Inflammation of the thyroid gland – also called thyroiditis – is a disease of the thyroid gland and accounts for about one to three percent of all diseases of the organ. At around 80 percent, Hashimoto’s thyroiditis, a chronic inflammation of the thyroid gland, is the most common form of thyroid inflammation.
What is thyroid inflammation?
Thyroiditis is either focal or diffuse inflammation of the thyroid tissue. The course can be acute, subacute or chronic. See deluxesurveillance for Menkes Syndrome Guide.
The various forms have completely different causes and therefore each represent an independent clinical picture. The disease is further subdivided into painless and painful thyroid inflammation.
Causes
Thyroid inflammation can have different causes. Some forms are caused by infections with bacteria or viruses, others by injury to the organ or exposure to ionizing radiation.
However, autoimmune diseases can also underlie thyroid inflammation. In autoimmune diseases, cells of the immune system do not just attack invading pathogens. In addition to foreign bodies, the body’s own healthy cells are also combated. Due to a wide variety of causes, the course of thyroid inflammation can also be different.
The causes of subacute inflammation of the thyroid, named after Fritz de Quervain and also known as Quervain’s thyroiditis, are still unknown. However, it has been observed that this form of thyroiditis often follows airway infections.
Symptoms, Ailments & Signs
In the case of acute thyroid inflammation, severe swallowing problems set in within a few hours or days. Sick people feel, among other things , hoarseness, coughing and increasing pain. In addition, a high fever develops, which is accompanied by chills, exhaustion and other general symptoms.
The thyroid swells and can often be felt from the outside. If thyroiditis is treated early, further complications can usually be avoided. Drug therapy counteracts the symptoms mentioned, which usually subside within two to three days. The subacute inflammation of the thyroid gland sets in over the course of two to three weeks.
During this period, the thyroid gland becomes very swollen and painful. A general malaise as well as fever and difficulty swallowing are added. The throat is usually very sensitive to pressure and the voice appears weakened or altered. In subacute thyroiditis there is usually no swelling of the lymph nodes.
However, at the beginning of the disease there can be a slight hyperfunction of the thyroid gland, which is usually associated with restlessness, irritability and physical complaints. The subacute form also quickly reappears with appropriate treatment. Most patients are free of symptoms after three weeks at the latest.
Diagnosis & History
In the case of acute thyroid inflammation, the enlarged thyroid gland can often be felt. A blood test reveals increased levels of white blood cells (leukocytes) and accelerated blood sedimentation, which can be understood as general indicators of an inflammatory reaction in the body.
In the next step, an ultrasound examination (sonography) is used to determine the acute inflammation of the thyroid gland and to rule out another disease. A subacute inflammation of the thyroid gland shows only a slightly increased concentration of white blood cells in the blood count, but a significantly increased blood sedimentation rate.
In many cases, thyroid antibodies can also be found in the blood, but these are far below the levels of chronic inflammation, such as Hashimoto’s thyroiditis. Doctors can often only confirm the diagnosis after a fine-needle biopsy, in which tissue is removed from the thyroid gland. If the thyroid is severely inflamed, examination of the removed tissue will reveal a severe reaction, often associated with nodule formation.
An inflammation of the thyroid gland can take a different course, painful or, as is often the case with chronic thyroiditis, extremely painless. The diseases can occur acutely or gradually and almost unnoticed, so that a therapy has to be designed individually depending on the type of thyroid inflammation.
Complications
Depending on its form, thyroiditis can cause various complications. First, thyroiditis causes the thyroid gland to become enlarged, which is associated with severe pain, fever, and a general feeling of illness. If the course is severe, the fever can develop into a life-threatening condition.
The disease can also lead to restlessness, irritability and lack of sleep – a frequent trigger for accidents in everyday life. Bacterial thyroid inflammation can lead to the development of abscesses as it progresses. The acute form often results in the connective tissue proliferating into the actual glandular tissue. If the hormone-producing tissue is displaced, this can result in hypothyroidism.
Scar tissue can form in the subacute form, which can also lead to hypothyroidism. When treating thyroiditis with hormone therapy, sleep problems, extreme malaise, and a decrease in sexual interest can occur. There is also an increased risk of osteoporosis and depression. In women, hormone treatment can lead to menstrual irregularities. The use of anti-inflammatory drugs and other preparations can also be associated with side effects and allergic reactions.
When should you go to the doctor?
