Thyroiditis

Description, Causes and Risk Factors: ICD-10: E06.9 The thyroid is a small butterfly-shaped gland, which rests in the lower neck. Its main function is to control your body's growth and metabolism. To control metabolism, your thyroid gland produces hormones (thyroxine [T4] and triiodothyronine [T3]). A properly functioning thyroid will produce the right amount of hormones required to keep your body functioning normally. The levels of thyroid hormones in the blood are controlled by your pituitary gland. Thyroiditis is the inflammation of the thyroid gland which can occur due to several underlying medical conditions but is typically caused by an autoimmune disease. There are several types of thyroiditis and this condition can sometimes be difficult to diagnose as it may cause numerous symptoms that mimic other conditions or diseases. Types may include:
  • Acute thyroiditis.
  • Autoimmune thyroiditis.
  • Chronic atrophic thyroiditis.
  • Chronic fibrous thyroiditis.
  • Chronic lymphadenoid thyroiditis.
  • Chronic lymphocytic thyroiditis.
  • Drug-induced thyroiditis.
  • De Quervain thyroiditis.
  • Focal lymphocytic thyroiditis.
  • Giant cell thyroiditis.
  • Giant follicular thyroiditis.
  • Hashimoto thyroiditis.
  • Ligneous thyroiditis.
  • Lymphocytic thyroiditis.
  • Parasitic thyroiditis.
  • Postpartum thyroiditis.
  • Radiation-induced thyroiditis.
  • Riedel thyroiditis.
  • Silent thyroiditis.
  • Subacute thyroiditis.
  • Subacute granulomatous thyroiditis.
  • Subacute lymphocyte thyroiditis.
  • Suppurative thyroiditis.
Thyroiditis is caused by an attack on the thyroid, causing inflammation and damage to the thyroid cells. Antibodies that attack the thyroid cause most types of thyroiditis.
  • Acute thyroiditis or suppurative thyroiditis is relatively rare and typically caused by an infection that starts within the thyroid gland.
  • Subacute thyroiditis is thought to occur from a viral infection and typically causes the thyroid gland to swell very rapidly.
  • Hashimoto's thyroiditis is a chronic inflammatory disorder of the thyroid gland caused by abnormal blood antibodies and white blood cells attacking and damaging thyroid cells. The end result of this so-called "autoimmune" destruction is hypothyroidism or underactive thyroid functioning. Some patients are able to retain sufficient thyroid reserve to prevent hypothyroidism.
  • Silent thyroiditis is also a typically a temporary condition with only a slight enlargement of the thyroid gland.
  • Radiation-induced thyroiditis is caused by radiation treatment that is given for the treatment of cancer or radioactive iodine treatment.
  • Sometime even taking certain drugs causes thyroiditis.
  • Postpartum thyroiditis occurs frequently in women with a past history of thyroid disease who have recently delivered a baby. In most respects, silent and post partum thyroiditis resemble Hashimoto's thyroiditis except that the gland tends to recover and thyroid hormone treatment need be given for only a few weeks. However, it does differ from subacute thyroiditis in that recurrences are common (10%) and progression to permanent hypothyroidism is more frequent (10%).
Symptoms: Symptoms may include the following:
  • Fatigue.
  • Muscle weakness
  • Tremors (shaking hands or fingers).
  • Unexpected weight gain.
  • Constipation.
  • Dry skin.
  • Depression.
  • Muscle aches.
  • Weight loss.
  • Nervousness, anxiety or irritability.
  • Difficulty sleeping.
  • Rapid heart rate.
Diagnosis: Your doctor will perform laboratory tests to determine if you have thyroiditis, and, if so, what type of thyroiditis you have. Blood tests measure the amount of thyroid hormone in your blood and can indicate whether your thyroid is releasing too much hormone or too little. Blood tests can also show how much thyroid-stimulating hormone your pituitary gland is producing and what antibodies are present in the body. Your doctor may also do a radioactive iodine uptake test to measure your thyroid's ability to take up iodine, a mineral that is needed to produce thyroid hormone. In some cases, a biopsy may be needed to determine what is attacking the thyroid. Treatment: Treatment depends on the type of thyroiditis and the clinical presentation. If you have symptoms of hyperthyroidism, your doctor may prescribe a medicine called a beta blocker to lower your heart rate and reduce any tremors you may be experiencing. Since the symptoms of hyperthyroidism may be temporary, your doctor may taper the dose of this medicine as your symptoms improve. Antithyroid medications are not used for the thyrotoxic phase of thyroiditis of any kind since the thyroid is not overactive. If you have symptoms of hypothyroidism, your doctor may prescribe thyroid hormone replacements to restore your body's hormone levels and shift your metabolism back to normal. It can take several tries to get the right dose of synthetic thyroid hormone. In some types of thyroiditis, the symptoms of hypothyroidism will improve over time and your doctor will slowly taper your dose of synthetic thyroid hormone. If you have pain in your thyroid, your doctor may recommend a mild anti-inflammatory medication like aspirin or ibuprofen (one brand name: Motrin) to manage the pain. Occasionally, severe thyroid pain requires treatment with steroid therapy. Treatment of Hashimoto's thyroiditis consists of replacing the missing thyroid hormone, thyroxine. This is accomplished by taking a pill containing thyroxine (Euthyrox®, Synthroid®, Eltroxin®). If the dysfunction is mild, doses of 50 to 75 micrograms per day may be sufficient. The average replacement dose for more severe dysfunction is 1.6 micrograms/kg of body weight. If patients present with hypothyroidism and goiter, the goiter will usually shrink 6 to 18 months after replacement therapy has been introduced. Once the proper dose of thyroxine has been established, patients with Hashimoto's thyroiditis should be seen by their family doctors at least once a year to ensure that the dose of thyroxine is still adequate. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.  

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