Thyroiditis is an inflammation of the thyroid gland. Depending on the cause of the condition, thyroiditis may or may not cause the gland to be tender or painful. Most cases of thyroiditis result first in the overactivity of the gland, or hyperthyroidism, and then underactivity of the gland, or hypothyroidism, before resolving. Thyroiditis is the most common cause of hypothyroidism and is 10 times more likely to occur in women.
Types of Thyroiditis
There are several types of thyroiditis. The treatment of the ailment depends on its cause.
The most common type of thyroiditis is Hashimoto's thyroiditis, also known as chronic thyroiditis. In patients with this condition, the body attacks its own thyroid tissue, preventing the production of thyroid hormones. When the gland cannot convert iodine into hormones, it compensates by enlarging, eventually forming a goiter or leading to hypothyroidism. Regular monitoring and hormone therapy are most often used to treat this condition.
Chronic thyroiditis may also sometimes occur with adrenal insufficiency, underactivity of the parathyroid gland, or type 1 diabetes.
Subacute thyroiditis, also known as De Quervain's thyroiditis, is a sudden, painful inflammation that most commonly occurs after a viral infection, along with fever and malaise. This condition also causes the thyroid gland to move hormones quickly into the blood, causing temporary hyperthyroidism. Treatment for subacute thyroiditis involves bed rest and aspirin to help reduce inflammation.
Postpartum thyroiditis occurs in 5 to 10 percent of women during the first several month after they give birth. Although it causes symptoms, it is usually benign and self-limiting
Silent thyroiditis is similar to the postpartum variety of the condition, but does not occur after a pregnancy. Both postpartum and silent thyroiditis are believed to be disorders of the immune system.
In rare instances, the symptoms of thyroiditis are indications of thyroid cancer. If thyroid cancer is suspected, a biopsy of the thyroid gland will be taken to make a definitive diagnosis.
Risk Factors for Thyroiditis
While the precise causes of thyroiditis are not known, there are several risk factors for the disorder. These include:
- Being female
- Being over the age of 50
- Being post partum
- Having a family history of the disease
- Being a smoker
- Having an autoimmune disorder
- Having certain other medical conditions
- Having an eating disorder
- Exposure to radiation, especially of the head or neck
- Treatment with certain drugs
- Excessive intake of iodine
While women develop thyroiditis more frequently, men more often develop thyroid cancer.
Symptoms of Thyroiditis
While occasionally, patients with thyroiditis are asymptomatic, enlargement, pain, or tenderness of the thyroid gland are common symptoms. Because thyroiditis may involve, in turn, hyperthyroidism and hypothyroidism, symptoms of either condition may be symptoms of thyroid inflammation.
Symptoms of Hyperthyroidism
The symptoms of hyperthyroidism, apart from enlargement of the thyroid gland, include:
- Irritability, hyperactivity, nervousness
- Tremors or muscle weakness
- Sleep disturbances
- Visual problems
- Weight loss
- Inability to tolerate heat
- Scant or infrequent menstrual periods
Symptoms of Hypothyroidism
Symptoms of hypothyroidism, which at times are difficult to distinguish from menopausal symptoms in middle-aged women, may include:
- Dry, coarse skin or hair
- Hair loss
- Inability to tolerate cold
- Weight gain
- Cognitive difficulties
- Joint or muscle pain
The most serious symptom of thyroiditis is thyrotoxic crisis, which develops suddenly and is life-threatening. It presents as a traumatic intensification of thyroid symptoms and necessitates immediate medical intervention.
Diagnosis of Thyroiditis
Diagnosis of thyroiditis is made through thorough physical examination and the administration of blood tests to assess hormone levels. A thyroid-stimulating hormone (TSH) test will be administered for diagnosis and during treatment in order to monitor thyroid function. Thyroid cancer, in the rare instances in which it occurs, will be diagnosed by a thyroid scan, a thyroid ultrasound or a fine-needle aspiration and biopsy of thyroid tissue.
Treatment of Thyroiditis
Thyroiditis is treated with various medications, depending of its type. Where the patients is experiencing symptoms of hypothyroidism, hormones will be prescribed to replace those the body is underproducing. Depending on the condition being treated, these hormones may need to be taken temporarily or throughout the patient's life.
Other medications may be prescribed to alleviate symptoms of the disorder. These may include:
- Pain relievers
- Corticosteroids to reduce inflammation
- Short-term beta blockers for hyperthyroid symptoms
When thyroiditis is the result of a malignancy, radioactive iodine may be administered. In some cases, particularly where cancer is present, partial or total surgical removal of the thyroid gland may be necessary. When such action is taken, the patient will need to take replacement hormones for the foreseeable future.