is enlarged, palpably irregular, or antibody testing is negative despite persistent clinical suspicion. Compatible findings include diffuse hypoechogenicity and heterogeneous parenchyma; ultrasound can show inflammatory change even while thyroid hormone tests remain normal. Do not use an ultrasound pattern alone to determine whether levothyroxine is indicated; treatment remains driven by thyroid function. [12][17][15]"
      ],
      "bullets": [
        "Overt hypothyroidism: elevated TSH plus low free or total T4; initiate levothyroxine. [17]",
        "Subclinical hypothyroidism: elevated TSH with normal thyroid hormone level; decide between observation and treatment based on clinical context rather than antibody positivity alone. [17]",
        "Euthyroid autoimmune thyroiditis: normal TSH and free T4 with TPOAb/TgAb positivity or compatible ultrasound; do not prescribe thyroid hormone solely for antibodies. [17]"
      ],
      "subsections": [],
      "table": {
        "caption": "Interpretation of initial testing in suspected Hashimoto thyroiditis. [17][12][16]",
        "columns": [
          "Pattern",
          "Most likely interpretation",
          "Next action"
        ],
        "rows": [
          [
            "Elevated TSH with low free or total T4",
            "Overt hypothyroidism due to autoimmune thyroiditis when TPOAb/TgAb or ultrasound supports etiology. [17][12]",
            "Start titrated oral levothyroxine and follow thyroid function during dose adjustment. [10][5]"
          ],
          [
            "Elevated TSH with normal thyroid hormone level",
            "Subclinical hypothyroidism; antibody-positive disease may carry greater likelihood of progression than antibody-negative disease. [17][16]",
            "Consider clinical context; if deferring treatment, check TSH once or twice yearly. [17]"
          ],
          [
            "Normal TSH and free T4 with positive TPOAb or TgAb",
            "Euthyroid autoimmune thyroiditis. [17][19]",
            "No thyroid hormone replacement; monitor thyroid function longitudinally. [17]"
          ],
          [
            "Negative antibodies with heterogeneous, hypoechoic thyroid on ultrasound",
            "Possible seronegative Hashimoto thyroiditis. [16][12]",
            "Base treatment on TSH and free T4, not on ultrasound alone. [17]"
          ]
        ]
      }
    },
    {
      "id": "distinguish-thyrotoxicosis-and-alternative-causes",
      "eyebrow": "Diagnostic branch points",
      "heading": "Do not misclassify transient thyrotoxicosis or nonautoimmune hypothyroidism",
      "intro": "An abnormal thyroid panel should be interpreted in its temporal and etiologic context.",
      "paragraphs": [
        "A transient hyperthyroid phase can occur in Hashimoto thyroiditis from follicular destruction and release of stored hormone. In a patient with suppressed TSH and biochemical thyrotoxicosis, do not assume Graves disease solely because thyroid autoimmunity is present; thyroid autoantibodies may be associated with both Graves disease and Hashimoto thyroiditis. Reassess the evolving thyroid function pattern and clinical phenotype before committing to a hyperthyroidism-specific treatment pathway. [10][1][19]",
        "When hypothyroidism is present, document competing causes before assigning all disease to Hashimoto thyroiditis. Prior neck or thyroid surgery, thyroid irradiation, radioiodine treatment for Graves disease, and medications affecting thyroid function are alternative etiologies; primary hypothyroidism is far more common than secondary disease. This distinction matters because positive thyroid antibodies can coexist with another reason for reduced thyroid reserve. [24]",
        "Escalate beyond routine autoimmune testing when structural findings are discordant with diffuse thyroiditis—for example, a rapidly enlarging gland or a concerning focal process. Hashimoto thyroiditis can produce multiple ill-defined sonographic nodules, whereas rapid enlargement may also occur with anaplastic thyroid cancer or infiltrative disease; a focal or rapidly progressive structural concern requires directed thyroid evaluation rather than serial antibody measurement. [15][22]"
      ],
      "bullets": [
        "Obtain history of thyroidectomy, neck irradiation, radioiodine exposure, and thyroid-active medications when TSH is elevated. [24]",
