Thyroiditis is a medical term to indicate inflammation of the thyroid gland, which can manifest as either hyperthyroidism or hypothyroidism.

The thyroid gland is located in the lower front part of the neck. It is responsible for the production of thyroid hormones that are involved in the growth and metabolism of the body.

Inflammation of the thyroid is most common in women from youth to middle age. It typically has three phases, the overactive, underactive and normalizing phase. These are caused by the initial damage by the inflammation-causing agent.

This leads to initial excessive release of thyroid hormones from the damaged cells, leading to hyperthyroidism.

Once the reserves are exhausted, the patient suffers from a deficient thyroid hormone level. Finally, as the condition runs its course, many patients find that their thyroid has recovered and is functioning normally.

Types of Thyroiditis

There are several different types of thyroiditis, including:

• Hashimoto’s thyroiditis: the most common type, which is caused by an autoimmune response that damages the cells of the thyroid gland and leads to hypothyroidism.
• De Quervain’s thyroiditis (subacute thyroiditis): triggered by a viral infection, this painful form of thyroiditis often causes hyperthyroidism initially followed by a longer period of underactivity and final recovery.
• Post-partum thyroiditis: caused by an autoimmune response after giving birth, it damages the thyroid gland and leads to hyperthyroidism initially, followed by hypothyroidism, though recovery is usual in the majority of cases within a year.
• Acute (infectious thyroiditis): triggered by a viral infection and may cause hypothyroidism or hyperthyroidism.
• Silent thyroiditis (painless thyroiditis): caused by an autoimmune response which damages the thyroid gland and leads to hyperthyroidism initially and then hypothyroidism.
• Drug-induced thyroiditis: caused by the use of a medication such an amiodarone or lithium, it may lead to hypothyroidism or hyperthyroidism.
• Radiation-induced thyroiditis: caused by radiation therapy and may lead to hypothyroidism or hyperthyroidism.

Each of these types has a unique cause, and the resulting symptoms and treatment depend on this.

Symptoms

The symptoms of thyroiditis are often subtle initially and may not be recognized until the condition progresses, after several months or years. Eventually, the imbalance of thyroid hormones in the body may cause noticeable symptoms, related to hypothyroidism or hyperthyroidism.

Symptoms of hypothyroidism may include:

• Fatigue
• Weight gain
• Cold intolerance
• Joint or muscle pain
• Constipation
• Dry skin and hair
• Heavy menstrual periods
• Difficulty conceiving
• Depression
• Impaired memory
• Bradycardia

Symptoms of hyperthyroidism include:

• Anxiety
• Insomnia
• Irritability
• Tachycardia or heart palpitations
• Tremor
• Weight loss

Goiter, or thyroid gland enlargement, is a common condition, one cause of which may be thyroiditis.

Thyroiditis may also manifest as mild tenderness in the thyroid region. It may be associated with both over- and under-production of the thyroid hormone.

Treatment

The treatment of thyroiditis will depend on the type of thyroiditis and the nature of the symptoms.

In some cases, treatment may not be needed initially and the best option is to wait and monitor for the progression of symptoms.

Most women with post-partum thyroiditis, for example, will find that their hormone levels return to normal several months after childbirth.

Additionally, if there is a specific cause, such as drug-induced or radiation-induced thyroiditis, hormone levels may return to normal when the trigger ceases to operate.

For individuals with symptomatic hypothyroidism, a thyroid hormone supplement such as levothyroxine is often the best option. This medication needs to be taken every day for the duration of the patient’s life to replace the deficiency of thyroid hormones in the body.

For patients with symptomatic hyperthyroidism, a beta-blocker drug can help to block the affect of the thyroid hormones and reduce symptoms quickly.

Other symptoms, such as pain, can be managed with the appropriate treatment technique. For example, non-steroidal anti-inflammatory drugs (NSAIDs) can help to reduce the pain and inflammation linked to de Quervain’s thyroiditis.

Surgery is sometimes needed for patients with thyroiditis to remove part or all of the thyroid gland. This is an option if the goiter lump causes discomfort or there is a suspicion of cancerous growth in the area.

References

• http://www.thyroid.org/thyroiditis/
• http://emedicine.medscape.com/article/925249-overview#showall
• http://www.nhs.uk/conditions/thyroiditis/Pages/Introduction.aspx
• http://umm.edu/health/medical/altmed/condition/thyroiditis