What is thyroiditis?
Thyroiditis is a general term that refers to “inflammation of the thyroid gland”. Thyroiditis includes a group of individual disorders that cause inflammation of the thyroid but manifest in different ways. For example, Hashimoto’s thyroiditis is the most common cause of hypothyroidism. However, there are other types of thyroiditis. Thyroiditis can lead to overproduction or underproduction of thyroid hormone.
What are the types of thyroiditis?
There are different types of inflammation of the thyroid gland, which we will discuss below.
This autoimmune condition, also called chronic lymphocytic thyroiditis, is caused by anti-thyroid antibodies. Hashimoto’s is the most common form of thyroiditis and the most common cause of hypothyroidism and requires lifelong treatment.
It is an autoimmune condition caused by anti-thyroid antibodies. As its name suggests, this disease has no symptoms. It is similar to postpartum thyroiditis and recovery usually takes up to 18 months. Silent thyroiditis begins with a phase of overproduction of thyroid hormone, followed by a longer period of decreased thyroid hormone production.
This is an autoimmune condition caused by anti-thyroid antibodies that can occur within a year of giving birth and is relatively rare. With proper treatment, the thyroid usually heals within 18 months.
This condition is caused by radiation therapy, which is used as a medical treatment for some cancers. It can also be caused by radioactive iodine used to treat hyperthyroidism.
This is an often-painful condition and is thought to be caused by a virus. This disease usually occurs before upper respiratory tract infections.
This rare condition is caused by an infectious organism or bacteria.
This condition is caused by the use of drugs such as amiodarone, interferons, lithium and cytokines. However, this disease is not very common and may happen only in a small part of people who use these drugs.
This condition is a rare disease caused by chronic inflammation and fibrosis of the thyroid gland. Fibrosis means thickening or scarring of the thyroid tissue.
What are the symptoms of thyroiditis?
The symptoms of this disease can be different according to the type of thyroid inflammation.
Thyroid inflammation can cause rapid damage to thyroid cells. This condition causes thyroid hormone to leak into the blood and increase thyroid hormone levels. When this happens, you will have symptoms of hyperthyroidism, which may include:
- Weight loss
- Nervousness, anxiety or irritability
- Sleep problem
- Fast heartbeat
- Fatigue
- Muscle weakness
- Tremors (shaking of hands or fingers)
- Diarrhea or loose stools
Thyroid inflammation can also lead to slow, long-term damage to thyroid cells. This causes the level of thyroid hormone in your blood to be low. When this happens, you will experience symptoms of hypothyroidism, which include:
- Unwanted weight gain
- Fatigue
- Constipation
- Dry skin
- Depression
- Muscle pains
People with thyroiditis may also have pain and swelling in the thyroid gland (in the front of the neck).
What is the cause of thyroiditis?
The cause of thyroiditis depends on the type of disease you have. Mostly, this disease occurs when the body’s immune system attacks the thyroid gland. This attack causes inflammation (the body’s response to injury) and damages thyroid cells.
The most common cause is an autoimmune disease that is the result of the immune system accidentally attacking the thyroid gland. It’s not clear why your immune system does this. Antibodies that attack the thyroid cause most types of thyroiditis. In the table below, you can see the possible causes of each type of thyroiditis.
Cause type of thyroiditis
The most common cause is an autoimmune disease that is the result of the immune system accidentally attacking the thyroid gland. It’s not clear why your immune system does this. Antibodies that attack the thyroid cause most types of thyroiditis. In the table below, you can see the possible causes of each type of thyroiditis.
| Cause | Thyroiditis type |
|---|---|
| Anti-thyroid antibodies, autoimmune disease | Hashimoto’s |
| Anti-thyroid antibodies, autoimmune disease | Painless or silent thyroiditis |
| Anti-thyroid antibodies, autoimmune disease | Postpartum thyroiditis |
| Possible presence of a virus | Subacute thyroiditis |
| any infectious organism; Bacteria | acute infectious thyroiditis |
| Following radioactive iodine therapy for hyperthyroidism or external beam radiation therapy for certain cancers | radiation-induced thyroiditis |
| Taking some drugs, including amiodarone, lithium, interferons, interleukin-2, and immunosuppressants | drug-induced thyroiditis |
| Thyroid fibrosis (thickening and scarring of the thyroid tissue) | Riedel’s thyroiditis |
Which people are more at risk of thyroiditis?
Any person of any age and gender can get this disease, but this condition usually happens in women, especially adult women. Hashimoto’s is 4 to 10 times more common in women than in men, and it usually occurs in women aged 30 to 50. Painless or silent thyroiditis is also more common in females and is the second most common cause of thyroid inflammation (after Hashimoto’s).
Stages of thyroiditis
In most types of thyroiditis, there are three phases, which are:
Thyrotoxic phase: During this phase, your thyroid becomes inflamed and secretes too many hormones, causing temporary thyrotoxicosis.
Hypothyroid phase: After oversecreting thyroid hormones for several weeks or months, your thyroid will not have enough thyroid hormone to secrete. This condition leads to a lack of thyroid hormones or hypothyroidism. Hashimoto’s thyroiditis and radiation-induced thyroiditis usually remain permanently in the hypothyroid phase.
Euthyroid phase: During the euthyroid phase, your thyroid hormone levels are normal. This phase may occur temporarily after the thyrotoxic phase and before going into the hypothyroid phase, or it may occur after the inflammation of the thyroid gland has recovered, in which the thyroid gland tries to maintain its normal hormone level.
