Thyroiditis Health Article

Definition

Thyroiditis is inflammation of the thyroid gland, a butterfly-shaped organ next to the windpipe.

Description

The thyroid is the largest gland in the neck. It produces, secretes, and stores thyroxine (T₄), a hormone that influences the metabolism of just about every body process.

When the thyroid gland is functioning properly, hormone release is carefully regulated. When bacteria or viruses invade and inflame the gland, T₄ surges into the bloodstream and raises hormone levels that then discourage the gland from creating more T₄. Eventually the hormone stores are exhausted, the thyroid loses its ability to manufacture T₄, and an underactive thyroid (hypothyroidism) results.

The major cause of hypothyroidism, thyroiditis affects about 12 million people in the United States. This condition is more common in women than in men and usually develops between ages 30–50.

Hashimoto's disease

Some cases of Hashimoto's disease remain stable for years. Others slowly progress to hypothyroidism, which is treated with thyroid hormone replacement therapy.

Subacute thyroiditis

Most patients with subacute thyroiditis recover fully after no more than a few months. This condition occasionally recurs, but severe or long-term complications are rare.

Silent thyroiditis

Four of every five patients with silent thyroiditis recover completely within three months. The thyroid status of these patients should be evaluated within 12 months. Because silent thyroiditis recurs in 10% of patients within three years and may progress to hypothyroidism, medical monitoring should continue for three years after recovery appears complete.

Acute thyroiditis

Acute thyroiditis requires emergency treatment with antibiotics and surgery.

Diagnosis

Family physicians and endocrinologists usually base a diagnosis of thyroiditis on:

• blood levels of thyroid hormones, thyroid-stimulating hormone, and anti-thyroid antibodies
• personal and family medical history
• the appearance of a patient's thyroid gland

Thyroid antibodies present in 95% of patients with Hashimoto's thyroiditis make it possible to diagnose this disease without surgery or biopsy. A blood test that measures sedimentation rate, an indication of the extent of inflammation, is a useful tool for diagnosing subacute thyroiditis.

Treatment

Medical therapy for thyroiditis includes:

• antibiotics to fight infection
• high doses of aspirin to relieve inflammation
• hormones to suppress or replace thyroid function
• pain medications

Cortisone drugs are sometimes prescribed to reduce persistent inflammation. In rare instances, surgery can be used to drain infection or relieve pressure near the thyroid gland.