Autoimmune thyroid diseases: A comprehensive literature review of treatment and the current state of knowledge

Introduction and Purpose: Autoimmune thyroid diseases (AITDs) are among the most common organ-specific autoimmune disorders worldwide. The two major forms, Hashimoto's thyroiditis and Graves' disease, result from a complex interaction between genetic susceptibility, environmental triggers, and immune dysregulation. These conditions significantly affect quality of life and are associated with numerous endocrine and non-endocrine complications. The purpose of this review is to summarize current knowledge regarding the epidemiology, pathophysiology, diagnosis, treatment, and emerging therapeutic approaches for autoimmune thyroid diseases. Description of the State of Knowledge: AITDs develop due to the loss of immune tolerance toward thyroid antigens, particularly thyroid peroxidase (TPO), thyroglobulin (Tg), and the thyroid-stimulating hormone receptor (TSHR). Hashimoto's thyroiditis is characterized predominantly by lymphocytic infiltration and progressive destruction of thyroid tissue, resulting in hypothyroidism, whereas Graves' disease is mediated by stimulating autoantibodies directed against TSH receptors, leading to hyperthyroidism. Current diagnostic strategies rely on clinical evaluation, measurement of thyroid hormone levels, detection of thyroid-specific autoantibodies, and thyroid ultrasonography. Standard treatment includes levothyroxine replacement therapy for Hashimoto's thyroiditis and antithyroid drugs, radioactive iodine therapy, or thyroidectomy for Graves' disease. Recent research focuses on biological therapies, immunomodulatory agents, and precision medicine approaches aimed at modifying disease progression and improving long-term outcomes. Conclusion: The understanding of autoimmune thyroid diseases continues to evolve. Although current therapeutic options effectively manage hormonal dysfunction, they do not directly address the underlying autoimmune process. Further research into disease mechanisms and targeted therapies may lead to more personalized and disease-modifying treatment strategies in the future.