Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, is an autoimmune disorder in which your immune system attacks your thyroid gland, causing damage to thyroid cells. The thyroid gland is a small butterfly-shaped gland located below your Adam’s apple. As part of the endocrine system, this gland releases thyroid hormone involved in the regulation of metabolic activity.

In cases of Hashimoto’s disease, your body forms self-attacking antibodies (Confused Antibodies) that destroy portions of the thyroid gland. Signs and symptoms of Hashimoto’s disease may take years before it becomes clinically apparent, however, the inflammation caused by these antibodies continue—affecting different parts of the thyroid gland .

With the progression of Hashimoto’s disease, the thyroid gland becomes diffusely nodular, eventually becoming under-active. An underactive gland produces decreased amount of thyroid hormone, eventually causing decreased metabolic activity (hypothyroidism).

Symptoms of Hashimoto’s Thyroiditis

While there is ongoing research to understand the causative agent of this autoimmune disorder, the cause is unknown. Medical literature refers to a combination of factors, including heredity, sex, and age that may determine the likelihood of developing this disorder. Data shows that Hashimoto’s thyroiditis is most common in middle-aged women but can occur in men and women at any age. Reports have also shown that children can be susceptible to Hashimoto’s disease.

Currently, there is no known way to prevent this disorder. However, large  nodules caused by Hashimoto’s disease can get treated without requiring surgical intervention by performing radiofrequency thyroid ablation.

The earlier you get diagnosed, the earlier you can start receiving the treatment of Hashimoto’s disease, the sooner you get better and resume your life without issues.

How would you know you need Hashimoto's disease treatment?

Signs and Symptoms: Some patients with Hashimoto’s thyroiditis may have no signs or symptoms. However, reports consistently show the following symptoms: fatigue, depression, sensitivity to cold, weight gain, forgetfulness, muscle weakness, puffy face, dry skin and hair, constipation, and/or muscle cramps.

In some patients the thyroid gland may become enlarged and form nodules. Your provider may refer to this change as a goiter. If this occurs you may feel discomfort during swallowing or breathing.

What are the tests used to diagnose Hashimoto's disease?

The following tests are commonly used is the diagnosis of Hashimoto’s disease:

  • Observance of the aforementioned signs and symptoms for Hashimoto’s disease.
  • Blood tests to monitor thyroid hormone and thyroid-stimulating hormone (TSH).
  • Thyroid antibody panel to determine if self-attacking antibodies are present.
  •  Fine Needle Aspiration (FNA) biopsy to obtain an exact diagnosis and confirm disease.
  • Radioactive thyroid uptake to evaluate function of the thyroid gland.
  • Ultrasound scan to monitor/detect any suspicious nodules.

If you are concerned about Hashimoto’s disease, please consult your primary care provider. In some cases your doctor may refer you to a specialist called an endocrinologist. Earlier diagnosis provides better treatment outcomes, allowing patients to resume normal activities sooner.

What are the complications of Hashimoto's disease?

If Hashimoto Thyroiditis is left untreated, your underactive thyroid gland can lead to major health complications.

  • Large thyroid nodule or goiter
  • Increased risk of heart disease
  • High cholesterol
  • Extreme fatigue and depression
  • Increased risk of developing thyroid carcinoma or lymphoma
  • Myxedema coma with progressive mental deterioration
  • In pregnant women, this can lead to babies with birth defect

What are your options for treating Hashimoto's disease?

As an initial option, your provider will first recommend healthy diet and lifestyle changes can aid in improving your symptoms. If these changes alone do not improve symptoms, or if lab studies indicate inconsistent changes, your provider may choose alternative treatment options.

Alternative treatment for Hashimoto’s disease may include observation and/or use of medications. If your thyroid is functioning normally, your provider may monitor thyroid function over a period of time. If Hashimoto’s disease causes abnormal thyroid blood studies, your provider may start you on thyroid hormone replacement medications.

Surgical intervention or radiofrequency thyroid ablation (RFA) is very limited in Hashimoto thyroiditis. These options are reserved for patients compression symptoms and/or large suspicious nodules that may be indicative of neoplasm or goiter.

What are the drawbacks of surgical Hashimoto's disease treatment ?

Surgery entitles removing half or the whole thyroid gland. Therefore you will lose at least part of your  thyroid. Surgery is completed under general anesthesia and requires at least one night hospital stay.

Post-operatively, there is a long recovery time with possible complications such as:

  • Bleeding
  • Infection
  • Neck scar
  • Vocal nerve damage

In some cases, accidental removal or damage to your parathyroid glands located in the posterior aspect of the thyroid can lead to decreased levels of parathyroid hormone (PTH) and decreased blood calcium levels.

Can anyone get Hashimoto's disease treatment without surgery?

