Thyroiditis

What is thyroiditis?

Thyroiditis refers to a group of disorders that cause inflammation of the thyroid. Your thyroid is the gland located in the front of your neck below your Adam’s apple. The thyroid makes hormones that control your metabolism and affect how your body works. Metabolism is how your body processes substances to produce energy or burn calories.

There are several types of thyroiditis:

Hashimoto’s thyroiditis

• The cause is antibodies that attack the thyroid.
• Symptoms are those of hypothyroidism.
• Hypothyroidism is permanent but can be treated.

Subacute thyroiditis (de Quervain’s thyroiditis)

• The possible cause is a viral infection.
• Symptoms include pain in the thyroid and those of hyperthyroidism, followed by hypothyroidism.
• Symptoms improve within a few months.
• Hypothyroidism is rarely permanent but can be treated.

Acute thyroiditis (suppurative thyroiditis)

• The cause is bacteria or infection.
• Symptoms include pain in the thyroid, mild illness, and those of hypothyroidism.
• Symptoms improve after treatment of the infectious cause.

Silent thyroiditis

• The cause may be antibodies that attack the thyroid or an autoimmune disorder.
• Symptoms are those of hyperthyroidism, followed by hypothyroidism.
• Symptoms improve within 12 to 18 months.
• Hypothyroidism may be permanent but can be treated.

Postpartum thyroiditis

• The cause is antibodies that attack the thyroid after delivery of a child.
• Symptoms of hyperthyroidism appear 1 to 3 months after delivery. Symptoms of hypothyroidism begin about 4 to 8 months after delivery.
• Symptoms improve within 12 to 18 months.
• Hypothyroidism may be permanent but can be treated.

Radiation-induced thyroiditis

• The cause is use of radioactive iodine for treatment of hyperthyroidism or radiation therapy for treatment of certain cancers.
• Symptoms are those of hypothyroidism.
• Hyperthyroidism may get better but then come back. Hypothyroidism often is permanent but can be treated.

Drug-induced thyroiditis

• The cause is the use of prescription drugs, such as amiodarone, lithium, interferons, and cytokines.
• Symptoms are those of hyperthyroidism or hypothyroidism.
• Symptoms continue as long as the drug is taken.

Symptoms of thyroiditis

Thyroiditis symptoms vary since it is a group of disorders with several types.

Thyroiditis can trigger rapid thyroid cell damage. This causes thyroid hormone to leak into your blood and increases thyroid hormone levels. When this happens, you have symptoms of hyperthyroidism (overactive thyroid). Possible symptoms are:

• Weight loss
• Nervousness, anxiety, or irritability
• Trouble sleeping
• Rapid heart rate
• Fatigue
• Muscle weakness
• Tremors (shaking hands or fingers)
• Diarrhea or loose stools

Thyroiditis also can lead to slow, long-term thyroid cell damage. This causes thyroid hormone levels in your blood to be low. When this happens, you have symptoms of hypothyroidism (underactive thyroid). Possible symptoms are:

• Unplanned weight gain
• Fatigue
• Constipation
• Dry skin
• Depression
• Muscle aches

People who have thyroiditis also may have pain and swelling in the thyroid gland (in the front of the neck).

What causes thyroiditis?

The cause of thyroiditis depends on the type of disease you have. Most types occur when your immune system attacks the thyroid gland. This causes inflammation (the body’s response to injury) and damages the thyroid cells. The reason for the attack often is an autoimmune disease, such as Hashimoto’s.

Other types of thyroiditis occur from use of radiation or certain medicines. Viral or bacterial infections also may cause thyroiditis.

How is thyroiditis diagnosed?

Lab tests often can diagnose thyroiditis, including what type you have. Your doctor will start with a blood test. This measures the amount of thyroid hormone in your blood. It will show if your hormone levels are too high or too low. Blood tests check your level of thyroid-stimulating hormone (TSH) as well. TSH is produced in the pituitary gland and can affect your thyroid hormone levels. Blood tests also can show if you have antibodies present in your body.

Your doctor may do a radioactive iodine uptake test. This measures your thyroid’s ability to absorb iodine, a mineral that is needed to produce thyroid hormone.

In some cases, you may need a biopsy to determine what is attacking the thyroid.

Can thyroiditis be prevented or avoided?

Most cases of thyroiditis cannot be prevented. If you have a health issue that requires treatment using radioactive iodine or radiation therapy, talk to your doctor about your risk of thyroiditis. You may be able to start with other treatments to avoid your chance of thyroiditis. If you take prescription drugs that can cause thyroiditis, talk to your doctor about your risk and if you can stop taking them. You still may not be able to avoid thyroiditis.

Thyroiditis treatment

Treatment for thyroiditis depends on your type and what symptoms you have.

If you have symptoms of hyperthyroidism, your doctor may prescribe a medicine called a beta blocker. This helps to lower your heart rate and reduce tremors. Since hyperthyroidism often is temporary, your doctor likely will taper the dose of this medicine as your symptoms improve.

If you have symptoms of hypothyroidism, your doctor may prescribe thyroid hormone replacements. These help to restore your body’s hormone levels and get your metabolism back to normal. It can take several tries to get the right dose of synthetic thyroid hormone. If you have Hashimoto’s thyroiditis, you will likely have to take this medicine for the rest of your life. The hypothyroidism from Hashimoto’s is usually permanent.

Talk to your doctor if you have pain in your thyroid. They may recommend a mild anti-inflammatory, such as aspirin or ibuprofen to manage the pain. Severe thyroid pain may require treatment with steroid therapy.

Living with thyroiditis

Thyroiditis and its symptoms may be temporary. In this case, you will be able to live a normal life following treatment. If the condition returns or is permanent, work with your doctor to manage symptoms.

If you do not get treatment, damage to your thyroid may continue and could lead to more health issues. For women, you may have problems with fertility or your children could be born with birth defects.

Low functioning thyroid can lead to heart conditions, elevated cholesterol, swelling, and other conditions in both men and women.

Questions to ask your doctor

• What type of thyroiditis do I have?
• What is the likely cause of my thyroiditis?
• What are the results of my blood test(s)? What do these results mean?
• Will I need to take medicine? If so, for how long and what are the side effects?
• Are there any lifestyle or diet changes I can make to manage symptoms?
• What is my risk of long-term health problems?

Resources

American Thyroid Association: Thyroiditis