The subclinical status of hypothyroidism, elevated anti-thyroid peroxidase (anti-TPO) antibody levels, and the characteristic features of thyroid ultrasound (Figure 1) of diffusely hypoechoic and heterogeneous echotexture, with increased vascularization, which all pointed to thyroiditis supported the diagnosis of Hashimoto’s disease. Management of the subclinical hypothyroidism (TSH levels were less than 10 μUI/mL and the patient was asymptomatic) was watchful waiting as recommended by the most recent guidelines [5]. This evidence concerns the gene TPO and thyroiditis.