Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Lifestyle modifications and adjunct therapies for a patient with Hashimoto's thyroiditis to improve overall health include:
- Ensure adequate levothyroxine treatment adherence: Advise the patient on correct levothyroxine administration, such as taking it 60 minutes before breakfast to optimise absorption, and discuss potential drug interactions with over-the-counter medicines to maintain stable thyroid hormone levels NICE CKS.
- Regular monitoring and symptom assessment: Encourage regular thyroid function tests (TSH and FT4) to ensure thyroid hormone levels remain within or close to the reference range, adjusting levothyroxine dose if symptoms persist, while avoiding overtreatment NICE CKS.
- Provide patient education and support: Offer written and verbal information about Hashimoto's thyroiditis, the role of the thyroid gland, treatment goals, and when to seek medical advice to empower self-management and shared decision-making NICE NG145.
- Screen for and manage associated autoimmune conditions: Consider testing for coeliac disease and other autoimmune diseases, as these can coexist with Hashimoto's thyroiditis and impact overall health NICE NG145.
- Promote general healthy lifestyle habits: Although specific lifestyle changes for Hashimoto's are not detailed in the guidelines, general advice includes maintaining a balanced diet, regular physical activity, and avoiding excessive iodine intake, which may affect thyroid function NICE CKS.
Currently, there is no evidence supporting the use of natural thyroid extracts or combination thyroid hormone therapies in primary care for Hashimoto's thyroiditis; levothyroxine monotherapy remains the standard treatment NICE CKS.