Editing Hashimoto's thyroiditis (section)

=== Surgery considerations ===
Surgery is not the initial treatment of choice for autoimmune disease, and uncomplicated Hashimoto's thyroiditis is not an [[Indication (medicine)|indication]] for [[thyroidectomy]].<ref name="Ramos-Levi2023" /> Patients generally may discuss surgery with their doctor if they are experiencing significant pressure symptoms, or cosmetic concerns, or have [[Thyroid nodule|nodules]] present on ultrasound.<ref name="Ramos-Levi2023" /> One well-conducted study of patients with troublesome general symptoms and with anti-thyroperoxidase (anti-TPO) levels greater than 1000 IU/ml (normal <100 IU/ml) showed that total thyroidectomy caused the symptoms to resolve and median anti-thyroid peroxidase levels to reduce from 2232 to 152 IU/mL,<ref name="Ramos-Levi2023" /><ref name="Garber-2019">{{Cite web | vauthors = Garber M |date=2019-08-12 |title=Is there a role for surgery in treating Hashimoto's thyroiditis? |url=https://www.health.harvard.edu/blog/is-there-a-role-for-surgery-in-treating-hashimotos-thyroiditis-2019081217443 |access-date=2024-12-05 |website=Harvard Health |language=en}}</ref> but post-operative complications were higher than expected:<ref name="Taylor-2024" /> [[infection]] (4.1%), permanent [[hypoparathyroidism]] (4.1%) and [[recurrent laryngeal nerve]] injury (5.5%).<ref name=":2">{{cite journal | vauthors = Perros P, Van Der Feltz-Cornelis C, Papini E, Nagy EV, Weetman AP, Hegedüs L | title = The enigma of persistent symptoms in hypothyroid patients treated with levothyroxine: A narrative review | journal = Clinical Endocrinology | volume = 98 | issue = 4 | pages = 461–468 | date = April 2023 | pmid = 33783849 | doi = 10.1111/cen.14473 }}</ref>