By this time the reader might have got a hint that thyroiditis is a condition that has something to do with the thyroid gland. Thyroiditis is actually an umbrella term that is used to refer to all kinds of inflammation of the thyroid gland. Thyroid gland is a bow-shaped organ that is located in front of the neck, below the Adam’s apple. Normally, the thyroid gland functions to produce thyroid hormone that controls metabolism (the pace of body process). Thyroiditis consists of many individual thyroid complications that cause inflammation of the thyroid gland but results in various clinical presentations. Thyroiditis is painful if the disorder is caused by injury or trauma and it’s painless if it is caused by auto-immune disease (immune system acting against one’s own organs) or medications. Inflammation of the thyroid gland interferes with the normal thyroid functioning ability.
Causes
Thyroiditis that causes inflammation of the thyroid gland is caused when one’s own antibodies act against the thyroid gland. Therefore, thyroiditis is called as an autoimmune disease. Thyroiditis tends to run in families but despite this, what triggers the body to make thyroid antibodies is unknown. Thyroiditis can also be caused by viral or bacterial infection, which works in the same way as the antibodies that attack the thyroid gland and causes it to swell. Few drugs like interferon-alpha, interleukin-2, and amiodarone can also damage thyroid gland and cause thyroiditis. Women develop thyroiditis after delivery if they are detected positive for thyroid antibody in their first trimester. Consuming excess iodine can also cause thyroid disorder.
Symptoms
Thyroiditis does not have a specific list of symptoms as it is not a single disorder; it has many thyroid disorders under it. If thyroiditis causes slow, long-term destruction of the thyroid cells, then it results in decrease in thyroid hormone level. Therefore, in such cases, the symptoms resemble that of hypothyroidism or Hashimoto’s thyroiditis, which includes:
- Sudden weight gain
- Constipation
- Fatigue/weakness
- Depression
- Dry skin
- Pain in the muscles
- Less exercise tolerance
If thyroiditis rapidly destroys the thyroid cells and causes the stored thyroid hormone to leak out and increase the amount of thyroid hormone in blood, and result in a condition called thyrotoxicosis, which display symptoms similar to hyperthyroidism. Symptoms include:
- Weight gain
- Fatigue
- Difficulty sleeping
- Fast heart beat
- Nervousness, anxiety, or irritability
- Muscle weakness
- Tremors (shaking of fingers or hands)
Pain in the thyroid gland is very rare.
Types of thyroiditis
There are different thyroid disorders that are placed under thyroiditis. Different kind of thyroiditis includes:
- Hashimoto’s thyroiditis: The very common type of thyroiditis that is caused when antibodies attack the thyroid gland. Symptoms are similar to hypothyroidism, which can be treated.
- Sub-acute thyroiditis: It is caused by viral infection, which causes pain of the thyroid gland. Symptoms, initially resemble hyperthyroidism and later result in hypothyroidism. Symptoms improve with treatment.
- Silent thyroiditis: Symptoms include that of hyperthyroidism and later hypothyroidism. Usually results in permanent hypothyroidism but symptoms improve with 12-18 months of treatment.
- Post-partum thyroiditis: Caused in women after delivery. It is an autoimmune disorder, which exhibits symptoms of hyperthyroidism after 4-6 months of delivery and followed by hypothyroidism. Symptoms usually improve after 12-18 months but may result in permanent hypothyroidism.
- Radiation-induced thyroiditis: It is detected after radiation treatment for cancer or after radioactive treatment for hyperthyroidism. The symptoms are similar to that of hypothyroidism. Usually results in permanent hypothyroidism, but treatment can control symptoms.
- Drug-induced thyroiditis: It is caused by consuming drugs like amiodarone, interferon, interleukin, and cytokines. Displays symptoms of either hypothyroidism or hyperthyroidism. Symptoms do not go until the person stops taking the drug.
- Acute thyroiditis or suppurative thyroiditis: Inflammation of the thyroid gland is caused by bacteria or other infection. This results in pain in the thyroid gland, general illness, and symptoms of mild hypothyroidism. It is cured once the infection is treated.
Diagnosis
Diagnosis is done to check whether the patient has thyroiditis and if so, what kind of thyroiditis is the person suffering from. Thyroiditis is diagnosed by blood test that determines the level of thyroid hormone in blood. The amount of thyroid hormone in blood shows whether the thyroid gland is releasing too little thyroid hormone (hypothyroidism) or too much of thyroid hormone (hyperthyroidism). The amount of thyroid-stimulating hormone released by the pituitary gland can also be measured using blood sample. The blood sample is also checked for presence of any thyroid antibodies. Apart from this, the doctor may also perform a radioactive iodine test that determines the amount of iodine the thyroid gland is able to use. Iodine is essential for normal thyroid hormone production. This test shows the functioning capability of the thyroid gland. In few patients, the doctor may want to do a biopsy to exactly determine what is attacking the thyroid gland.
Treatment
Treatment usually depends on the type of thyroiditis and its clinical presentation. Taking into consideration the three common clinical presentation of thyroiditis – thyrotoxicosis, hypothyroidism, and thyroid pain, the treatment for these includes:
- For thyrotoxicosis, the doctor may prescribe beta blockers that help to decrease palpitation (rapid heartbeat) and tremors. As the doctor notices improvement, the dosage of medication is reduced as thyrotoxic phase is transient.
- For hypothyroidism, the best treatment option is thyroid hormone replacement therapy, which brings the body’s hormone level to normal and increases metabolism rate. It may take several attempts to know the exact dosage of synthetic thyroid hormone. If the symptoms are seen improving, the dosage of synthetic thyroid hormone will be tapered.
- For thyroid pain, a mild anti-inflammatory drug like aspirin and ibuprofen is prescribed to reduce pain. Very rarely, if the pain is very severe then, steroid-like prednisone is required.
Outlook
Being diagnosed with any form of thyroiditis requires perfect treatment and management to lead a normal life. Patient should understand the type of thyroiditis they are suffering from and discuss with their doctor about the treatment options and its benefits.
