EXTRATHYROIDAL INFLUENCE OF HASHIMOTO’S THYROIDITIS – A LITERATURE REVIEW
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5990Keywords:
Hashimoto’s Thyroiditis, Papillary Thyroid Cancer, Anxiety Disorder, Depressive Disorder, MigraineAbstract
Hashimoto’s thyroiditis (HT) is a chronic lymphocytic inflammation of thyroid gland. The incidence is estimated to be 5% in general population and is higher in women. Primary role in pathogenesis is given to two types of antibodies – anti-peroxidase (anti-TPO) antibodies and anti-thyroglobulin (anti-TG) antibodies that lead to chronic lymphocyte mediated inflammation and thyroid follicular cell destruction. Clinically it usually leads to hypothyroidism and its symptoms like weight gain, cold intolerance, bradycardia and fatigue. As chronic inflammation HT leads to elevated levels of inflammatory factors like Tumor Necrosis Factor α (TNF-α), Interferon-γ (IFN- γ) and high sensitivity C-reactive protein (hs-CRP). Levels of anti-TPO and anti-TG were positively correlated with levels of TNF-α and IFN-γ and severity of symptoms, while they were negatively correlated with general health and vitality score. The overall cancer risk in patients is increased, but HT is negatively associated with primary tumor size of 4 cm or greater, extranodal extension and distant metastasis in Papillary thyroid carcinoma. Hashimoto’s thyroiditis may also have impact on the course of migraine by more migraine days monthly and higher risk of chronic migraine. Level of anti-TPO antibodies is a significant independent risk factor of depressive disorder, while negativity of anti-TG was correlated with lower anxiety levels. That finding suggests that autoantibodies are more important than thyroid hormone levels in pathogenesis of psychiatric disorders. Patients with HT also report lower health-related quality of life.
References
Aguilar-Shea, A. L., Membrilla, J. A., & Diaz-de-Teran, J. (2022). Migraine review for general practice. Atención Primaria, 54(2), 102208. https://doi.org/10.1016/j.aprim.2021.102208
Aydin, E., Bingöl Aydin, D., Çarkaxhiu Bulut, G., & İşgüven, Ş. P. (2023). Psychopathological analysis of adolescent girls with autoimmune thyroiditis. Cureus, 15(12), e50418. https://doi.org/10.7759/cureus.50418
Cayres, L. C. F., de Salis, L. V. V., Rodrigues, G. S. P., Lengert, A. V. H., Biondi, A. P. C., Sargentini, L. D. B., Brisotti, J. L., Gomes, E., & de Oliveira, G. L. V. (2021). Detection of alterations in the gut microbiota and intestinal permeability in patients with Hashimoto’s thyroiditis. Frontiers in Immunology, 12, 579140. https://doi.org/10.3389/fimmu.2021.579140
Harmantepe, A. T., Ozdemir, K., Bayhan, Z., & Kocer, B. (2024). The underestimated impact of Hashimoto’s thyroiditis on thyroid papillary carcinoma. Updates in Surgery, 76(3), 1085–1089. https://doi.org/10.1007/s13304-024-01854-y
Hu, X., Wang, X., Liang, Y., Chen, X., Zhou, S., Fei, W., Yang, Y., & Que, H. (2022). Cancer risk in Hashimoto's thyroiditis: A systematic review and meta-analysis. Frontiers in Endocrinology, 13, 937871. https://doi.org/10.3389/fendo.2022.937871
Huang, H., Xu, S., Ni, S., Liu, W., & Liu, S. (2023). Hashimoto's thyroiditis is negatively associated with lymph node metastasis in PTMC. Journal of Cancer Research and Clinical Oncology, 149(17), 15525–15533. https://doi.org/10.1007/s00432-023-05332-7
Klubo-Gwiezdzinska, J., & Wartofsky, L. (2022). Hashimoto’s thyroiditis: An evidence-based guide to etiology, diagnosis and treatment. Polish Archives of Internal Medicine, 132, 16222. https://doi.org/10.20452/pamw.16222
