Autoimmune thyroiditis: Hashimoto’s thyroiditis treatment

Hashimoto's thyroiditis, also known as autoimmune thyroiditis, does not always need to be treated. Because even if the antibody values are high - as long as the thyroid values TSH and fT4 are normal, i.e. the thyroid gland is functioning well, no medication is necessary.

Treatment with thyroid hormones

However, if elevated antibody levels have already been detected, you should have your TSH level checked annually to be on the safe side, so that a dysfunction can be detected early and countermeasures can be taken. The special thing about this chronic thyroid disease is that it is not the disease itself that is the target of the therapy; the inflammation cannot and does not need to be treated, but its symptoms, caused by the hypothyroidism as a result of the inflammation. Only when hypothyroidism occurs is treatment necessary, namely in the form of hormone replacement therapy, which can compensate for the lack of thyroid hormones. L-thyroxine (levothyroxine) is used as the active ingredient, with the dose depending exactly on how severe the deficiency of this hormone is. You should have your thyroid levels checked at regular intervals to ensure that the amount is optimal. In most cases, thyroid function continues to decline over the course of a person’s life, which is why the dose of the hormone medication needs to be adjusted. Of course, the medication usually has to be taken for the rest of the patient’s life because thyroid tissue that has already gone under does not recover, so the hypothyroidism remains and has to be compensated for.

Autoimmune thyroiditis – beware of iodine

In connection with hypothyroidism, it is often advised to ensure sufficient iodine intake, as this element is a prerequisite for the thyroid gland to be able to produce hormones. In the case of autoimmune thyroiditis, however, hormone replacement therapy is carried out without this supplement, as iodine can even fuel the inflammation under certain circumstances. This is also why those affected do not need a special iodine-rich diet.

Pregnancy and Hashimoto’s thyroiditis

You should be particularly careful in connection with hormone replacement therapy for autoimmune thyroiditis if you want to become pregnant or are already pregnant: More frequent blood tests are then necessary to closely monitor the thyroid hormone situation. It is often the case that more thyroid hormones need to be taken during the first half of pregnancy.

Responsible senior physician

Jan Krützfeldt, Prof. Dr. med.

Attending Physician with extended responsibilites, Department of Endocrinology, Diabetology and Clinical Nutrition

Tel. +41 44 255 36 20
Specialties: Thyroid ultrasound, Autoimmune thyroiditis, Thyroid carcinoma

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