What question did this study set out to answer?

To explore the pathogenesis of Hashimoto’s thyroiditis and assess the current clinical management strategies.

February 5, 2026Open Access

Hashimoto’s thyroiditis: from pathogenesis to clinical management

LWLinghui WangZhejiang Chinese Medical University XZXi ZhuLishui Central Hospital SXShuting XuLishui Central Hospital

Key Points

To explore the pathogenesis of Hashimoto’s thyroiditis and assess the current clinical management strategies.
Reviewed literature on autoimmune thyroiditis and its clinical diagnosis.
Analyzed genetic and environmental factors involved in pathogenesis.
Evaluated current treatment approaches, particularly levothyroxine (T4) replacement.
Hashimoto’s thyroiditis more prevalent in women than men, about four times higher.
Positivity for thyroid-specific autoantibodies (TPOAb, TGAb) is key for diagnosis.
Current treatment primarily involves hormone replacement therapy with levothyroxine.

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.

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