How to diagnose thyroiditis
A specialist doctor may use one or more of the following tests to diagnose this disease.
Thyroid function tests:
These blood tests measure the levels of thyroid-related hormones and thyroid hormones in the body; including thyroid stimulating hormone (TSH), T3 (triiodothyronine) and T4 (thyroxine). TSH comes from your pituitary gland and stimulates the thyroid gland to produce the hormones T4 and T3, which together are called thyroid hormones.
Thyroid antibody tests:
These blood tests measure thyroid antibodies, which include antithyroid antibodies (TPO) or thyroid receptor-stimulating antibodies (TRAb). These antibodies can indicate that you have a type of thyroiditis caused by an autoimmune disease.
Radioactive iodine absorption test (RAIU)
Because iodine accumulates in the thyroid gland, your doctor or nurse will give you radioactive iodine in pill or liquid form. Over the next 24 hours, your doctor will check several points to see how much iodine your thyroid has absorbed.
Thyroid scan:
You get a shot of radioactive iodine. Then you lie on the table and tilt your head back so that your neck is clearly defined. The doctor uses a special machine to take pictures of your thyroid gland.
C-reactive protein (CRP):
This test measures the level of C-reactive protein (CRP) in your blood. When there is inflammation in the body, CRP increases, and usually in acute infectious thyroiditis, we will see a significant increase in CRP.
Red blood cell sedimentation rate (ESR) or sed rate
This test measures the amount of swelling or inflammation by the sedimentation rate of your red blood cells. High ESR may mean subacute thyroiditis.
Ultrasound:
A thyroid ultrasound can show a nodule or tumor, changes in blood flow and tissue, or density of the gland.
thyroiditis treatment
The treatment of this disease depends on its type and symptoms.
Treatment of thyrotoxicosis
If you are in the thyrotoxic phase, your doctor may prescribe beta-blockers to reduce palpitations (fast heart rate) and tremors. As the symptoms improve, the doctor will reduce the medication because the thyrotoxic phase is temporary.
Treatment of hypothyroidism
If you have Hashimoto’s, your doctor will prescribe thyroid hormone replacement drugs such as levothyroxine. In most cases, you will have to take this medication for the rest of your life because Hashimoto’s hypothyroidism is usually permanent.
If you have subacute, painless (off) or postpartum thyroiditis and are experiencing symptoms of hypothyroidism, your doctor will prescribe thyroid hormone replacement medications. You should probably take the medication for about 6 to 12 months and then taper off to see if you have permanent hypothyroidism.
If hypothyroidism is mild and you have few symptoms, you may not need to take medication.
Other treatments for thyroid inflammation
If you have acute infectious thyroiditis, the infection must be treated. Treatment for this infection will likely include taking antibiotics. If an abscess develops in your thyroid, your doctor may need to drain the fluid and pus by aspiration with a fine needle (needle biopsy).
Drug-induced thyroiditis usually lasts as long as you take the drug that caused it. The doctor may change your medicine to a similar medicine to treat thyroid inflammation or may ask you to use levothyroxine (thyroid hormone medicines) at the same time as taking the medicines that cause this disease without changing the current medicine.
Pain from acute infectious thyroiditis and subacute thyroiditis is usually manageable with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. In some cases, this pain can be severe and may require steroid treatment.
Riedel’s thyroiditis requires surgical treatment.
Complications of thyroiditis
This disease is generally not dangerous and may even be temporary. In this case, you can live a normal life after treatment. If the condition recurs or becomes permanent, work with your doctor to manage symptoms.
If thyroiditis is not treated, damage to the thyroid may continue and lead to more health problems. For women, fertility problems may occur or babies with birth defects may be born. An underactive thyroid can lead to heart disease, high cholesterol, swelling, and other unpleasant conditions in both men and women.
Although thyroiditis is usually not life-threatening, you may experience a life-threatening condition called thyroid storm. This condition can develop if you have long-term untreated or uncontrolled hyperthyroidism, which may be caused by inflammatory thyroid disease.
Symptoms of thyroid storm include:
- Very high fever
- Fast heartbeat (tachycardia) that can be more than 140 beats per minute.
- Feeling confused, irritable or anxious.
- Delirium
If you experience these symptoms, go to the emergency room.
Is it possible to prevent thyroiditis?
Unfortunately, most cases of thyroiditis cannot be prevented. If you have health problems that need to be treated with radioactive iodine or radiation therapy, talk to your doctor about your risk. You may be able to start with other treatments to prevent it from developing.
If you are taking medications prescribed by your doctor that can cause thyroiditis, talk to your doctor about the risk of this disease and whether it is possible to stop or change the medications. However, you still may not be able to prevent this disease.
FAQ
This disease is generally not fatal. This means that it is completely controllable if properly diagnosed and received proper treatment and you don’t need to worry about its complications. But if you don’t get treatment for it, it can cause many unpleasant side effects.
Most cases of this disease occur due to the immune system attacking the thyroid gland and causing inflammation in it. However, some of its types can be caused by medication, virus infection, thyroid fibrosis, etc.
Various drugs are used to control and treat this disease. Based on its type, symptoms and your clinical condition, the doctor may recommend the use of drugs such as levothyroxine, antibiotics, beta blockers, etc.
The prevalence of Hashimoto’s (the most common type of thyroiditis) is about 1-2%. Other types of disease are rarer.
This disease is Hashimoto’s thyroid, which is a permanent and lifelong problem.
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