For people with signs and symptoms of Hashimoto’s disease, a doctor will first obtain a complete medical history and family medical history, since, like many autoimmune diseases, Hashimoto’s disease can have a genetic component. A physical exam will also be performed to examine the thyroid gland and check for enlarged lymph nodes in the neck, an indication of an active immune response and characteristic symptom of Hashimoto’s disease. Specific tests will also usually be done to rule out thyroid cancer.[1]
Ultrasound may also be performed to look for abnormalities in the thyroid gland, although for the majority of patients, it may not be essential to confirm a diagnosis of Hashimoto’s disease.[2][3] Blood testing for hypothyroidism and autoimmunity will also be performed by measuring thyroid hormones (such as TSH, T3, and T4), and checking for antibodies against thyroglobulin and thyroid peroxidase.
Ultimately the combination of high TSH, low free T4, and anti-thyroid antibodies confirms a diagnosis of Hashimoto’s disease.[3]