        "Interpret positive TPOAb/TgAb as evidence of thyroid autoimmunity, not proof that every abnormal thyroid test reflects Hashimoto thyroiditis. [19][24]",
        "A rapidly enlarging thyroid or suspicious focal structural change should trigger focused structural assessment rather than routine longitudinal observation. [22][15]"
      ],
      "subsections": [],
      "table": {
        "caption": "Actionable etiologic distinctions in patients with suspected Hashimoto thyroiditis. [10][19][22][24]",
        "columns": [
          "Clinical pattern",
          "Discriminator",
          "Management consequence"
        ],
        "rows": [
          [
            "Thyrotoxicosis in a patient with autoimmune markers",
            "Hashimoto thyroiditis can cause a transient destructive hyperthyroid phase; autoantibodies can also occur in Graves disease. [10][19]",
            "Avoid assigning a permanent hyperthyroid diagnosis from antibody status alone; follow the biochemical and clinical trajectory. [10]"
          ],
          [
            "Hypothyroidism after radioiodine, surgery, or neck irradiation",
            "Clear iatrogenic exposure history. [24]",
            "Treat hormone deficiency but document iatrogenic thyroid loss as the principal or contributing cause. [24]"
          ],
          [
            "Rapid gland enlargement or atypical structural progression",
            "Rapid enlargement may reflect processes beyond autoimmune thyroiditis, including anaplastic thyroid cancer or infiltrative disease. [22]",
            "Pursue focused thyroid structural evaluation rather than attributing change to stable Hashimoto thyroiditis. [22]"
          ]
        ]
      }
    },
    {
      "id": "levothyroxine-treatment",
      "eyebrow": "Hormone replacement",
      "heading": "Use levothyroxine for hypothyroidism, not for antibody positivity",
      "intro": "Replacement corrects hormone deficiency but does not reliably halt the autoimmune process.",
      "paragraphs": [
        "Initiate oral levothyroxine for clinical hypothyroidism from Hashimoto thyroiditis. Available dosing references describe a typical adult maintenance requirement of about 1.7 mcg/kg/day, commonly 100 to 150 mcg/day, but starting dose should be individualized to age and cardiac risk. In older adults or patients considered dose-sensitive, begin 25 to 50 mcg daily; in elderly patients with coronary artery disease, 12.5 mcg daily is advised because more rapid replacement can precipitate angina. [5]",
        "Adjust the dose in 25-mcg increments no more often than every 6 to 8 weeks, using serum TSH and clinical response. One source describes titration every 6 weeks until thyroid function tests normalize, followed by thyroid testing every 6 months or sooner when symptoms recur. Keep the patient on a consistent levothyroxine formulation when feasible because formulation changes may introduce clinically meaningful dose variability. [5]",
        "For patients with high thyroid antibody levels but normal TSH and free T4, do not use levothyroxine merely to treat seropositivity. For mild subclinical hypothyroidism, medication may be deferred, with TSH checked once or twice per year to identify progression to clinical hypothyroidism. This approach separates management of autoimmune risk from treatment of biochemical hormone deficiency. [17]",
        "Address apparent under-replacement before reflexively escalating dose. Levothyroxine is best taken early in the morning on an empty stomach; iron, calcium, aluminum hydroxide, and proton-pump inhibitors can impair absorption. Review timing and interacting products at each unexplained TSH elevation, then repeat thyroid function testing after the corrected administration routine and adequate titration interval. [10]"
      ],
      "bullets": [
        "Typical adult maintenance estimate: approximately 1.7 mcg/kg/day; commonly 100 to 150 mcg/day. [5]",
        "Older or dose-sensitive patient: start 25 to 50 mcg orally daily. [5]",
        "Elderly patient with coronary artery disease: start 12.5 mcg orally daily. [5]",
        "Dose adjustment: increase by 25 mcg at 6- to 8-week intervals according to TSH and clinical response. [5]",
        "Administration: take fasting; separate from iron, calcium, aluminum hydroxide, and proton-pump inhibitors. [10]"
      ],
      "subsections": [
        {
          "heading": "When symptoms persist despite euthyroid testing",
          "paragraphs": [
