Thyroiditis
Thyroiditis is inflammation of the thyroid, which is a gland in your neck under the Adam’s apple. The thyroid is part of the endocrine system that produces and releases certain hormones. An endocrinologist will oversee your care and treatment of thyroiditis.
The thyroid is mainly responsible for your metabolism (how quickly your body turns food into energy), but it can also impact your heart rate, brain development, body temperature and more.
Thyroiditis is relatively rare and tends to affect women more than men. There are many types of thyroiditis, the most common being Hashimoto’s thyroiditis.
Causes, Types and Risk Factors of Thyroiditis
Thyroiditis is an umbrella term for the different kinds of thyroid inflammation. The thyroid may become inflamed due to a virus or an autoimmune response.
Autoimmune Factors
Some types of thyroiditis are autoimmune conditions, where your body mistakenly attacks itself. These include:
- Hashimoto’s thyroiditis (the most common type of thyroiditis)
- Postpartum thyroiditis
- Silent or painless thyroiditis
The exact cause of autoimmune disorders is not yet fully understood. Some risk factors for autoimmune diseases include:
- Being female
- Having a family history of autoimmune disease
- Aging
Environmental and Infectious Triggers
Some types of thyroiditis are triggered by viruses or radiation (for cancer treatment). These include:
- Radiation-induced thyroiditis
- Subacute thyroiditis
- Acute infectious thyroiditis
- Riedel thyroiditis
Drug-Induced Thyroiditis
Other types of thyroiditis may be caused by certain medications, including amiodarone, interferons, lithium and cytokines. The majority of people taking these medications do not develop thyroiditis.
Symptoms of Thyroiditis
Symptoms of thyroiditis will vary person-to-person and will depend on what stage you’re in and what type you have.
Thyroiditis generally occurs in three stages and includes some common symptoms.
- Overactive thyroid: Thyroid is inflamed and releases too many hormones (hyperthyroidism).
Symptoms include:
- Increased heart rate
- Increased appetite
- Unexplained weight loss
- Anxiety
- Irritability
- Trouble sleeping
- Tremors
- Underactive thyroid: Thyroid releases too few thyroid hormones (hypothyroidism).
In some types of thyroiditis, this stage can be permanent. Symptoms include:
- Fatigue, lethargy
- Unexplained weight gain
- Constipation
- Slower heart rate
- Depression
- Dry skin
- Muscle weakness or joint stiffness
- Difficulty concentrating, or brain fog
- Euthyroid phase: Thyroid hormone levels are normal.
Diagnosis and Tests
If you have symptoms of thyroiditis, talk with your health care provider. They will ask questions about your symptoms and medical history, perform a physical evaluation and order some blood tests.
Lab Tests
Laboratory (blood) tests to diagnose thyroiditis may include:
- Thyroid function test, measures thyroid hormones in your body
- Thyroid antibody test, measures antithyroid antibodies and thyroid receptor stimulating antibodies, which may indicate an autoimmune disease
- Erythrocyte sedimentation rate, detects inflammation
- C-reactive protein, is usually elevated in acute infectious thyroiditis
Imaging
Your provider may do an ultrasound of your thyroid gland to look for:
- Abnormal growths
- Changes in blood flow
- Gland density
Management and Treatment of Thyroiditis
Treatment and management of thyroiditis will depend on the type you have.
Medication and Hormone Replacement
Your doctor may prescribe medications to manage symptoms or replace thyroid hormone if you have an underactive thyroid. Medications may include:
- Beta blockers to alleviate anxiety and lower a fast heart rate
- Anti-inflammatory medicine to alleviate swelling and inflammation
- Levothyroxine is a synthetic thyroid hormone replacement that may be used for a short period or as a lifelong therapy for conditions like Hashimoto’s
- Antibiotics to treat thyroiditis caused by an infection
Symptomatic Relief and Pain Management
Some types of thyroiditis, like acute infectious thyroiditis, can be painful, and may be managed with aspirin or ibuprofen. If your pain is severe, your doctor may recommend steroid therapy.
Long-term Monitoring and Follow-up
If you have permanent hypothyroidism, like Hashimoto’s, you can manage it with lifelong hormone replacement therapy and live an otherwise healthy life.
Other types of thyroiditis will resolve with time and you will make a full recovery. People who have had postpartum, subacute and painless thyroiditis are at a higher risk of developing permanent hypothyroidism.
