{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T02:44:01Z","timestamp":1793933041844,"version":"4.8.0"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Hashimoto\u2019s thyroiditis (HT) is the most common type of thyroid disease and can cause many different manifestations. The local symptoms of HT are an under-studied area of research. Therefore, the purpose of this study was to investigate the local symptoms of HT and their prevalence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review was performed to find articles in PubMed that discuss the local symptoms of HT. Relevant vocabulary terms and key terms included: autoimmune thyroid disease (AITD), hyperthyroidism, hypothyroidism, neck, throat, pharynx, airway, esophagus, breathe, swallow, globus, sleep apnea, symptoms, and quality of life. Two investigators independently screened the eligible studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 54 articles fulfilled the inclusion criteria. Of these, 25 were clinical studies, 24 were case reports, and five were reviews. These clinical studies and case reports included a total of 2660 HT patients. There were eight local symptoms related to HT: neck pain (0.02%~16%), voice changes (7%~30%), throat discomfort (20%~43.7%), shortness of breath (28%~50%), dysphagia (29%), goiter-related symptoms (69.44%), sleep apnea, and generally defined compressive symptoms. Due to the use of different outcome measures among all the studies, a meta-analysis of the data could not be performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Goiter symptoms, which are an item on the ThyPRO scales, are the most frequent local symptoms in HT patients, and include neck pain, voice changes, throat discomfort, and dysphagia. These local symptoms should be identified in the clinic and included in the early diagnosis and management of HT, as well as evaluated further to understand their relevance in the pathogenesis of HT.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.1076793","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T05:29:15Z","timestamp":1674106155000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["Local symptoms of Hashimoto\u2019s thyroiditis: A systematic review"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiaojiao","family":"Yuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xufan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hezheng","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Xiaoheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simiao","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiguo","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2019.101367","article-title":"Hashimotos\u2019 thyroiditis: Epidemiology, pathogenesis, clinic and therapy","volume":"33","author":"Ragusa","year":"2019","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102649","article-title":"Hashimoto\u2019s thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation","volume":"19","author":"Ralli","year":"2020","journal-title":"Autoimmun Rev"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.007","article-title":"Hashimoto thyroiditis: clinical and diagnostic criteria","volume":"13","author":"Caturegli","year":"2014","journal-title":"Autoimmun Rev"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00278-6","article-title":"Hyperthyroidism","volume":"388","author":"De Leo","year":"2016","journal-title":"Lancet"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30703-1","article-title":"Hypothyroidism","volume":"390","author":"Chaker","year":"2017","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.3667-19","article-title":"Follicle-stimulating hormone-secreting pituitary adenoma accompanied by painful thyroiditis","volume":"59","author":"Ichijo","year":"2020","journal-title":"Intern Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27099","article-title":"Surgical management of neck pain and headache associated with pediatric hashimoto\u2019s thyroiditis","volume":"128","author":"Krakovitz","year":"2018","journal-title":"Laryngoscope"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-017-1686-9","article-title":"An unusual case of neck pain in hashimoto\u2019s thyroiditis","volume":"12","author":"Tamborini Permunian","year":"2017","journal-title":"Intern Emerg Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0055","article-title":"Hashimoto\u2019s thyroiditis presenting as acute painful thyroiditis and as a manifestation of an immune reconstitution inflammatory syndrome in a human immunodeficiency virus-seropositive patient","volume":"22","author":"Visser","year":"2012","journal-title":"Thyroid"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.45.1506","article-title":"Four cases of graves\u2019 disease which developed after painful hashimoto\u2019s thyroiditis","volume":"45","author":"Ohye","year":"2006","journal-title":"Intern Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021498","article-title":"Painful hashimoto\u2019s thyroiditis as an indication for thyroidectomy: clinical characteristics and outcome in seven patients","volume":"88","author":"Kon","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"B12","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1007\/BF03344075","article-title":"Autoimmune thyroid disease accompanied by recurring episodes of painful thyroid ameliorated by thyroidectomy","volume":"25","author":"Konno","year":"2002","journal-title":"J Endocrinol Invest."