Chronic lymphatic thyroiditis, also known as Hashimoto’s disease, was first reported by Dr. Saku Hashimoto in Japan. In the past, because the public knew little about it, when doctors gave the diagnosis of the disease, patients often thought they had some strange disease. In fact, it is the most common type of thyroiditis, accounting for about 1/4 to 1/3 of all outpatient visits to thyroid specialists, so patients should not be nervous. Hashimoto’s disease is a typical autoimmune disease that is caused by a variety of reasons that lead to a disruption of the body’s immune system and the body produces toxic substances against its own thyroid gland —- autoantibodies, leading to the destruction of thyroid cells and eventually hypothyroidism. Hashimoto’s disease is most often seen in women of childbearing age between 30 and 50 years old, with a female to male ratio of 20:1. Moreover, many patients often find that their mothers, daughters, aunts and other close relatives, especially siblings, are affected, showing that the disease has a clear genetic predisposition. The onset of the disease is relatively insidious, which means that the patients themselves do not know when they get the disease. Many patients only find out that their necks have become thicker by chance, and more often than not, they go to the hospital to find out that they have the disease because “people say my neck is big”. In the early stages of the disease, the thyroid gland is usually enlarged, and the degree of enlargement varies, from a slight enlargement that is not noticeable to a thyroid gland that is 2-4 times larger than normal. Patients usually do not feel pain in the thyroid area, and there is no pressure pain. At this time, thyroid function tests (e.g., serum TT3, TT4, FT3, FT4, TSH measurement, thyroid 131 iodine uptake rate measurement, etc.) will not reveal any abnormalities. With the further development of the disease, the symptoms of hypothyroidism, such as fear of cold, swelling, loss of appetite, constipation and rough skin, may appear over several years or longer. This is when thyroid function is checked. This can further confirm that the patient has hypothyroidism. Blood tests for thyroglobulin antibodies and thyroid microsomal antibodies are often positive, both in the early stages of the disease and later in life, and thyroid (ECT) scans can also reveal a sparse distribution of radioactivity in the thyroid gland. Because of the insidious onset, many patients are not found to have chronic lymphatic thyroiditis until they are seen for hypothyroidism. A small number of patients may have transient hyperthyroidism at some point and may also have recurrent hyperthyroidism or alternating hyperthyroidism and hypothyroidism if affected by iodine intake and thyroid inflammation and repair. The current treatment for Hashimoto’s thyroiditis is mainly symptomatic, and those with normal thyroid function can be followed up. If you have hyperthyroidism, you can take anti-thyroid medication and levothyroxine tablets at the same time. Short-term hormone therapy or surgery can be used only when the enlarged thyroid gland is obviously accompanied by pressure symptoms. However, if there are nodules in the thyroid, it is best to review them every six months. When the disease progresses and hypothyroidism develops, it is necessary to start replacement therapy with levothyroxine tablets in adequate doses, starting with small doses for older people. Iodine intake can be reduced in the daily diet. Iodine intake is an important environmental factor affecting the development of Hashimoto’s thyroiditis, and the incidence of the disease increases significantly with increased iodine intake. In particular, increased iodine intake can promote the development of clinical hypothyroidism in patients with latent Hashimoto’s thyroiditis. Foods rich in iodine are mainly seafood, nori and kelp, etc. You can also replace the regular iodized salt with non-iodized salt. You can also take appropriate selenium supplements under the guidance of your doctor. Selenium is named after the Greek legendary moon goddess (Selefie). Selenium is an essential trace element for living things. At present, its biological role is being recognized by domestic and foreign scholars, and research has proved that the appropriate nutritional status of selenium in the body is conducive to the maintenance of normal immune defense, thyroid function, reproductive function, etc. Foods rich in selenium include meat, especially animal liver and kidney, as well as seafood, cereals, mushrooms, onions, garlic, asparagus and other products, eggs, tuna and oysters are also rich in selenium. In the case of meeting nutritional needs, a daily supplement of 200 micrograms of selenium is appropriate. In conclusion, having unraveled the mystery of Hashimoto’s thyroiditis, patients should be relieved that it is not some weird disease! It is not a terminal disease, but a common disease caused by immune dysfunction. Patients should follow up regularly to know themselves and each other, so that they can “live peacefully” with it without too much worry.