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OVERVIEW

What is thyroiditis?

Thyroiditis refers to several disorders that cause an inflammation of the thyroid, a gland located in the front of your neck below your Adam’s apple. The thyroid makes hormones that control metabolism, the pace of your body’s processes. Metabolism includes things like your heart rate and how quickly you burn calories.

What are the different types of thyroiditis and how do they affect the body?

There are several types of thyroiditis.

Hashimoto’s thyroiditis

• Caused by antibodies that attack the thyroid.
• Shows symptoms of hypothyroidism.
• Results in permanent hypothyroidism, which can be treated.

Subacute thyroiditis (also called de Quervain’s thyroiditis)

• Possibly caused by a viral infection.
• Causes pain in the thyroid and symptoms of hyperthyroidism, followed by hypothyroidism.
• Symptoms improve within a few months. There is a slight chance of permanent hypothyroidism, which can be treated.

Silent thyroiditis

• Shows symptoms of hyperthyroidism, followed by hypothyroidism.
• Symptoms improve within 12 to 18 months. May result in permanent hypothyroidism.

Postpartum thyroiditis

• Caused by antibodies that attack the thyroid after delivery of a child.
• Four to 6 months after delivery, symptoms of hyperthyroidism appear, followed by hypothyroidism.
• Symptoms improve within 12 to 18 months. May result in permanent hypothyroidism.

Drug-induced thyroiditis

• Caused by prescription drugs such as amiodarone, lithium, interferons and cytokines.
• Shows symptoms of hyperthyroidism or hypothyroidism.
• Symptoms continue as long as the drug is taken.

Radiation-induced thyroiditis

• Follows treatment with radioactive iodine for hyperthyroidism or radiation therapy for certain cancers.
• Most commonly shows symptoms of hypothyroidism.
• Hypothyroidism is usually permanent, but can be treated.

Acute thyroiditis (also called suppurative thyroiditis)

• Caused by bacteria or other infectious organisms.
• Symptoms include a painful thyroid, generalized illness and occasionally symptoms of mild hypothyroidism.
• Symptoms improve after treatment of the infectious cause.

SYMPTOMS

What are the symptoms of thyroiditis?

Since thyroiditis refers to a group of disorders rather than just one disorder, the symptoms vary.

Thyroiditis can cause slow, long-term thyroid cell damage and destruction that causes thyroid hormone levels in the blood to fall. If so, the symptoms are like those of hypothyroidism (underactive thyroid). Symptoms include the following:

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

Thyroiditis can cause rapid thyroid cell damage and destruction that causes thyroid hormone in the gland to leak out and increase the thyroid hormone levels in your blood. If so, it causes symptoms that are like those of hyperthyroidism (overactive thyroid). Symptoms include the following:

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

People who have thyroiditis can sometimes have pain in the thyroid gland (in the front of the neck).

CAUSES & RISK FACTORS

What causes thyroiditis?

Thyroiditis is caused by an attack on the thyroid gland. The attack causes inflammation (the body’s response to injury) and damages the thyroid cells. Usually, the attack on the thyroid is due to an autoimmune disease. Normally, antibodies produced by the body’s immune system help protect the body against viruses, bacteria and other foreign substances. An autoimmune disease is when your immune system produces antibodies that attack your body’s tissues and/or organs.

Thyroiditis can also be caused by an infection or certain medicines.

DIAGNOSIS & TESTS

How will my healthcare provider know if I have thyroiditis?

Your healthcare provider will perform laboratory tests to determine if you have thyroiditis, and, if so, what type of thyroiditis you have. Blood tests measure the amount of thyroid hormone in your blood and can indicate whether your thyroid is releasing too much hormone or too little. Blood tests can also show how much thyroid-stimulating hormone your pituitary gland is producing and what antibodies are present in the body.

Your healthcare provider may also do a radioactive iodine uptake test to measure your thyroid’s ability to take up iodine, a mineral that is needed to produce thyroid hormone. In some cases, a biopsy may be needed to determine what is attacking the thyroid.

TREATMENT

How is thyroiditis treated?

Your treatment depends on what type of thyroiditis you have and what symptoms you are experiencing.

If you have symptoms of hyperthyroidism, your healthcare provider may prescribe a medicine called a beta blocker to lower your heart rate and reduce any tremors you may be experiencing. Since the symptoms of hyperthyroidism may be temporary, your healthcare provider may taper the dose of this medicine as your symptoms improve.

If you have symptoms of hypothyroidism, your healthcare provider may prescribe thyroid hormone replacements to restore your body’s hormone levels and shift your metabolism back to normal. It can take several tries to get the right dose of synthetic thyroid hormone. In some types of thyroiditis, the symptoms of hypothyroidism will improve over time and your healthcare provider will slowly taper your dose of synthetic thyroid hormone.

If you have pain in your thyroid, your healthcare provider may recommend a mild anti-inflammatory medication like aspirin or ibuprofen (one brand name: Motrin) to manage the pain. Occasionally, severe thyroid pain requires treatment with steroid therapy.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• What kind 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? For how long?
• Am I at risk for any long-term health problems?