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Johns Hopkins Symptoms and Remedies

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Thyroiditis

What is it?

Thyroiditis is inflammation of the thyroid, the gland at the base of the neck that produces thyroid hormone (thyroxine), crucial in the regulation of body growth and metabolism. There are three types of thyroiditis: acute, subacute, and chronic. Although inflammation of the thyroid gland is common to all three, they differ significantly in terms of symptoms, cause, and outcome. Acute thyroiditis is extremely rare. Subacute thyroiditis is self-limited, meaning it resolves spontaneously without treatment, usually in a matter of months. Chronic thyroiditis, the most serious of the three, may lead to tissue destruction and scarring of the thyroid; indeed, it is the leading cause of insufficient thyroid hormone production in adults (see Hypothyroidism).

What Causes It?

  • Acute thyroiditis is rare, resulting from direct infection of the thyroid following a penetrating neck wound or, more rarely still, a bacterial infection elsewhere in the body that spreads to the thyroid via the bloodstream.
  • The cause of subacute thyroiditis is unknown, although it is often preceded by a viral infection of the upper respiratory tract, suggesting some association with the body's response to infection.
  • The cause of chronic thyroiditis is also uncertain, but evidence is strong that it involves autoimmune activity (an attack by the body's defenses on its own healthy tissue). Hereditary factors may play a role.
  • A painless and typically temporary form of thyroiditis affects about one in 20 women after they give birth (postpartum thyroiditis). Either hyper- or hypothyroidism may occur transiently.

Prevention

  • There is no known way to prevent thyroiditis.

Diagnosis

  • Patient history and physical exam are necessary.
  • Blood levels of thyroid hormone, thyroidstimulating hormone, and antibodies to the thyroid gland are measured.
  • A scan of the thyroid may be taken after administration of radioactive iodine to evaluate thyroid function.
  • A fine-needle biopsy, extracting tissue directly from the thyroid, may be done to rule out thyroid cancer in patients with chronic thyroiditis.

How to Treat It

  • Antibiotics are used to treat the infection associated with acute thyroiditis.
  • Because subacute thyroiditis resolves on its own, treatment is aimed at relieving symptoms only. Aspirin or other pain relievers may ease inflammation and tenderness. Beta-blocker medications are helpful at treating the symptoms of hyperthyroidism. Corticosteroids such as prednisone may sometimes be used.
  • Some patients with subacute thyroiditis may develop transient hyper- or hypothyroidism, which may require brief periods of treatment with, respectively, either beta-blockers or thyroid hormone.
  • Treatment for chronic thyroiditis primarily consists of thyroid hormone (thyroxine) replacement to correct hypothyroidism (see Hypothyroidism).

When to Call a Doctor

  • Call a doctor if you suffer from pain or swelling in the neck; pain in the ears, lower jaw, or back of the head; fatigue, unexplained weight gain, or other symptoms of hypothyroidism.