Abstract
Treatment of Hashimoto thyroiditis (HT) is mainly medical supplementing L-thyroxine (L-T4) for hypothyroidism. L-thyroxine has proved to reduce the volume of the thyroid gland in both hypothyroidism and euthyroid state. The dose of L-T4 is tailored according to the patient's needs; the standard dosage is 1.6-1.8 µ/kg/day. The level of TSH is frequently monitored for dose adjustment till euthyroid state is attained thereafter every 6-12 months. Thyroidectomy is considered in patients with cosmetic problem; with compressive symptoms (such as dysphagia, dyspnea, change of voice), suspicion of malignancy as papillary thyroid carcinoma is commonly associated. Surgery has a beneficial effect in cases of painful thyroiditis. Radioactive iodine treatment can be considered as a last option in elderly patients with large goiter who refuse surgery and their thyroiditis is not responding to L-T4 treatment. This chapter explores the management of Hashimoto's disease.