Thyroiditis

Thyroiditis can proceed acutely, sub-acutely or chronically, and cause very different symptoms. The cause will determine how it proceeds. Bacteria, viruses or an autoimmune disease may be behind it. The treatment depends on the causes and the symptoms.

The thyroid, which lies under the larynx, produces important hormones for the metabolism of the body. Inflammation of the thyroid gland can – depending on the cause – upset the thyroid hormone. The most common form of thyroiditis is Hashimoto’s thyroiditis, in which a person’s thyroid gland attacks their own immune system (autoimmune disease) and causes chronic inflammation. Hypothyroidism can develop from Hashimoto's thyroiditis. Bacterial or viral inflammation of the thyroid is less common. Acute thyroiditis with swelling of the thyroid glands and fever is mostly caused by bacteria. If the thyroiditis occurs in connection with a viral infection, it usually proceeds sub-acutely. This means that the symptoms develop more slowly and are less pronounced. Subacute thyroiditis is also known as De Quervain’s thyroiditis after the man who discovered it.

The symptoms and the course of thyroiditis vary, depending on the form and cause of the disease.

Hashimoto’s thyroiditis develops over years. Symptoms occur only if hypothyroidism develops as a result. Typical symptoms of hypothyroidism are tiredness, sensitivity to cold, constipation, need for sleep, concentration difficulties, dry skin and breakable hair.

Sub-acute De Quervain's thyroiditis usually develops two or three weeks after a viral throat infection. The thyroid gland increases in size and is painful. Difficulty swallowing, fever, hoarseness, swelling of the lymph nodes, muscle and joint pain can also occur concomitantly. In the case of sub-acute thyroiditis, this can often result in temporary [hyperthyroidism] with symptoms such as agitation, increased sweating, more rapid heartbeat, weight loss, nervousness and shaking. After the phase of hyperthyroidism, hypothyroidism can develop over time. Depending on the phase of the illness, the symptoms can be very different. Acute bacterial thyroiditis causes similar symptoms such as sub-acute thyroiditis; however, the symptoms usually develop more quickly.

Different clarifications are carried out to diagnose hypothyroidism and determination of the cause. They include palpating the thyroid gland, ultrasound examination and determination of the thyroid gland hormone in the blood. Depending on the situation, a contrast agent x-ray (scintigraphic scan) and a biopsy (tissue sample) will also be carried out.

The treatment depends on the causes of the thyroiditis and the symptoms. Sub-acute bacterial thyroiditis is treated with antibiotics. Sub-acute thyroiditis usually heals within several weeks without any consequences. Anti-inflammatory medication is administered to ease the symptoms.

In the case of chronic Hashimoto's thyroiditis, the focus is on treating the hypothyroidism. Life-long hormone replacement treatment with thyroxine, the thyroid gland hormone, is usually also required. In rare cases, surgical removal of the thyroid gland is necessary if the thyroid gland is severely enlarged or makes it very difficult for the affected party to swallow. Find out more about surgery on the thyroid in the thyroid gland surgery section.