What lifestyle modifications or adjunct therapies should I recommend to a patient with Hashimoto's Thyroiditis to improve their overall health?

Lifestyle modifications and adjunct therapies for a patient with Hashimoto's thyroiditis to improve overall health include:

• Ensure adequate levothyroxine treatment adherence: Advise the patient on correct levothyroxine administration, such as taking it 60 minutes before breakfast to optimise absorption, and discuss potential drug interactions with over-the-counter medicines to maintain stable thyroid hormone levels ³.
• Regular monitoring and symptom assessment: Encourage regular thyroid function tests (TSH and FT4) to ensure thyroid hormone levels remain within or close to the reference range, adjusting levothyroxine dose if symptoms persist, while avoiding overtreatment ³.
• Provide patient education and support: Offer written and verbal information about Hashimoto's thyroiditis, the role of the thyroid gland, treatment goals, and when to seek medical advice to empower self-management and shared decision-making ².
• Screen for and manage associated autoimmune conditions: Consider testing for coeliac disease and other autoimmune diseases, as these can coexist with Hashimoto's thyroiditis and impact overall health ².
• Promote general healthy lifestyle habits: Although specific lifestyle changes for Hashimoto's are not detailed in the guidelines, general advice includes maintaining a balanced diet, regular physical activity, and avoiding excessive iodine intake, which may affect thyroid function ¹.

Currently, there is no evidence supporting the use of natural thyroid extracts or combination thyroid hormone therapies in primary care for Hashimoto's thyroiditis; levothyroxine monotherapy remains the standard treatment ³.