Practice Essentials

Hashimoto thyroiditis is part of the spectrum of autoimmune thyroid diseases (AITDs) and is characterized by the destruction of thyroid cells by various cell- and antibody-mediated immune processes. This condition is the most common cause of hypothyroidism in the United States in individuals older than 6 years.^[1] The treatment of choice for Hashimoto thyroiditis (or hypothyroidism from any cause) is thyroid hormone replacement. The drug of choice is orally administered levothyroxine sodium, usually for life.

Signs and symptoms of Hashimoto thyroiditis

Hypothyroidism in Hashimoto thyroiditis is usually insidious in onset, with subtle signs and symptoms that may progress to more advanced or even florid signs and symptoms over months to years. The presentation of patients with hypothyroidism may also be subclinical, diagnosed based on routine screening of thyroid function. Such patients may have nonspecific symptoms that are difficult to attribute to thyroid dysfunction. They frequently do not improve with thyroid hormone supplementation.

Early nonspecific symptoms may include the following:

Fatigue
Constipation
Dry skin
Weight gain

More advanced/florid symptoms may include the following:

Cold intolerance
Voice hoarseness and pressure symptoms in the neck from thyroid enlargement
Slowed movement and loss of energy
Decreased sweating
Mild nerve deafness
Peripheral neuropathy

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Author

Janki Patel, MD Fellow, Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Texas Health Science Center at Houston, McGovern Medical School

Janki Patel, MD is a member of the following medical societies: American Association of Clinical Endocrinology, American College of Physicians, American Medical Association, Endocrine Society, Medical Council of India

Disclosure: Nothing to disclose.

Coauthor(s)

Philip R Orlander, MD, FACP Professor, Department of Internal Medicine, Director, Division of Endocrinology, Diabetes and Metabolism, Associate Dean for Educational Programs, Vice-Chair of Medicine for Education, Edward Randall III Chair in Internal Medicine, Program Director, Endocrinology, Diabetes and Metabolism Fellowship Program, University of Texas Health Science Center at Houston, McGovern Medical School

Philip R Orlander, MD, FACP is a member of the following medical societies: American Association of Clinical Endocrinology, American Diabetes Association, Endocrine Society, Harris County Medical Society, Texas Medical Association

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for Physician Leadership, American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society, International Society for Clinical Densitometry, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Sylvester Odeke, MD, FACE Endocrinologist, Banner Health Physicians Colorado, LLC, North Colorado Medical Center

Sylvester Odeke, MD, FACE is a member of the following medical societies: American Association of Clinical Endocrinology, American College of Endocrinology, North Carolina Medical Society

Disclosure: Nothing to disclose.

Stephanie L Lee, MD, PhD Associate Professor, Department of Medicine, Boston University School of Medicine; Director of Thyroid Health Center, Section of Endocrinology, Diabetes and Nutrition, Boston Medical Center; Fellow, Association of Clinical Endocrinology

Stephanie L Lee, MD, PhD is a member of the following medical societies: American College of Endocrinology, American Thyroid Association, Endocrine Society

Disclosure: Nothing to disclose.

Steven B Nagelberg, MD Clinical Professor, Department of Medicine, Division of Endocrinology and Metabolism, Drexel University College of Medicine

Steven B Nagelberg, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Clinical Endocrinology, American College of Physicians, American Diabetes Association, American Medical Association, Endocrine Society, Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Acknowledgements

Don S Schalch, MD Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics

Don S Schalch, MD is a member of the following medical societies: American Diabetes Association, American Federation for Medical Research, Central Society for Clinical Research, and Endocrine Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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