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.4158\/EP.8.4.259","article-title":"Successful outcome after surgical management in two cases of the \u201cpainful variant\u201d of hashimoto\u2019s thyroiditis","volume":"8","author":"Gourgiotis","year":"2002","journal-title":"Endocr Pract"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-70-2-385","article-title":"Chronic thyroiditis with painful tender thyroid enlargement and transient thyrotoxicosis","volume":"70","author":"Shigemasa","year":"1990","journal-title":"J Clin Endocrinol Metab"},{"key":"B15","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1007\/BF01995872","article-title":"Autoimmune thyroiditis presenting as painful thyroiditis","volume":"149","author":"Leung","year":"1989","journal-title":"Eur J Pediatr"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1016\/j.amjmed.2021.03.009","article-title":"Does subclinical hypothyroidism add any symptoms? evidence from a Danish population-based study","volume":"134","author":"Carl\u00e9","year":"2021","journal-title":"Am J Med"},{"key":"B17","article-title":"Clinical, biochemical & cytomorphologic study on hashimoto\u2019s thyroiditis","volume":"140","author":"Thomas","year":"2014","journal-title":"Indian J Med Res"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2007.0384","article-title":"Thyroidectomy for hashimoto\u2019s thyroiditis: complications and associated cancers","volume":"18","author":"Shih","year":"2008","journal-title":"Thyroid"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-017-0655-5","article-title":"Painful hashimoto\u2019s thyroiditis: myth or reality","volume":"40","author":"Rotondi","year":"2017","journal-title":"J Endocrinol Invest"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.45.0144","article-title":"Painful hashimoto\u2019s thyroiditis","volume":"45","author":"Kasagi","year":"2006","journal-title":"Intern Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1590\/2359-3997000000121","article-title":"Cerebellar ataxia as presenting feature of hypothyroidism","volume":"60","author":"Kotwal","year":"2016","journal-title":"Arch Endocrinol Metab"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2011.05.003","article-title":"Hypothyroidism in the elderly: diagnostic pitfalls illustrated by a case report","volume":"55","author":"Maselli","year":"2012","journal-title":"Arch Gerontol Geriatr."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1159\/000027661","article-title":"Diagnosis and physiopathology of laryngeal deposits in autoimmune disease","volume":"61","author":"Hosako-Naito","year":"1999","journal-title":"ORL J Otorhinolaryngol Relat Spec."},{"key":"B24","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1080\/08820139.2018.1529040","article-title":"Thyroglobulin antibodies are associated with symptom burden in patients with hashimoto\u2019s thyroiditis: A cross-sectional study","volume":"48","author":"Bari\u0107","year":"2019","journal-title":"Immunol Invest."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1177\/0333102416658714","article-title":"Headache in recent onset hypothyroidism: Prevalence, characteristics and outcome after treatment with levothyroxine","volume":"37","author":"Lima Carvalho M de","year":"2017","journal-title":"Cephalalgia"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.14.11077","article-title":"Using acoustic structure quantification during b-mode sonography for evaluation of hashimoto thyroiditis","volume":"34","author":"Rhee","year":"2015","journal-title":"J Ultrasound Med"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22366","article-title":"Thyroid disease and compressive symptoms","volume":"122","author":"Banks","year":"2012","journal-title":"Laryngoscope"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2011.01.037","article-title":"Should patients with symptomatic hashimoto\u2019s thyroiditis pursue surgery","volume":"170","author":"McManus","year":"2011","journal-title":"J Surg Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.jvoice.2010.03.008","article-title":"The prevalence of undiagnosed thyroid disease in patients with symptomatic vocal fold paresis","volume":"25","author":"Heman-Ackah","year":"2011","journal-title":"J Voice"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAJ.0000292195.68453.67","article-title":"When sore throat gets serious: three different cases, three very different causes","volume":"107","author":"Kamienski","year":"2007","journal-title":"Am J Nurs."