Elevated anti-thyroid peroxidase antibody levels (120 IU/mL) suggested autoimmune thyroiditis.<h4>Management and outcome</h4>Levothyroxine (50 μg/day) was initiated with a target TSH of 0.4-2.5 μIU/mL as per the European Thyroid Association guidelines, along with lifestyle modifications, including breathing exercises and moderate aerobic activity. This evidence concerns the gene TPO and autoimmune thyroid disease.