Editing Hashimoto's thyroiditis (section)

=== Reducing antibodies ===
It is not established that reducing [[Antithyroid autoantibodies|antithyroid antibodies]] in Hashimoto's has benefits.<ref name="Chaker-2022">{{cite journal | vauthors = Chaker L, Razvi S, Bensenor IM, Azizi F, Pearce EN, Peeters RP | title = Hypothyroidism | journal = Nature Reviews. Disease Primers | volume = 8 | issue = 1 | pages = 30 | date = May 2022 | pmid = 35589725 | pmc = 6619426 | doi = 10.1038/s41572-022-00357-7 }}</ref><ref name="Klubo-Gwiezdzinska-2022" /><ref name=":0">{{cite journal | vauthors = Wichman J, Winther KH, Bonnema SJ, Hegedüs L | title = Selenium Supplementation Significantly Reduces Thyroid Autoantibody Levels in Patients with Chronic Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis | journal = Thyroid | volume = 26 | issue = 12 | pages = 1681–1692 | date = December 2016 | pmid = 27702392 | doi = 10.1089/thy.2016.0256 }}</ref> A systematic review and meta-analysis of selenium trials found that while selenium reduces TPO antibodies, there was a lack of evidence of effects on "disease [[Remission (medicine)|remission]], progression, lowered levothyroxine dose or improved [[quality of life]]".<ref name="Winther-2020" />

Selenium,<ref>{{cite journal | vauthors = Huwiler VV, Maissen-Abgottspon S, Stanga Z, Mühlebach S, Trepp R, Bally L, Bano A | title = Selenium Supplementation in Patients with Hashimoto Thyroiditis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials | journal = Thyroid | volume = 34 | issue = 3 | pages = 295–313 | date = March 2024 | pmid = 38243784 | pmc = 10951571 | doi = 10.1089/thy.2023.0556 }}</ref><ref name="Winther-2020" /> [[vitamin D]],<ref>{{cite journal | vauthors = Jiang H, Chen X, Qian X, Shao S | title = Effects of vitamin D treatment on thyroid function and autoimmunity markers in patients with Hashimoto's thyroiditis-A meta-analysis of randomized controlled trials | journal = Journal of Clinical Pharmacy and Therapeutics | volume = 47 | issue = 6 | pages = 767–775 | date = June 2022 | pmid = 34981556 | pmc = 9302126 | doi = 10.1111/jcpt.13605 }}</ref> and [[metformin]]<ref name="Jia-2020">{{cite journal | vauthors = Jia X, Zhai T, Zhang JA | title = Metformin reduces autoimmune antibody levels in patients with Hashimoto's thyroiditis: A systematic review and meta-analysis | journal = Autoimmunity | volume = 53 | issue = 6 | pages = 353–361 | date = September 2020 | pmid = 32741222 | doi = 10.1080/08916934.2020.1789969 }}</ref> can reduce thyroid peroxidase antibodies. There is preliminary evidence that levothyroxine,<ref>{{cite journal | vauthors = Aksoy DY, Kerimoglu U, Okur H, Canpinar H, Karaağaoğlu E, Yetgin S, Kansu E, Gedik O | title = Effects of prophylactic thyroid hormone replacement in euthyroid Hashimoto's thyroiditis | journal = Endocrine Journal | volume = 52 | issue = 3 | pages = 337–343 | date = June 2005 | pmid = 16006728 | doi = 10.1507/endocrj.52.337 }}</ref><ref>{{cite journal | vauthors = Padberg S, Heller K, Usadel KH, Schumm-Draeger PM | title = One-year prophylactic treatment of euthyroid Hashimoto's thyroiditis patients with levothyroxine: is there a benefit? | journal = Thyroid | volume = 11 | issue = 3 | pages = 249–255 | date = March 2001 | pmid = 11327616 | doi = 10.1089/105072501750159651 }}</ref> {{Needs update|date=February 2025|reason=Articles are from the very early 2000s.}}[[aloe vera]] juice<ref>{{cite journal | vauthors = Metro D, Cernaro V, Papa M, Benvenga S | title = Marked improvement of thyroid function and autoimmunity by <i>Aloe barbadensis</i> miller juice in patients with subclinical hypothyroidism | journal = Journal of Clinical & Translational Endocrinology | volume = 11 | pages = 18–25 | date = March 2018 | pmid = 29527506 | pmc = 5842288 | doi = 10.1016/j.jcte.2018.01.003 }}</ref> and [[Black cumin|black cumin seed]]<ref>{{cite journal | vauthors = Osowiecka K, Myszkowska-Ryciak J | title = The Influence of Nutritional Intervention in the Treatment of Hashimoto's Thyroiditis-A Systematic Review | journal = Nutrients | volume = 15 | issue = 4 | pages = 1041 | date = February 2023 | pmid = 36839399 | pmc = 9962371 | doi = 10.3390/nu15041041 | doi-access = free }}</ref> may reduce thyroid peroxidase antibodies. Metformin can reduce thyroglobulin antibodies.<ref name="Jia-2020" /> It is not established that a [[gluten-free diet]] can reduce antibodies when there is no comorbid [[coeliac disease]].<ref name="Szczuko-2022">{{cite journal | vauthors = Szczuko M, Syrenicz A, Szymkowiak K, Przybylska A, Szczuko U, Pobłocki J, Kulpa D | title = Doubtful Justification of the Gluten-Free Diet in the Course of Hashimoto's Disease | journal = Nutrients | volume = 14 | issue = 9 | pages = 1727 | date = April 2022 | pmid = 35565695 | pmc = 9101474 | doi = 10.3390/nu14091727 | doi-access = free }}</ref><ref name="Larsen-2022" /> Gluten-free diets have been shown in several studies to reduce antibodies, and in other studies to have no effect, however there were significant confounding issues in these studies, including not ruling out [[Comorbidity|comorbid]] coeliac disease.<ref name="Szczuko-2022" />

One study found [[Thyroidectomy|surgical thyroid removal]] can substantially reduce anti-thyroid antibody levels,<ref name="Taylor-2024" /><ref name="Ramos-Levi2023" /> see Surgery considerations, below.