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Hashimoto Thyroiditis

Chronic Autoimmune Thyroiditis — Most Common Cause of Hypothyroidism

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Hashimoto Thyroiditis?

Hashimoto thyroiditis (chronic autoimmune thyroiditis) is the leading cause of hypothyroidism in iodine-sufficient regions.

The disease is characterized by lymphocytic infiltration of thyroid tissue and positive anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin antibodies.

Progressive follicular destruction causes subclinical, then overt, hypothyroidism with elevated TSH and low or low-normal free T4.

The disease may present with a firm, painless goiter or a shrunken atrophic gland; genetic susceptibility and female predominance are notable.

Symptoms

Fatigue, cold intolerance, and weight gain
Dry skin, hair loss, and brittle nails
Constipation, menstrual irregularities, and low libido
Slow cognition, depression, and memory complaints
Bradycardia, hoarse voice, and puffy facies
Painless diffuse goiter or firm nodular thyroid

Risk Factors

Female sex and age 30–50 years
Family or personal history of autoimmune disease (type 1 diabetes, celiac, vitiligo)
Excess iodine intake in susceptible individuals
Postpartum period and certain HLA haplotypes
Radiation exposure to the neck
Drugs: amiodarone, lithium, interferon-alpha, checkpoint inhibitors

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Symptoms of hypothyroidism or a growing goiter
  • Elevated TSH with or without low free T4
  • Rapidly enlarging, painful, or dominant thyroid nodule warranting evaluation

Treatment Methods

01
Levothyroxine titrated to age- and situation-appropriate TSH target (usually 0.5–2.5 mIU/L)
02
Recheck TSH every 6–8 weeks after dose change, then annually when stable
03
Careful dose adjustment during pregnancy (30–50% increase) with trimester-specific TSH targets
04
Avoid interference from calcium, iron, soy, PPIs; take levothyroxine consistently on empty stomach
05
Screen for associated autoimmune diseases (celiac, pernicious anemia, adrenal insufficiency)
06
Ultrasound and FNA of suspicious nodules; patient education on lifelong therapy and monitoring

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.