Diagnosis of Hashimoto's Thyroiditis

Hashimoto's thyroiditis is a chronic inflammatory thyroid disease caused by immune system abnormalities, often manifested as progressive thyroid enlargement and hypothyroidism. If not diagnosed early, it may develop into permanent hypothyroidism, leading to endocrine disorders, emotional disturbances, fertility issues, and multi-system damage. Diagnosis requires a combination of clinical manifestations, hormone levels, antibody detection, and ultrasound imaging to achieve early detection and treatment, preventing disease progression and irreversible gland damage.

Diagnostic Basis of Hashimoto's Thyroiditis

1. Serum Thyroid-Stimulating Hormone (TSH) Test
Elevated serum TSH is one of the earliest signs of hypothyroidism. In Hashimoto’s-induced hypothyroidism, the pituitary secretes more TSH to stimulate the thyroid, but due to gland damage, hormone synthesis cannot proceed normally.

2. Free Thyroxine (FT4) and Free Triiodothyronine (FT3) Test
FT4 and FT3 levels can be used to assess thyroid function. In the early stages, most Hashimoto's patients have normal FT4 and slightly low FT3; as the disease progresses, both FT4 and FT3 decrease, indicating significant hypothyroidism.

3. Anti-Thyroid Peroxidase Antibody (TPOAb)
TPOAb is a core indicator of Hashimoto's thyroiditis. Elevated TPOAb levels in serum suggest the presence of autoimmune reactions and are one of the specific antibodies for diagnosis.

4. Anti-Thyroglobulin Antibody (TgAb) Test
TgAb is also an important antibody for Hashimoto’s. It usually elevates together with TPOAb. The coexistence of both significantly increases the likelihood of diagnosis, especially when symptoms are atypical.

5. Thyroid Color Doppler Ultrasound
Ultrasound can observe structural changes in the thyroid. Patients with Hashimoto’s often show diffusely reduced echogenicity, unclear borders, and heterogeneous nodular-like echoes, which are important imaging signs of chronic inflammation.

6. Comprehensive Clinical Symptom Assessment
Patients often report fatigue, cold intolerance, weight gain, constipation, and menstrual irregularities. If accompanied by thyroid enlargement or neck compression symptoms, Hashimoto’s should be strongly suspected. Doctors can make preliminary identification based on symptoms.

7. Family History and Genetic Background
Hashimoto’s has a genetic predisposition. If direct relatives have thyroid diseases or other autoimmune conditions, screening should be strengthened for early detection of latent disease.

8. Dynamic Follow-Up of Thyroid Function
Some early-stage patients may already show elevated serum antibodies but normal hormone levels. It is recommended to recheck TSH and FT4 every 3–6 months to monitor disease progression.

9. Multi-Indicator Comprehensive Evaluation
The diagnosis of Hashimoto’s thyroiditis cannot rely on a single indicator but requires comprehensive evaluation of antibodies, hormones, imaging, and symptoms to ensure accurate and scientific diagnosis, avoiding misdiagnosis or missed diagnosis.

Conclusion

Early recognition of Hashimoto's thyroiditis is particularly critical. Multiple biochemical indicators and ultrasound imaging provide clear evidence for diagnosis. Experts at United Life International Medical Center recommend that individuals with a family history or symptoms of hypothyroidism undergo early screening. Emerging technologies such as stem cell therapy also offer new avenues for early intervention to prevent irreversible disease progression.