            "Confirm TSH and free T4, adherence, formulation consistency, fasting administration, and interacting agents before attributing persistent symptoms to refractory Hashimoto thyroiditis. Levothyroxine corrects hypothyroidism but does not block the autoimmune process, and persistent symptoms in a biochemically euthyroid patient should prompt evaluation for nonthyroid contributors rather than automatic dose escalation. [9][10]"
          ],
          "bullets": [
            "Do not use symptoms alone to justify increasing levothyroxine when thyroid function tests have normalized. [5][9]",
            "Review iron, calcium, aluminum hydroxide, and proton-pump inhibitor exposure before labeling levothyroxine failure. [10]"
          ]
        }
      ],
      "table": {
        "caption": "Levothyroxine dosing and follow-up points supported for Hashimoto-related hypothyroidism. [5][10][17]",
        "columns": [
          "Clinical situation",
          "Dose or action",
          "Monitoring or caution"
        ],
        "rows": [
          [
            "Typical adult replacement",
            "Average maintenance requirement about 1.7 mcg/kg/day, often 100 to 150 mcg/day. [5]",
            "Titrate to thyroid function test normalization and symptom response. [5]"
          ],
          [
            "Older or dose-sensitive patient",
            "Start 25 to 50 mcg orally daily. [5]",
            "Adjust by 25 mcg every 6 to 8 weeks. [5]"
          ],
          [
            "Elderly patient with coronary artery disease",
            "Start 12.5 mcg orally daily. [5]",
            "Avoid rapid escalation because higher initial doses may precipitate angina. [5]"
          ],
          [
            "Elevated TSH despite prescribed therapy",
            "Verify fasting dosing and separation from iron, calcium, aluminum hydroxide, and proton-pump inhibitors. [10]",
            "Correct administration barriers before increasing dose; reassess after an adequate titration interval. [10][5]"
          ],
          [
            "Positive antibodies with normal TSH and free T4",
            "Do not prescribe thyroid hormone for seropositivity alone. [17]",
            "Monitor thyroid function longitudinally. [17]"
          ]
        ]
      }
    },
    {
      "id": "pregnancy-and-postpartum",
      "eyebrow": "Reproductive endocrinology",
      "heading": "Plan earlier monitoring in pregnancy and the postpartum period",
      "intro": "Pregnancy alters thyroid autoimmunity and can change replacement requirements.",
      "paragraphs": [
        "In patients with established Hashimoto-related hypothyroidism who become pregnant, continue levothyroxine and monitor TSH serially because pregnancy changes thyroid physiology and dose requirements. Pregnancy-specific management requires special consideration because maternal thyroid dysfunction can adversely affect pregnancy; historical guidance cited in current reviews supports dedicated pregnancy and postpartum thyroid management. [15][13]",
        "TPO antibody positivity has prognostic relevance even when thyroid function is not overtly abnormal: it is associated with a 2- to 4-fold increased risk of recurrent miscarriage and preterm birth. This association should prompt deliberate thyroid-function surveillance and obstetric coordination rather than empiric thyroid hormone treatment solely on the basis of antibodies when the patient remains euthyroid. [13][17]",
        "Recheck thyroid function after delivery because antibody levels generally decline during pregnancy, then rise postpartum; goiter and hypothyroidism may emerge or recur 2 to 6 months after delivery. Patients whose levothyroxine requirement changed during gestation need a documented postpartum testing plan rather than waiting for symptoms alone. [15]"
      ],
      "bullets": [
        "Continue levothyroxine in pregnant patients with established hypothyroidism and use serial TSH monitoring for dose adjustment. [15][21]",
        "Recognize TPOAb positivity as associated with a 2- to 4-fold increased risk of recurrent miscarriage and preterm birth. [13]",
        "Schedule postpartum thyroid reassessment because autoimmune activity and hypothyroidism can recur 2 to 6 months after delivery. [15]"
      ],
      "subsections": [],
      "table": {
        "caption": "Pregnancy-related decision points in Hashimoto thyroiditis. [13][15][17]",
        "columns": [
          "Time point",
          "Risk or interpretation",
