Thyroiditis

The term “thyroiditis” refers to inflammation of the thyroid gland.  The thyroid is a butterfly-shaped gland that is located centrally in the neck, just above the collarbones and below the larynx (voicebox). 

The main function of the thyroid is to regulate the body’s metabolism through production of thyroid hormones, T4 and T3.

The production of T4 and T3 is controlled by TSH (thyroid stimulating hormone), which is produced by the pituitary gland.   Too much or too little production of thyroid hormones by the thyroid is recognised by the pituitary gland, resulting in a reduction or increase in TSH levels respectively. 

In thyroiditis, the inflammation of the thyroid gland results in leakage of thyroid hormone stored in the thyroid gland into the bloodstream.  This causes symptoms of HYPERthyroidism (overactive thyroid).   This is generally a temporary phase, often lasting around 6-8weeks.  It may be shorter or longer depending on the cause/ individual case.  The thyroid may become swollen, painful &/or tender during this phase. 

The damage caused by the period of inflammation of the thyroid then results in a period of HYPOthyroidism (underactive thyroid).  This is usually also temporary, lasting 2-8 weeks.

Symptoms of hyperthyroidism

  • Fatigue, loss of energy, weakness
  • Tremor
  • Irritability, anxiety
  • Palpitations (fast and possibly irregular heartbeat)
  • Feeling hot and sweaty

The damage caused by the period of inflammation of the thyroid then results in a period of HYPOthyroidism (underactive thyroid).  This is usually also temporary, lasting 2-8 weeks.

Symptoms of hypothyroidism

  • Fatigue, loss of energy
  • Constipation
  • Feeling cold
  • Swelling of hands and feet

The thyroid function usually resolves by itself within 6 months or possibly longer or shorter depending on the individual case or cause

Causes

  • Immune problems.  The body incorrectly recognises the thyroid as foreign tissue and produces antibodies against it, which attack it
  • Following childbirth (post partum)
  • Viruses
  • Certain medications eg. Amiodarone
  • Radiation

Diagnosis

The diagnosis usually involves a combination of blood tests, checking thyroid function and thyroid antibodies, ultrasound and nuclear medicine scan of the thyroid.

Treatment

Treatment depends on the cause of thyroiditis and the symptoms it is causing.  Treatment may include:

  • Pain relief, usually in the form of Non-Steroidal anti-inflammatory drugs, such as aspirin or ibuprofen (if appropriate in the individual)
  • Beta blockers (eg. Propranolol, atenolol, metoprolol) to help control palpitations, fast heart rate and tremor
  • Thyroxine (thyroid hormone replacement, if hypothyroid)