The inflammation or swelling of the thyroid gland is called thyroiditis. It is caused by the attack of certain agents, such as antibodies, drugs, radiation or bacteria, on the thyroid. Hence, thyroiditis can be an autoimmune disease, a disease in which the body attacks itself. There are three phases of thyroiditis:
- Thyrotoxic phase in which the thyroid produces excessive hormones. This is the initial phase.
- Hypothyroid phase in which the thyroid does not have enough hormones to release after the initial phase of excessive hormones production.
- Euthyroid phase in which the thyroid functions normally. This phase may come temporarily between thyrotoxic phase and hypothyroid phase or after the hypothyroid phase when the inflammation has been treated.
There are different types of thyroiditis depending on the agent causing the inflammation, including:
- Acute thyroiditis caused by infectious organism or bacteria. It is relatively rare.
- Drug-induced thyroiditis caused by the use of drugs. It is uncommon in normal population.
- Hashimoto’s thyroiditis caused by anti-thyroid antibodies. This is most prevalent in women than in men and is most common in normal population.
- Post-partum thyroiditis caused by anti-thyroid antibodies in women after delivery.
- Radiation-induced thyroiditis caused when a person is exposed to external radiations during cancer treatments or by radioactive iodine to treat hyperthyroidism.
- Silent thyroiditis caused by anti-thyroid antibodies, most common in women and second most common after the Hashimoto’s thyroiditis.
- Sub-acute thyroiditis caused by a virus. It is often painful.
Symptoms
The symptoms of thyroiditis depend on the type and cause of the disease.
Symptoms during hyperthyroid phase include:
- Feeling worried or irritable
- Increased heart rate
- Tiredness
- Unexplainable weight loss
- Troubled sleep cycle
- Increased sweating and heat intolerance
- Increased hunger
- Tremors
- Anxiety and nervousness
Symptoms during hypothyroid phase include:
- Tiredness
- Depression
- Dry skin
- Unexplainable weight gai
- Decreased concentration and focus
- Constipation
- Difficulty in performance physical exercise
Diagnosis
Tests for thyroiditis involve:
- Thyroid function test which is a blood test to measure the levels of thyroid hormones, T3 and T4, and TSH in your blood. Increased levels of thyroid hormones and decreased levels of TSH indicate hyperthyroidism.
- Thyroid antibody test which is a blood test to measure thyroid antibodies.
- Erythrocyte sedimentation rate which is also a blood test that indicates inflammation by measuring the rate at which the red blood cells decrease.
- Ultrasound of the thyroid to produce an image on the screen that can be studied by your doctor to determine the change in blood flow and the presence of nodules on the gland, if any.
- Radioactive iodine uptake test in which you are asked to orally ingest radioactive iodine. The rate at which the iodine is absorbed by your thyroid gland is checked. The amount is low in the thyrotoxic phase.
- Thyroid scan in which a special camera and radioactive isotope, injected in your vein, is used to produce images of your thyroid to be studied by the doctor.
- Fine-needle aspiration biopsy to collect a sample of the thyroid tissue, using a long thin needle inserted through the skin, for testing.
Treatment
Your doctor will carry out a treatment plan that will depend on the phase, type and symptoms of the thyroiditis.
Treatments for the phases include:
- For the thyrotoxic phase, generally no treatment is given as it is a temporary phase that will eventually recover or move onto the euthyroid phase or to the hypothyroid phase.
- For the hypothyroid phase, hormone replacement therapy is used until the disease is cured.
Treatments for the symptoms include:
- Beta blockers to treat palpitation, anxiety, tremors, heat intolerance and increased sweating.
- Anti-inflammatory medications for thyroidal pain.
- Steroid therapy for severe thyroidal pain.
Treatments for the types include:
- Drug- induced thyroid normally lasts as long as the drugs are taken and may not require a treatment.
- Hashimoto’s thyroiditis causes hypothyroidism permanently and will require you to take hormone replacement therapy for life.
- Sub-acute, post-partum and silent thyroiditis do not require any treatment.
- Acute thyroiditis is cured once then infection causing it is treated.