          "Clinical action"
        ],
        "rows": [
          [
            "Preconception or early pregnancy",
            "TPOAb positivity is associated with a 2- to 4-fold increased risk of recurrent miscarriage and preterm birth. [13]",
            "Assess thyroid function and coordinate pregnancy-specific management. [13][15]"
          ],
          [
            "During pregnancy with treated hypothyroidism",
            "Thyroid physiology and levothyroxine requirements may change. [15][21]",
            "Continue levothyroxine and monitor TSH serially for dose adjustment. [15][21]"
          ],
          [
            "Two to six months postpartum",
            "Antibody levels may rise after delivery, with sudden goiter and hypothyroidism. [15]",
            "Repeat thyroid function testing even if symptoms are nonspecific. [15]"
          ]
        ]
      }
    },
    {
      "id": "longitudinal-monitoring-and-associated-autoimmunity",
      "eyebrow": "Long-term care",
      "heading": "Monitor thyroid function and use associated autoimmune disease as a clinical trigger",
      "intro": "Hashimoto thyroiditis evolves from euthyroidism or subclinical disease to persistent hypothyroidism in some patients.",
      "paragraphs": [
        "Follow untreated euthyroid or mildly subclinical disease with periodic TSH rather than serial antibody titers. For a patient with elevated antibodies but normal thyroid function, thyroid hormone is not required; for mild subclinical hypothyroidism when treatment is deferred, check TSH once or twice per year. The relevant progression endpoint is clinical hypothyroidism, defined by elevated TSH with low thyroid hormone level. [17][12]",
        "Use the clinical history to identify clustering of autoimmune disease. Hashimoto thyroiditis is frequently associated with vitiligo, Addison disease, and type 1 diabetes, including autoimmune polyglandular syndrome type 2. Target evaluation toward symptoms or established disease patterns rather than using the Hashimoto diagnosis alone as a mandate for indiscriminate testing. [12][24]",
        "A persistent or enlarging goiter deserves examination at follow-up even when thyroid function is stable. Hashimoto thyroiditis may produce diffuse enlargement and heterogeneous or very low-echogenicity ultrasound changes, but new focal or rapidly progressive structural findings should redirect evaluation toward thyroid pathology beyond routine autoimmune monitoring. [15][22]"
      ],
      "bullets": [
        "Euthyroid antibody-positive disease: no levothyroxine; monitor thyroid function. [17]",
        "Mild subclinical hypothyroidism managed without medication: measure TSH once or twice yearly. [17]",
        "Screen clinically for associated autoimmune disease when symptoms suggest vitiligo, adrenal insufficiency, or type 1 diabetes. [12][24]",
        "Reassess a changing goiter structurally; do not use stable antibody positivity as reassurance against a new focal process. [15][22]"
      ],
      "subsections": [],
      "table": {
        "caption": "Longitudinal follow-up priorities in Hashimoto thyroiditis. [12][15][17][22]",
        "columns": [
          "Follow-up finding",
          "Interpretation",
          "Next step"
        ],
        "rows": [
          [
            "Normal TSH and free T4 with antibody positivity",
            "Autoimmune thyroiditis without current hormone deficiency. [17]",
            "No replacement therapy; continue thyroid-function monitoring. [17]"
          ],
          [
            "Mild subclinical hypothyroidism without immediate treatment",
            "Possible progression to clinical hypothyroidism. [17][12]",
            "Check TSH once or twice yearly. [17]"
          ],
          [
            "Symptoms suggesting vitiligo, Addison disease, or type 1 diabetes",
            "Autoimmune clustering is recognized in Hashimoto thyroiditis. [12]",
            "Direct testing to the suspected associated autoimmune disorder. [12][24]"
          ],
          [
            "New focal finding or rapid gland enlargement",
            "Possible pathology beyond routine chronic thyroiditis. [22][15]",
            "Undertake focused structural thyroid evaluation. [22]"
          ]
        ]
      }
    }
  ],
  "faq": [],
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  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