Headaches and muscle pain, difficulty swallowing and tiredness are typical symptoms of thyroid inflammation. A doctor’s visit is recommended if the symptoms persist for more than two to three days. If pain occurs in the thyroid area, it is best to consult a doctor immediately. Thyroiditis often occurs after trauma, radioiodine or radiation therapy, or bacterial infections in the ear, nose, and throat area. The subacute form results from an infection of the upper respiratory tract. Those who belong to the risk groups must have the symptoms mentioned quickly clarified. People with an immune deficiency, the chronically ill, the elderly, pregnant women and children should see their family doctor if they suspect thyroid inflammation.
Postpartum thyroiditis can also occur in pregnant women six to 24 weeks after childbirth, which is manifested by repeated infections and must be treated quickly. If the symptoms occur after taking certain medications such as interferon or amiodarone, a change in medication is necessary. Thyroid inflammation is treated by an internist or family doctor. Chronic and severe symptoms should be clarified in a specialist clinic for thyroid diseases.
Treatment & Therapy
Depending on the form of the disease, the course of the thyroid inflammation varies. Acute and subacute thyroiditis respond well to therapy and often heal after a few weeks or three to six months.
In the case of chronic thyroid inflammation, the situation is different. In the long run, the destruction of the hormone-producing tissue can be observed here, whereupon a therapy with the missing thyroid hormone is prescribed, starting with a low dose that has to be adjusted again and again and maintained for life.
Thyroid infections need to be treated depending on the type of culprit. Acute inflammation of the thyroid gland due to a bacterial infection can be effectively treated with antibiotics. In the case of a milder course, tablets are sufficient, but in the case of a more severe form of thyroiditis, infusions are administered. In the case of a fever, high fluid intake and strict bed rest are recommended. The neck can be cooled for support until the symptoms subside.
The subacute inflammation of the thyroid often takes a rather mild course. Antiphlogistics, i.e. anti-inflammatory preparations with a slight anesthetic effect, help here. If the symptoms are severe, cortisone will bring relief the very next day. Chronic thyroid inflammation means that the tissue is gradually destroyed and ultimately a non-functional thyroid remains. Therefore, for example, Hashimoto’s thyroiditis itself is not curable. However, the supply of thyroid hormone in the form of L-thyroxine must be substituted for life.
Prevention
The prevention of thyroid inflammation is only possible insofar as care can be taken to treat bacterial and viral infections sustainably. A disease that has not healed favors a secondary infection, which can favor or even cause thyroid inflammation.
Aftercare
In most cases, thyroid inflammation is not an independent disease. The symptoms are often caused by other illnesses. Thyroid infections are often caused by autoimmune diseases. The doctor adapts the follow-up care to the respective symptoms, their severity and the actual cause.
In addition, it must be differentiated whether chronic or acute thyroid inflammation is present. The aim of aftercare is to alleviate and heal the inflammation. If another illness is causing the symptoms, it will be corrected during follow-up care. A biopsy is sometimes necessary at the discretion of the specialist.
The development of an overactive or underactive thyroid gland should also be prevented. The patient is given medication to counter secondary symptoms such as fatigue. Painkillers are also prescribed. As part of the aftercare, the doctor monitors the healing progress. A healed acute inflammation requires no further follow-up care.
In the chronic form, the checks extend over months or even years. Regular blood tests provide information about the hormone production in the thyroid gland. Deviating hormone values are treated with appropriate medicine or require further examination.
In the case of severe inflammation, foci of pus can form on the thyroid gland. They are punctured or surgically removed. The specialist ends the follow-up care when the healing is satisfactory. At this point the treatment is complete.
You can do that yourself
Patients with thyroid inflammation can strengthen their organism by taking various measures that stabilize the immune system. In addition to a balanced and healthy diet, the intake of vitamins and sufficient exercise, avoiding harmful substances is particularly important. Therefore, the consumption of alcohol, drugs, nicotine or non-prescribed medication should be completely avoided.
Sporting activities and an optimal supply of oxygen support the body’s immune system. Optimal sleep hygiene, sufficient rest and recovery phases, and leisure activities geared to the needs of those affected promote well-being and strengthen the organism.
If the disease becomes chronic, mental strengthening is particularly important for overcoming the disease. Mental techniques can be used to reduce stressors. Cognitive training, yoga or meditation are just some of the options that can be used as part of self-help. They support the quality of life and contribute to a positive attitude.
It is important to ensure that a sufficient amount of liquid is consumed every day. Therefore, the fluid balance should be well monitored and adequately regulated. Since there are often difficulties in swallowing, ingested food should be broken up sufficiently in the mouth. The grinding process of the teeth should be used so that no large pieces of food are transported into the esophagus.