As we discussed before the role of intervention in Hashimoto is very limited. Intervention is only beneficial in cases of nodular symptomatic Hashimoto thyroiditis when the patient has a large dominant benign nodule.Or in patients who are ineligible, high risk, or decide to refuse surgical intervention. In this subset of patients Ultrasound (US)-guided Ablation techniques, such as Radiofrequency Thyroid Ablation (RFA) becomes the answer .

RFA ablation therapy is a safe and effective option in the eradication and shrinking of these large solid hashimoto nodules

Benefits to choosing radiofrequency ablation for Hashimoto's disease treatment over surgery?

Thyroid Radiofrequency Ablation (RFA) is a very safe procedure with minimal risk. The whole RFA procedure is done through a small puncture / hole into your neck. No postoperative scar or suture . 

It is an as an  outpatient procedure typically takes 30-45 minutes depending on the nodule size.

It is  performed under local anesthesia so you can avoid all complications related to general anesthesia 

No down time you can resume your normal activity the day after your.  If you are not already in thyroid hormone treatment you may not need it after RFA or delay the need for it.

Learn more about non surgical alternative for treating enlarged thyroid by performing Radiofrequency ablation treatment 

About the possible side effects of Hashimoto's disease treatment using radiofrequency ablation?

As with any medical procedure there is some inherited risk however RFA has a very low complication rate and  much lower side effects compared to surgery. 

Some reported  risk are:

  • Temporary hoarseness
  • Minor skin bruise
  • Burn at puncture site
  • Minimal bleeding
  • Nodule rupture
  • Thyrotoxicosis
  •   Hypothyroidism
  •   Fever
  • Wound infection

How long does it take to recover from radiofrequency ablation treatment of Hashimoto's disease?

The RFA procedure is approximately 30-45 minutes long, depending on your nodule size. It is done at our center as an office based procedure under local anesthesia.You can go to work or resume your normal activity the next day.


About our approach to Hashimoto's thyroiditis treatment

Prior to your Radiofrequency Thyroid Ablation therapy (RFA): You will have a consultation appointment with Dr. Elshenawy. She will perform an outpatient ultrasound scan of your nodule and review your fine needle aspiration (FNA) biopsy results. She will then determine if another FNA prior to RFA is required. There is a limited blood panel for thyroid functions and coagulation factors that is also required. During your appointment, Dr. Elshenawy will explain the details of the RFA procedure, benefits, risks, possible outcomes, and/or alternative options. Please feel to ask any questions/concerns you may have regarding the procedure at any of the appointments.

During the RFA procedure:

  • On the day of the RFA appointment, you will fill out all necessary paperwork at the office. You will be guided you an outpatient room where you will change your clothes into disposable gowns. No jewelry, body piercing and/or metalware can be worn.
  • Two grounding pads will be attached to the front of your thighs by your provider.
  • Your neck will be cleaned with skin antiseptic. Then under sterile conditions marks will be placed on your skin to distinguish parts of the nodule. Your head will rest on a small cushion and an eye mask will be provided.
  • Your heart rate, blood pressure, and voice are monitored during the entire RFA procedure.
  • Your provider will place a local anesthetic under the skin in the front of the neck and surrounding the thyroid gland.
  • A thin probe will pass into your neck targeting your thyroid mass. The RFA will start by ablating the deeper and posterior portion of your mass then proceed to superficial and anterior portions of your nodule.
  • A popping sound will be heard during RFA as the tissue is sequentially and successfully ablated.
  • After your ablation is complete, an ice pack will be placed on your neck and you will be monitored for approximately 30 minutes.
  • It is recommended that you take over-the-counter medications, such as acetaminophen (Tylenol), for inflammation after RFA. 
  • The day after RFA your neck may be mildly sore, however, you will be able to resume all your normal activities. It is advised that you refrain from strenuous activities for 48 hours, if possible.

Why OCC thyroid center for your Hashimoto's disease treatment?

OCC thyroid center  is dedicated to a patient-centered approach, with specialized and individualistic care. OCC thyroid center is accredited by the College of American Pathologists (CAP). Our providers are USA boarded, MD & ECNU certified providers with three doctors who have performed more than 50,000 thyroid interventional procedures including FNA biopsies, Ethanol Ablation, and RFA. Our center has been established since 1991 and is considered national leader in thyroid diagnosis.

  • Our center has been established since 1991 and is considered national leader in thyroid diagnosis. We have the newest and the highest quality machines.
  • We are one of the pioneering thyroid centers in the United States, we offer  radiofrequency ablation for benign Hashimoto’s nodule treatment that’s performed by our experienced physicians. We only ablate and target your nodule so we preserve the functions of your gland. 
  • When considering financial cost, RFA procedures at our OCC center are more cost effective than hospital-based procedures as we have no facility fee charge.
  • We hope you will choose the Outpatient Cytopathology Center for your thyroid RFA treatment.

Regards to Coronavirus (COVID-19) pandemic and its health implications, we offer an online reservation to help you get the care you need in a safe way