form of autoimmune thyroiditis, again more common in women and most common in late middle age, produces atrophic changes with regeneration, leading to goitre formation. The gland is usually firm and rubbery but may range from soft to hard. TPO antibodies are present, often in very high titres (> 1000 IU/L).
Patients may be hypothyroid or euthyroid, though they may go through an initial toxic phase, 'Hashi-toxicity'. Thyroxine therapy may shrink the goitre even when the patient is not hypothyroid, though this may take a long time.
Hashimoto's is more common in women, especially of child-bearing age. It can result in diffuse swelling of the thyroid gland. Patients may not have any thyroid function complaints at all. Sometimes patients can develop symptoms of low thyroid function, and rarely, overactive thyroid symptoms.
Treatment of Hashimoto's Syndrome consists of replacing thyroid hormone in the body. This will alleviate the symptoms and produce a marked reduction in the gland size within 2 to 4 weeks. Once thyroid hormone has been started, it should be continued for life, since it is unlikely that the disease will regress spontaneously.