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.33160\/yam.2021.11.007","article-title":"Use of cervical ultrasonography in globus sensation investigation: A retrospective cohort study","volume":"64","author":"Fukuhara","year":"2021","journal-title":"Yonago Acta Med"},{"key":"B32","article-title":"The increased risk of globus pharyngeus in patients with chronic thyroiditis: a case control study","volume":"19","author":"Karahatay","year":"2015","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9837-9","article-title":"Thyroid resection improves perception of swallowing function in patients with thyroid disease","volume":"33","author":"Greenblatt","year":"2009","journal-title":"World J Surg"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-007-0636-8","article-title":"Association between thyroid autoimmunity and fibromyalgic disease severity","volume":"26","author":"Bazzichi","year":"2007","journal-title":"Clin Rheumatol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2005.00586.x","article-title":"Mental and physical complaints in thyroid disorders in the general population","volume":"112","author":"Grabe","year":"2005","journal-title":"Acta Psychiatr Scand"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1111\/crj.12403","article-title":"Acute severe asthma with thyroid crisis and myasthenia: a case report and literature review","volume":"11","author":"Gong","year":"2017","journal-title":"Clin Respir J"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1643","article-title":"Airway obstruction after the development of hashimoto\u2019s thyroiditis","volume":"348","author":"Mohamed","year":"2014","journal-title":"BMJ"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13041","article-title":"Type 2 respiratory failure and falls in elderly adults: beware of the thyroid","volume":"62","author":"Vargas","year":"2014","journal-title":"J Am Geriatr Soc"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1080\/08035250600711074","article-title":"Goitrous congenital hypothyroidism in a twin pregnancy causing respiratory obstruction at birth: implications for management","volume":"95","author":"Reynolds","year":"2006","journal-title":"Acta Paediatr"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031355","article-title":"Medical cure of plasma cell granuloma of the thyroid associated with hashimoto\u2019s thyroiditis: a case report and review","volume":"89","author":"Laurent","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"B41","doi-asserted-by":"publisher","first-page":"918","DOI":"10.21037\/atm-20-944","article-title":"Dissociation between airway and systemic autoantibody responses in chronic obstructive pulmonary disease","volume":"8","author":"Liang","year":"2020","journal-title":"Ann Transl Med"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1179\/acb.2006.007","article-title":"Dysphagia as a primary manifestation of hyperthyroidism: a case report","volume":"61","author":"Guldiken","year":"2006","journal-title":"Acta Clin Belg."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2000.10.833","article-title":"Concomitant presentation of hashimoto\u2019s thyroiditis and maltoma of the thyroid in a twenty-year-old man with a rapidly growing mass in the neck","volume":"10","author":"Pereira","year":"2000","journal-title":"Thyroid"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.136.3.601","article-title":"Dysphagia due to thyroid immobilization: value of real-time sonography","volume":"136","author":"Shawker","year":"1981","journal-title":"AJR Am J Roentgenol."},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2006.0250","article-title":"Goitrous hashimoto\u2019s thyroiditis presenting as obstructive sleep apnea","volume":"17","author":"Eloy","year":"2007","journal-title":"Thyroid"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1053\/ajot.2001.20698","article-title":"Dysarthria as the leading symptom of hypothyroidism","volume":"22","author":"St\u00f6llberger","year":"2001","journal-title":"Am J Otolaryngol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-018-1756-x","article-title":"Lack of associations between thyroid function and obstructive sleep apnea severity in adults with prediabetes and diabetes mellitus","volume":"23","author":"Sriphrapradang","year":"2019","journal-title":"Sleep Breath"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej12-0106","article-title":"The association between severity of obstructive sleep apnea and prevalence of hashimoto\u2019s thyroiditis","volume":"59","author":"Bozkurt","year":"2012","journal-title":"Endocr J"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.5664\/jcsm.8054","article-title":"Hashimoto thyroiditis as a cause or consequence of obstructive sleep apnea","volume":"15","author":"Xerfan","year":"2019","journal-title":"J Clin Sleep Med"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-020-02449-4","article-title":"Correlation between