University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Family Medicine


Dr. Mark Archambault


Hashimoto’s disease, also known as Hashimoto’s thyroiditis (HT), is a chronic autoimmune thyroid disease (AITD) that causes patients to experience symptoms of thyroid dysfunction and the effects of the autoimmune process itself.1 Five to ten percent of patients with HT report persistent fatigue, cognitive dysfunction, and decreased psychological or general well-being despite a normal thyroid stimulating hormone (TSH) with replacement levothyroxine (L-thyroxine).2,3 The explanation for persistent symptoms remains unclear. Theories include an inability to establish therapeutic levels of replacement thyroid hormone in all tissues3 and inadequate L-thyroxine conversion to triiodothyronine (T3).2,4 However, we should also consider the effects of circulating antithyroid antibodies and selenium on antibody titers.5,6 This article will review the relationship between antithyroid antibodies and HT, the extra-thyroidal effects of elevated circulating antibodies, and the current research involving selenium’s influence on thyroid antibody titers.


Available when accessing via a campus IP address or logged in with a University of Lynchburg email address.

Off-campus users can also use 'Off-campus Download' button above for access.