With the popularity of thyroid screening in medical checkups, more and more people are being diagnosed with “Hashimoto’s thyroiditis,” a common autoimmune thyroid infection that is particularly likely to occur in women. What is the thyroid gland: The thyroid gland, usually located in the front of the neck and shaped like a butterfly, is an important endocrine organ of the body. The thyroid gland’s main function is to produce and store thyroid hormones, which are transported through the bloodstream to various tissues in the body. Thyroid hormones are important for maintaining the body’s energy metabolism, thermoregulation, and the normal functioning of the brain, heart, muscles and other organs. What is Hashimoto’s thyroiditis? Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis, occurs as a result of a combination of genetic and environmental factors and is the most common form of autoimmune thyroiditis. Patients have a diffuse infiltration of lymphocytes and plasma cells in the thyroid tissue, and the normal glandular tissue is destroyed. As the degree of glandular destruction progresses, the ability of the thyroid gland to produce sufficient thyroid hormone is compromised and hypothyroidism is likely to occur. What are the general symptoms of Hashimoto’s thyroiditis? Patients usually have an insidious onset and slow progression, and the early clinical manifestations are often atypical. As the disease progresses, patients may develop symptoms including: 1. goiter: mostly diffuse, lobar or nodular enlargement, mostly tough and hard in texture. 2. 2. Patients may have pharyngeal discomfort or mild dysphagia, and sometimes a feeling of pressure in the neck. 3. When thyroid tissue destruction occurs in hypothyroidism, it can show symptoms of hypothyroidism: fear of cold, bradycardia, constipation, weakness, water preference, mucinous edema, etc. 4. A few patients can develop thyroid-related ophthalmopathy. In a few patients, Hashimoto’s thyroiditis coexists with Graves’ disease, called Hashimoto’s thyrotoxicosis, which can manifest as symptoms of hyperthyroidism and is more complex Laboratory tests for Hashimoto’s thyroiditis: 1. Serum thyroid hormones and thyroid stimulating hormone (TSH): In general, the degree of thyroid destruction varies and can show normal, subclinical hypothyroidism, and hypothyroidism changes. A few patients have alternating hyperthyroidism and hypothyroidism. 2. Thyroid autoantibodies: Significantly elevated TgAb and TPOAb titers are one of the characteristics of this disease. The detection of antibodies has a certain positive rate. 3. Ultrasonography of the thyroid gland: most show goiter with uneven echogenicity, which may be accompanied by multiple hypoechoic areas or thyroid nodules 4. Fine needle aspiration of the thyroid gland: has confirmatory value and can be used when it is necessary to differentiate from other thyroid disorders with difficulty. How is Hashimoto’s thyroiditis diagnosed? The diagnosis of Hashimoto’s thyroiditis can be made if the thyroid gland is diffusely enlarged and has a tough texture, especially if it is accompanied by an enlarged isthmic cone lobe, regardless of changes in thyroid function. The diagnosis is further supported by the presence of clinical hypothyroidism or subclinical hypothyroidism. Treatment of Hashimoto’s thyroiditis: If thyroid function is normal, follow-up is the main management measure. Follow-up visits every 6 months to 1 year are generally recommended, mainly to check thyroid function and, if necessary, to perform ultrasonography of the thyroid gland. There is no treatment available for the cause of the disease. In the case of hypothyroidism and subclinical hypothyroidism, thyroid hormone replacement therapy should be administered as appropriate. In cases of significant goiter, thyroid hormone may have a beneficial effect in reducing the goiter in those with normal thyroid function, but it is important to evaluate the cardiac and systemic conditions and weigh the pros and cons. Hashimoto’s thyroiditis and pregnancy: If TPOAb is known to be positive before pregnancy, thyroid function must be checked and normal thyroid function must be confirmed before pregnancy. In case of hypothyroidism or low T4emia, thyroxine treatment should be given, otherwise it will lead to insufficient supply of thyroid hormones to the fetus and affect its neurodevelopment. The general thyroid hormone requirement during pregnancy increases with the number of weeks of gestation, and thyroid function tests need to be strengthened during pregnancy to adjust the dose in a timely manner.