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      "snippet": "Autoimmune Thyroiditis (AIT) is a common and refractory autoimmune disease of the clinical endocrine system, including Hashimoto's thyroiditis, postpartum thyroiditis, painless thyroiditis, juvenile thyroiditis, atrophic thyroiditis, and focal thyroiditis (Ragusa et al., 2019). AIT is characterized ",
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      "authors": "www.sciencedirect.com",
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      "snippet": "Hashimoto disease or chronic autoimmune thyroiditis is the most common autoimmune thyroid disorder (AITD), causing symptomatic hypothyroidism in approximately 20% to 30% of affected patients.13 Risk factors include female sex and increasing age. This condition is caused by the development of autoimm",
      "score": 0.5462305
    },
    {
      "number": 3,
      "title": "Hypothyroidism and chronic autoimmune thyroiditis in the pregnant state: maternal aspects - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1521690X0400017X",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Elsevier logo\nBest Practice & Research Clinical Endocrinology & Metabolism\n\n## Best Practice & Research Clinical Endocrinology & Metabolism\n\n## Published by: Elsevier\n\n### Published by\n\nElsevier\n\n# 7 Hypothyroidism and chronic autoimmune thyroiditis in the pregnant state: maternal aspects\n\n## Articl",
      "score": 0.50241756
    },
    {
      "number": 4,
      "title": "What antibody studies are helpful in the... : Evidence-Based Practice",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/ebp/fulltext/2012/01000/what_antibody_studies_are_helpful_in_the_diagnosis.7.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Approximately 68% of patients with Hashimoto's thyroiditis were positive for both antibodies, whereas only 1.8% were negative for both antibodies. 2. Including",
      "score": 0.4611872
    },
    {
      "number": 5,
      "title": "Levothyroxine Sodium - an overview | ScienceDirect Topics",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/topics/neuroscience/levothyroxine-sodium",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "| Thyroid Hormone | Generic (Trade Name) | Starting Oral Dose | Average Daily Dose and Titration |\n ---  --- |\n| Synthetic T4 alone | T4 levothyroxine (Synthroid, Unithroid, Levoxyl, Tirosint) Note: Stick with one formulation (generic or brand name) throughout the course of treatment because of dose",
      "score": 0.5189612
    },
    {
      "number": 6,
      "title": "Rook's Textbook of Dermatology",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/pdf/10.1002/9780470750520.index",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "gluten-free 59.34–5 in dermatitis herpetiformis 41.58 in psoriasis 35.49–50 ... Hashimoto's thyroiditis 58.18, 59.8. Haverhill fever 27.68. HAVS 21.18 ...Read more",
      "score": 0.20929222
    },
    {
      "number": 7,
      "title": "Abstract - 2024 - JPGN Reports",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1002/jpr3.12148",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Jan 23, 2025 — CG is linked to autoimmune diseases like celiac disease and autoimmune thyroiditis. current consensus supports oral iron pathology,",
      "score": 0.19132802
    },
    {
      "number": 8,
      "title": "Flash talks (FT) - 2024 - Allergy - Wiley Online Library",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1111/all.16299",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Results: The median age of the patients with sIgED (n = 1203) was 39 years (25–50), and 904 (75.1%) were female. The median age of the 2489 patients with IgE > 2 kIU/L was 40 years (29–54), and 1564 (62.8%) were female. Autoimmune diseases were identified in 34.5% of subjects with sIgED and in 24.3%",
      "score": 0.1002869
    },
    {
      "number": 9,
      "title": "Hashimoto’s thyroiditis: from pathogenesis to clinical management",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12907336",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "##  is a chronic autoimmune thyroiditis characterized by thyroid-specific autoantibodies (TPOAb, TGAb) positivity and lymphocytic infiltration, and is a major cause of hypothyroidism in iodine-sufficient regions. Epidemiological data show a significant increase in the prevalence of HT, which is abou",
      "score": 0.6977124
    },
    {
      "number": 10,
