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What Is Thyroiditis and Its Treatments?

Thyroiditis is an inflammation (not an infection) of the thyroid gland. Several types of thyroiditis exist, and the thyroiditis treatment is different for each. Three types of common thyroiditis are Hashimoto’s thyroiditis, De Quervain’s thyroiditis, Silent Thyroiditis. Hashimoto’s thyroiditis, also called Autoimmune or Chronic Lymphocytic Thyroiditis, is the most common type of thyroiditis. The thyroid gland is always enlarged in Hashimoto’s thyroiditis, although only one side may be enlarged enough to feel.

The radioactive iodine uptake treatment for thyroiditis may be paradoxically high while the patient is hypothyroid because the gland retains the ability to take-up or “trap” iodine even after it has lost its ability to produce thyroid hormone.

Thyroiditis treatment should begin with thyroid hormone replacement. This prevents or corrects the Thyroiditis, and it also generally keeps the gland from getting larger. In most cases, the thyroid gland will decrease in size once Thyroiditis treatment with hormone replacement is started.

De Quervain’s thyroiditis was first described in 1904 and is much less common than Hashimoto’s thyroiditis. The thyroid gland generally swells rapidly and is very painful and tender. Patients frequently become ill with fever and prefer to be in bed. Thyroid antibodies are not present in the blood, but the sedimentation rate is very high. Thyroiditis treatment is usually bed rest and aspirin to reduce inflammation. A few patients will become hypothyroid once the inflammation settles down and therefore will need to stay on thyroid hormone replacement indefinitely.

Silent thyroiditis is the third and least common type of thyroiditis. It was not recognized until the 1970s, although it probably existed and was treated as Graves’ disease before that. This type of thyroiditis resembles in part Hashimoto’s thyroiditis and in part De Quervain’s thyroiditis.

The blood thyroid test is high and the radioactive iodine uptake is low, but there is no pain and needle biopsy resembles Hashimoto’s thyroiditis. This type of Thyroiditis usually needs no treatment, and 80% of patients show complete recovery and return of the thyroid gland to normal after 3 months. The thyroid gland is only slightly enlarged and exophthalmos does not occur. Thyroiditis treatment is usually bed rest with beta blockers to control palpitations (drugs to prevent rapid heart rates). Radioactive iodine, surgery, or anti-thyroid medication is never needed.

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