How to treat autoimmune thyroiditis

The treatment of autoimmune thyroiditis must of course be carried out scientifically. The use of drugs is relatively common, such as adding steroid hormones and azathioprine. The use of these immunosuppressants has better effects, and radioactive iodine treatment is also relatively effective.

There is currently no unified understanding of the treatment of AITD-related nephrotic syndrome. Foreign literature reports that immunosuppressants and thyroidectomy may be effective. However, more emphasis should be placed on the adequate treatment of AITD itself. Because clinically large amounts of proteinuria in nephrotic syndrome can cause the loss of thyroid-binding globulin and often aggravate hypothyroidism, the dose of thyroid replacement therapy for such patients usually needs to be increased. Clearing thyroid antibodies and abnormal thyroid antigens is the main part of treatment.

1. In Graves' disease, the drugs pyrimidines and imidazoles used to treat hyperthyroidism can slightly inhibit the autoimmune response of Graves' disease and reduce thyroid autoantibodies in the blood circulation, thus reducing proteinuria.

2. The use of immunosuppressants plus steroid hormones and azathioprine (Imuran) can reduce proteinuria in some patients.

3. The effect of thyroidectomy on proteinuria is unclear, but in the first case of a patient with Graves' disease and nephrotic syndrome, long-term use of methimazole (methimazole) had poor efficacy and finally the thyroid was removed and followed up for 11 months. Proteinuria was significantly reduced and the glomerular filtration rate did not change. The timing of thyroidectomy is important, as relief is almost exclusively achieved in patients with stage I to II membranous nephritis.

4. The efficacy of radioactive iodine therapy for proteinuria is also unclear and may even worsen proteinuria.