      "title": "Hashimoto Thyroiditis - StatPearls - NCBI Bookshelf - NIH",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK459262",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "## Treatment / Management\n\nCurrent clinical guidelines emphasize disease management rather than prevention or cure.\n\nThyroid Hormone Replacement\n\nThe mainstay of treatment for hypothyroidism that develops due to Hashimoto thyroiditis is thyroid hormone replacement. The drug of choice is titrated lev",
      "score": 0.694241
    },
    {
      "number": 11,
      "title": "Current Practices in Hashimoto’s Thyroiditis: Differences in Attitudes Between Pediatric and Adult Endocrinologists in Türkiye: A National Survey - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12372645",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "## Introduction\n\nHashimoto’s thyroiditis (HT), also known as autoimmune thyroiditis or chronic lymphocytic thyroiditis, remains the most common thyroid disease group in the general population. In recent years, the reported prevalence of HT in childhood is 1.2%, the prevalence in adults has been repo",
      "score": 0.6914979
    },
    {
      "number": 12,
      "title": "[Autoimmune thyroiditis (Hashimoto's thyroiditis): current diagnostics and therapy] - PubMed",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/pubmed/20676951",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Title: [Autoimmune thyroiditis (Hashimoto's thyroiditis): current diagnostics and therapy] - PubMed\nAn official website of the United States government. **The .gov means it’s official.**. Federal government websites often end in .gov or .mil. sharing sensitive information, make sure you’re on a fede",
      "score": 0.68496037
    },
    {
      "number": 13,
      "title": "Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9478900",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "26. Alexander, Pearce, Brent, _et al._ 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. _Thyroid_. 2017; 27: 315–389. doi: 10.1089/thy.2016.0457  [DOI] [PubMed] [Google Scholar]\n   27. Toulis, Anastasilakis, ",
      "score": 0.6625569
    },
    {
      "number": 14,
      "title": "Persistent symptoms in euthyroid Hashimoto’s thyroiditis: current hypotheses and emerging management strategies",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12313505",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "4. Caturegli, De Remigis, Rose. Hashimoto thyroiditis: clinical and diagnostic criteria. _Autoimmun Rev_. (2014) 13:391–7. doi: doi: 10.1016/j.autrev.2014.01.007 , PMID:  [DOI] [PubMed] [Google Scholar]\n   5. Jonklaas, Bianco, Bauer, Burman, Cappola, Sawka, _et al._. Guidelines for the treatment of ",
      "score": 0.6356076
    },
    {
      "number": 15,
      "title": "Hashimoto’s Thyroiditis - Endotext - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK285557",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Remission of Hashimoto's thyroiditis, with loss of goiter, hypothyroidism, and serum thyroid autoantibodies, has been reported during pregnancy, with relapse after delivery(54). Antibody levels usually fall during pregnancy(55). These phenomena may reflect the immunosuppressive effects of pregnancy.",
      "score": 0.585789
    },
    {
      "number": 16,
      "title": "Vol 7 Issue 9 p.10-11 |  American Thyroid Association",
      "detail": "www.thyroid.org",
      "url": "https://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-7-issue-9/vol-7-issue-9-p-10-11",
      "authors": "www.thyroid.org",
      "host": "www.thyroid.org",
      "snippet": "BACKGROUND  \nHashimoto’s thyroiditis, also known as chronic autoimmune hypothyroidism, is the most common cause of hypothyroidism in the United States. It is caused by antibodies that attack the thyroid and destroy it. Most patients with Hashimoto’s thyroiditis have measurable antibodies in the bloo",
      "score": 0.68496037
    },
    {
      "number": 17,
      "title": "[PDF] Hashimoto's Thyroiditis",
      "detail": "www.thyroid.org",
      "url": "https://www.thyroid.org/wp-content/uploads/patients/brochures/Hashimotos_Thyroiditis.pdf",
      "authors": "www.thyroid.org",
      "host": "www.thyroid.org",
      "snippet": "HASHIMOTO’S THYROIDITIS (Chronic Lymphocytic Thyroiditis or Autoimmune Thyroiditis) HOW IS THE DIAGNOSIS OF HASHIMOTO’S THYROIDITIS MADE? The diagnosis of Hashimoto’s thyroiditis may be made when you have symptoms of hypothyroidism, and a blood test shows an underactive thyroid gland [an elevated Th",