TSH levels and quality of life among subjects with well-controlled primary hypothyroidism","volume":"72","author":"Mor\u00f3n-D\u00edaz","year":"2021","journal-title":"Endocrine"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156925","article-title":"Disease-specific as well as generic quality of life is widely impacted in autoimmune hypothyroidism and improves during the first six months of levothyroxine therapy","volume":"11","author":"Winther","year":"2016","journal-title":"PloS One"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.08.001","article-title":"Quality of life improvement in patients with hashimoto thyroiditis and other goiters after surgery: A prospective cohort study","volume":"21","author":"Zivaljevic","year":"2015","journal-title":"Int J Surg"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-013-0462-1","article-title":"Few items in the thyroid-related quality of life instrument ThyPRO exhibited differential item functioning","volume":"23","author":"Watt","year":"2014","journal-title":"Qual Life Res"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1159\/000342623","article-title":"Is thyroid autoimmunity per se a determinant of quality of life in patients with autoimmune hypothyroidism","volume":"1","author":"Watt","year":"2012","journal-title":"Eur Thyroid J"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtauto.2021.100101","article-title":"Persisting symptoms in patients with hashimoto\u2019s disease despite normal thyroid hormone levels: Does thyroid autoimmunity play a role? a systematic review","volume":"4","author":"Groenewegen","year":"2021","journal-title":"J Transl Autoimmun"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13770","article-title":"Association of thyroid hormone therapy with quality of life and thyroid-related symptoms in patients with subclinical hypothyroidism: A systematic review and meta-analysis","volume":"320","author":"Feller","year":"2018","journal-title":"JAMA"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2010.08.021","article-title":"Hashimoto\u2019s thyroiditis: outcome of surgical resection for patients with thyromegaly and compressive symptoms","volume":"201","author":"Wormer","year":"2011","journal-title":"Am J Surg"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0604","article-title":"Effect of thyroid-related symptoms on long-term quality of life in patients with differentiated thyroid carcinoma: A population-based study in Sweden","volume":"27","author":"Hedman","year":"2017","journal-title":"Thyroid"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1982.00790590062017","article-title":"The globus symptom. incidence, therapeutic response, and age and sex relationships","volume":"108","author":"Moloy","year":"1982","journal-title":"Arch Otolaryngol"},{"key":"B60","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s10067-018-4129-8","article-title":"The prevalence of dysphonia and dysphagia in patients affected by immunomediated diseases and the role of psychometric tests","volume":"38","author":"Galli","year":"2019","journal-title":"Clin Rheumatol"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1016\/s0385-8146(12)80057-5","article-title":"On the frequency of thyroid diseases in outpatients in an ENT clinic","volume":"22","author":"Morinaka","year":"1995","journal-title":"Auris Nasus Larynx."},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-018-4129-8","article-title":"Association between anti-thyroid peroxidase antibody and asthma in women","volume":"11","author":"Samareh Fekri","year":"2012","journal-title":"Iran J Allergy Asthma Immunol"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.3906\/sag-1511-95","article-title":"Importance of sonographic paratracheal lymph node evaluationin early autoimmune thyroiditis","volume":"46","author":"\u00d6rmeci","year":"2016","journal-title":"Turk J Med Sci"},{"key":"B64","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1097\/RUQ.0000000000000324","article-title":"Sonographic features of cervical lymph nodes in patients with hashimoto thyroiditis and the impacts from the levothyroxine with prednisone therapy","volume":"34","author":"Lyu","year":"2018","journal-title":"Ultrasound Q"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1007\/s10396-017-0804-7","article-title":"Significance of perithyroidal lymph nodes in benign thyroid diseases","volume":"45","author":"Ohta","year":"2018","journal-title":"J Med Ultrason (2001)."}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1076793\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T05:29:20Z","timestamp":1674106160000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1076793\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,19]]},"references-count":65,"alternative-id":["10.3389\/fendo.2022.1076793"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.1076793","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,19]]},"article-number":"1076793"}}