This paper is ultimately confusing.
I agree with abandoning the eponym Hashimoto's thyroiditis. (Though, at least in the abstract of the paper, the eponym Ord's thyroiditis isn't even recognised.)
But I strongly disagree with the assertion that we should not test for thyroid autoantibodies, and we should avoid imaging. Another case of ensuring that by not looking, you won't find?
In common with many other diseases/disorders, it might be useful to subdivide "autoimmune thyroiditis" and/or "autoimmune thyroid disease" into those with various antibodies or other features. And you also need to include those who are hypothyroid despite not having been diagnosed with either of the classic antibodies.
I very much question how many asymptomatic people are ever diagnosed and treated. Rather, I suspect that numerous signs and symptoms are missed/ignored as they are not recognised as the classic indicators of autoimmune thyroid disease - or, indeed, non-autoimmune thyroid disease. After all, we see multiple posts by HealthUnlocked forum members who have what appear euthyroid results for the TSH test (often the only test), and Free T4, and (if ever done) Free T3. This is part of the course of the disease for many. A variation of thyroid hormone levels, with possibly unclear other symptoms, and potentially over years.
And it bizarrely tells us not to use the word "disease", then discourages the use of the word when only tests and imaging show the issues, but gives no replacement word? How about "autoimmune thyroid not yet recognised as disease"?
Hashimoto's thyroiditis- What's in a name?
Mikhail Khachaturov 1 , Dimitrios G Goulis 2 , Petros Perros 3
PMID: 40172784 DOI: 10.1007/s42000-025-00646-2
Abstract
Hashimoto's thyroiditis (HT) is the most common autoimmune endocrine disease worldwide with an annual incidence of 0.3-1.5 per 1000 people and a prevalence of 8% of the general population. At least nine terms appear in the literature denoting HT, which are used as synonyms or are terms describing disorders closely related to HT. Moreover, the definitions of HT vary, and the role of several parameters in making a diagnosis remains unclear. Furthermore, the term "thyroiditis" is often used among experts to describe the triphasic evolution in thyroid status (thyrotoxicosis, hypothyroidism, and euthyroidism) that can occur not only after some forms of HT but also in other causes of thyroid inflammation. The present work proposes novel approaches for the nomenclature problems. Firstly, we should abandon the eponym "Hashimoto" in keeping with recent trends. The void left can be replaced by the terms "autoimmune thyroiditis" or "autoimmune thyroid disease", which are already in use. In communicating among ourselves and with patients, it is imperative and good practice to provide, whenever possible, context to these terms by specifying whether they apply to thyroid status, presence or absence of goiter, thyroid autoantibodies, imaging, cytology/histology, epidemiology, or etiology. Secondly, the considerable potential harm associated with treating euthyroid people with thyroid hormones could be curtailed by avoiding testing for thyroid autoantibodies or performing thyroid imaging in asymptomatic euthyroid patients following the current guidelines and by discouraging the use of the word "disease" when the evidence is based only on results of investigations, such as positive antibodies, or imaging.
Keywords: Definition; Endocrinology; ICD-11; Immunology; Nomenclature; Pathology; Radiology.
https://link.springer.com/article/10.1007/s42000-025-00646-2
