Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis also known as autoimmune thyroiditis, is a chronic inflammatory autoimmune disease that uses its own thyroid tissue as an antigen and is the most common form of thyroiditis. How is Hashimoto’s thyroiditis diagnosed? 1. Diffuse enlargement of the thyroid gland with tough texture, uneven surface or nodules; 2. Positive TGAb and TMAb; 3. Elevated blood TSH; 4. Irregularly concentrated or sparse thyroid scan; 5. Positive potassium perchlorate excretion test. The diagnosis of CLT can be made if two of the five items are present, and the diagnosis can be confirmed if four items are present. In general, CLT can be clinically diagnosed as long as there are typical clinical manifestations of CLT and positive serum TGAb and TPOAb. For those with atypical clinical manifestations, a high titer of anti-thyroid antibody is required for diagnosis. In these patients, if the serum TGAb and TPOAb are positive, the necessary imaging studies should be given to confirm the diagnosis, and thyroxine diagnostic treatment should be given, and if necessary, the diagnosis should be confirmed by FNAC or frozen section histology. How to choose the treatment for Hashimoto’s thyroiditis? There is no specific treatment available, and in principle, surgery is generally not indicated. After clinical diagnosis, treatment should be determined by the size of the thyroid gland and the presence or absence of symptoms of compression. If the thyroid gland is small and there are no obvious symptoms of pressure, it may be possible to follow up without treatment. What are the conservative treatments for Hashimoto’s thyroiditis? 1. Surgical treatment is generally not indicated. For subacute onset with pain, prednisone treatment is effective, but the effect is not long-lasting. For those with significant goiter or hypothyroidism, thyroxine treatment should be given. 50-100ug/d of levothyroxine or 60-120mg/d of thyroxine tablets can be used, which can be increased or decreased according to the condition to achieve a stable titer of TSH. 3. Hashimoto’s hyperthyroidism can be treated with antithyroid drugs, such as tabazol or propylthioxypyrimethamine, but the dose should be less than that of general hyperthyroidism and the duration of medication should not be too long. In case of transient hyperthyroidism (clinical symptom type), symptomatic treatment with beta-blockers (Tamsulosin) only is sufficient. How is Hashimoto’s thyroiditis surgery done and what should I pay attention to after surgery? Frozen section tissue biopsy should be routinely performed during surgery. If the disease is confirmed, only partial thyroid lobectomy and isthmus resection should be performed. The main objective is to remove the larger solitary nodule and relieve the compression, and try to preserve the reversible thyroid tissue. If the pathology is confirmed as malignant, it should be treated according to the principles of thyroid cancer management. After surgery, thyroxine should be routinely applied to continue treatment to prevent hypothyroidism.