Hashimoto's thyroiditis: from pathogenesis to clinical management.

Linghui Wang, Xi Zhu, Shuting Xu, Bin Zhou, Yong Wu, Zhouting Li, Yanjie Zhao, Shuhui Li, Feng Cheng, Lei Zhu

Journal: Frontiers in endocrinology 2026;17():1729316

PMID: 41704486

Abstract

Hashimoto's thyroiditis (HT) is a chronic autoimmune thyroiditis characterized by thyroid-specific autoantibodies (TPOAb, TGAb) positivity and lymphocytic infiltration, and is a major cause of hypothyroidism in iodine-sufficient regions. Epidemiological data show a significant increase in the prevalence of HT, which is about four times more common in adult women than in men. The pathogenesis of HT involves a complex interaction of genetic susceptibility, environmental factors, and immune regulation. Its clinical diagnosis is mainly based on serological tests (TPOAb/TGAb) and thyroid ultrasound features. The current treatment of Hashimoto's is based on levothyroxine (T4) replacement. This article presents a narrative review of the pathogenesis, status, and challenges of treatment of HT to provide a theoretical basis for optimizing clinical practice and basic research.

Address: Graduate Joint Training Base of Zhejiang Chinese Medical University (Lishui Joint Training Base - Lishui Municipal Central Hospital), Hangzhou, Zhejiang, China.; Department of Head and Neck Surgery, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang, China.; Department of Head and Neck Surgery, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang, China.; Department of Head and Neck Surgery, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang, China.; Hangzhou Medical College, Hangzhou, Zhejiang, China.

DOI: 10.3389/fendo.2026.1729316

MeSH Terms: Humans, Hashimoto Disease, Autoantibodies, Thyroxine, Disease Management, Female