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Feature Article

Hashimoto’s thyroiditis: how to spot the diagnosis and how to manage it

KIERNAN HUGHES, CRESWELL J. EASTMAN

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Abstract

Hashimoto’s thyroiditis is a chronic destructive autoimmune disorder and the leading cause of hypothyroidism in Australia. Its high prevalence justifies a low threshold for measuring thyroid stimulating hormone (TSH) level in adults, particularly women. Decisions about who to treat should be based on thyroid function test results, symptoms of hypothyroidism, patient age, comorbid conditions and patient preference.
Correction
A correction for the print version of this article will be published in the October 2017 issue of Medicine Today. The online and full text PDF versions of this article (see link above) have been corrected.

Key Points

  • Hashimoto’s thyroiditis is a chronic destructive autoimmune inflammatory disorder of the thyroid gland.
  • Hashimoto’s thyroiditis is the leading cause of hypothyroidism in Australia.
  • The decision to commence levothyroxine therapy should be based on an assessment of thyroid function tests (particularly measurement of the serum thyroid stimulating hormone level), symptoms of hypothyroidism, patient age, comorbid conditions and patient preference.
  • Pregnancy requires careful management in patients with Hashimoto’s thyroiditis to prevent adverse obstetric and fetal outcomes.
  • Managing patients whose symptoms persist after they have achieved a euthyroid state with levothyroxine therapy is a clinical challenge.
  • Hashimoto’s thyroiditis is associated with other autoimmune disorders, including coeliac disease, type 1 diabetes and pernicious anaemia. 


    Picture credit: © Lydie/stock.adobe.com
    Models used for illustrative purposes only

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