      "score": 0.65835214
    },
    {
      "number": 18,
      "title": "Vol 15 Issue 8 p.9-10 |  American Thyroid Association",
      "detail": "www.thyroid.org",
      "url": "https://www.thyroid.org/patient-thyroid-information/ct-for-patients/august-2022/vol-15-issue-8-p-9-10",
      "authors": "www.thyroid.org",
      "host": "www.thyroid.org",
      "snippet": "Thyroid antibodies (thyroid peroxidase/TPO and thyroglobulin/Tg antibodies): these are antibodies that attack the thyroid instead of bacteria and viruses, they are a marker for autoimmune thyroid disease, which is the main underlying cause for hypothyroidism and hyperthyroidism in the United States.",
      "score": 0.64182705
    },
    {
      "number": 19,
      "title": "Vol 4 Issue 10 p.11-12 | American Thyroid Association",
      "detail": "www.thyroid.org",
      "url": "https://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-4-issue-10/vol-4-issue-10-p-11-12",
      "authors": "www.thyroid.org",
      "host": "www.thyroid.org",
      "snippet": "Autoimmune thyroid disease is caused by the body making antibodies that attack the thyroid and either turn it on (Graves’ disease, hyperthyroidism) or turn it off (Hashimoto’s thyroiditis, hypothyroidism). Some people with positive thyroid antibodies have normal thyroid function and develop either G",
      "score": 0.6102915
    },
    {
      "number": 20,
      "title": "Antithyroid peroxidase autoantibodies in thyroid diseases - PubMed",
      "detail": "www.ccjm.org",
      "url": "https://www.ccjm.org/lookup/external-ref?access_num=2168432&link_type=MED&atom=%2Fccjom%2F92%2F4%2F221.atom",
      "authors": "www.ccjm.org",
      "host": "www.ccjm.org",
      "snippet": "The highest anti-TPO Ab concentrations were found in untreated hypothyroid Hashimoto's thyroiditis, but no simple relationship between anti-TPO Ab levels",
      "score": 0.42176673
    },
    {
      "number": 21,
      "title": "Thyroid Peroxidase Antibody - an overview",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/topics/neuroscience/thyroid-peroxidase-antibody",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "a normal intra-uterine pregnancy. The patient continues on levothyroxine throughout her pregnancy with serial monitoring of TSH levels. Her dose is adjusted to maintain a TSH level between 2.0 and 4.5 mIU/l. By the end of the third trimester her dose has increased to 88 μg daily. She delivers a heal",
      "score": 0.40627348
    },
    {
      "number": 22,
      "title": "Euthyroidism - an overview | ScienceDirect Topics",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/euthyroidism",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "2.\nPatients should be rendered euthyroid with antithyroid drugs before surgery.\n\n3.\nComplications of surgery include hypothyroidism (28% to 43% after 10 yr), hypoparathyroidism, and vocal cord paralysis (1%).\n\n4.\nHyperthyroidism recurs after surgery in 10% to 15% of patients.\n\nADJUNCTIVE THERAPY: Pr",
      "score": 0.22308958
    },
    {
      "number": 23,
      "title": "Celiac disease detection in hypothyroid patients requiring elevated thyroid supplementation: A prospective cohort study - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0953620515002964",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "### Am J Med\n\n### Guidelines for the management of iron deficiency anaemia\n\n### Gut\n\n### Subclinical coeliac disease is a frequent cause of iron-deficiency anaemia\n\n### Scand J Gastroenterol\n\n## Cited by (22)\n\n### Precision Medicine in Autoimmune Thyroiditis and Hypothyroidism\n\n### The Stability of ",
      "score": 0.43093804
    },
    {
      "number": 24,
      "title": "Hypothyroidism - an overview | ScienceDirect Topics",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/topics/medicine-and-dentistry/hypothyroidism",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Hypothyroidism is a common condition. The prevalence of overt hypothyroidism in the United States is estimated at 0.3% to 0.4%, whereas that of subclinical hypothyroidism is much higher (4%-8%). The mean age at diagnosis is the mid-50s. Hypothyroidism is much more common in women, with a female-to-m",
      "score": 0.4018996
    }
  ],
  "publishedAt": "2026-09-16T00:20:14.082468+00:00",
  "updatedAt": "2026-09-16T00:20:14.082468+00:00",
  "readingMinutes": 7,
  "slug": "hashimoto-thyroiditis"
}