What is Thyroiditis?
Thyroiditis is the inflammation of the thyroid gland. There are many different causes and types of this thyroid disease. The symptoms and treatment depend on the cause and the severity of the inflammation.
There are many different symptoms for thyroiditis – the symptoms vary depending on the severity of the disease. Many of the signs imitate symptoms of other diseases, so thyroiditis can sometimes be difficult to diagnose. Common hypothyroid symptoms occur when the thyroid damage is slow and chronic, and may include fatigue, weight gain, feeling “fuzzy headed,” depression, dry skin, and constipation. Other, rarer symptoms include swelling of the legs, vague aches and pains, and decreased concentration.
When the thyroid conditions become more severe, depending on the type of thyroiditis, other symptoms may develop including puffiness around the eyes, slowing of the heart rate, a drop in body temperature, or even heart failure. If the thyroid damage is acute, the thyroid hormone within the gland leaks out into the bloodstream causing symptoms of thyrotoxicosis, which is similar to those of hyperthyroidism. These symptoms include weight loss, irritability, anxiety, insomnia, fast heart rate, and fatigue. Elevated levels of thyroid hormone in the bloodstream cause both conditions, but thyrotoxicosis is the term used with thyroiditis since the thyroid gland is not overactive, as in the case of hyperthyroidism.
Thyroiditis is a group of disorders that all cause thyroid inflammation. Forms of the disease are Hashimoto’s thyroiditis, the most commom cause of hypothyroidism, postpartum thyroiditis, subacute thyroiditis, silent thyroiditis, drug-induced thyroiditis, radiation-induced thyroiditis, acute thyroiditis, and Riedel’s thyroiditis.
Each different type of this disease has its own causes, clinical features, diagnoses, durations, resolutions, conditions and risks. The following summary contains information about some of the more commonly seen types.
- Hashimoto’s thyroiditis is the most common form of thyroiditis and is usually characterised by enlargement of the thyroid with or without pain.
- Hashimoto’s is much more common in women and occasionally causes pressure symptoms
- Many patients have normal thyroid function but some will develop hyperthyroidism (Hashitoxicosis) or hypothyroidism
- Hashimoto’s is an autoimmune disease and appropriate treatment for most patients consists of giving suppressive doses of thyroxine.
- Surgery is required for pressure symptoms, suspected tumour and for cosmetic reasons.
- Subacute thyroiditis is known by many names, including de Quervain’s thyroiditis, painful thyroiditis, giant cell thyroiditis, and granulomatous thyroiditis
- Subacute thyroiditis is caused by a viral infection of the thyroid and often appears after an upper respiratory tract infection.
- Symptom relief may be provided by ß-blockers, prednisone and pain medication before the hyperthyroid state resolves spontaneously
- After pregnancy around 5-10% of all women develop this thyroid disease
- Typically there will be a transient hyperthyroid phase between 6 weeks and 6 months after childbirth, followed by a hypothyroid phase, and finally a return to normal thyroid function by the end of one year
- Since up to 25% of women with this condition may develop permanent hypothyroidism in the long-term annual follow-up is recommended
Treatments depend on the specific disease and thyroid symptoms that are diagnosed. For the most common type, which is – Hashimoto’s, the treatment is to immediately start hormone replacement. This prevents or corrects the hypothyroidism, and it also generally keeps the gland from getting larger. Often, patients only need non-steroidal anti-inflammatory medications; however, sometimes steroids are needed to reduce inflammation and to control palpitations. Depending on the symptoms, beta blockers may be needed to lower the heart rate and reduce tremors.
If you have any questions about thyroid or parathyroid surgery, you should speak to your local doctor, who will arrange to contact your thyroid surgeon.