Feature Article

Hashimoto’s thyroiditis: when to observe, to treat or to refer

Dulani Kottahachchi, Duncan J Topliss



Most patients with Hashimoto’s thyroiditis can be diagnosed and treated by their GPs, with specialist input in specific circumstances. The decision whether to observe patients or treat them with thyroxine replacement therapy depends on thyroid function results and factors such as age, symptoms and vascular risk.

Key Points

  • Hashimoto’s thyroiditis is a common autoimmune disease, mainly affecting women.
  • The aetiology of HT is believed to involve genetic and environmental factors.
  • Presentations of HT range from incidental detection of antithyroid antibodies, clinical euthyroidism with goitre to subclinical or overt hypothyroidism.
  • Diagnosis of HT relies on a combination of clinical and biochemical parameters.
  • Levothyroxine is the mainstay of treatment.
  • Patients with disease that is difficult to diagnose or manage should be referred for specialist opinion.

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