Li, J., Huang, Q., Sun, S., Zhou, K., Wang, X., Pan, K., Zhang, Y., Wang, Y., Han, Q., Si, C., Li, S., Fan, S., & Li, D. (2024). Thyroid antibodies in Hashimoto's thyroiditis patients are positively associated with inflammation and multiple symptoms. Scientific Reports, 14(1), 27902. https://doi.org/10.1038/s41598-024-78938-7
Li, R., Sun, X., Hu, L., Yu, Z., Liu, N., Li, P., Zhao, X., & Liang, W. (2026). Hashimoto's thyroiditis is associated with reduced invasiveness in papillary thyroid carcinoma: A propensity score-matched retrospective cohort study. Frontiers in Immunology, 16, 1745452. https://doi.org/10.3389/fimmu.2025.1745452
Martino, G., Caputo, A., Vicario, C. M., Feldt-Rasmussen, U., Watt, T., Quattropani, M. C., Benvenga, S., & Vita, R. (2021). Alexithymia, emotional distress, and perceived quality of life in patients with Hashimoto's thyroiditis. Frontiers in Psychology, 12, 667237. https://doi.org/10.3389/fpsyg.2021.667237
Nowaczewska, M., Straburzyński, M., Meder, G., & Waliszewska-Prosół, M. (2024). The relationship between migraine and Hashimoto's thyroiditis: A single center experience. Frontiers in Neurology, 15, 1370530. https://doi.org/10.3389/fneur.2024.1370530
Resende de Paiva, C., Grønhøj, C., Feldt-Rasmussen, U., & von Buchwald, C. (2017). Association between Hashimoto's thyroiditis and thyroid cancer in 64,628 patients. Frontiers in Oncology, 7, 53. https://doi.org/10.3389/fonc.2017.00053
Silva, I. B., & Puig-Domingo, M. (2025). The impact of thyroid disorders on the gut microbiome: Emerging mechanisms and clinical relevance. Archives of Endocrinology and Metabolism, 70(Spe1), e250075. https://doi.org/10.20945/2359-4292-2025-0075
Tian, Z., Wang, B., & Chen, L. (2025). Thyroid antibodies and depression: Is the relationship overstated? Journal of Psychiatric Research, 190, 216–224. https://doi.org/10.1016/j.jpsychires.2025.08.003
Tzioni, M. M., Watanabe, N., Chen, Z., Wu, F., Madej, E., Makker, J., Guo, S., Attygalle, A. D., Wotherspoon, A., Sugino, K., Ito, K., & Du, M. Q. (2025). Primary thyroid B-cell lymphoma: Molecular insights into its clonal evolution and relapse. The Journal of Pathology, 265(2), 123–131. https://doi.org/10.1002/path.6380
Uhliarova, B., & Hajtman, A. (2018). Hashimoto's thyroiditis: An independent risk factor for papillary carcinoma. Brazilian Journal of Otorhinolaryngology, 84(6), 729–735. https://doi.org/10.1016/j.bjorl.2017.08.012
Xu, S., Huang, H., Qian, J., Liu, Y., Huang, Y., Wang, X., Liu, S., Xu, Z., & Liu, J. (2021). Prevalence of Hashimoto’s thyroiditis in adults with papillary thyroid cancer and its association with cancer recurrence and outcomes. JAMA Network Open, 4(7), e2118526. https://doi.org/10.1001/jamanetworkopen.2021.18526
Yao, S., & Zhang, H. (2025). Papillary thyroid carcinoma with Hashimoto’s thyroiditis: Impact and correlation. Frontiers in Endocrinology, 16, 1512417. https://doi.org/10.3389/fendo.2025.1512417
Zhu, X., Zhang, C., Feng, S., He, R., & Zhang, S. (2024). Intestinal microbiota regulates the gut-thyroid axis: The new dawn of improving Hashimoto’s thyroiditis. Clinical and Experimental Medicine, 24(1), 39. https://doi.org/10.1007/s10238-024-01304-4
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Lilianna Jasińska, Michał Niespodziewański, Patrycja Szczygielska, Sylwia Hejna, Weronika Teterycz, Łukasz Jaworek, Weronika Goździejewska, Weronika Smutkiewicz, Magdalena Roman, Martyna Lipiarz

This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.

