THYROIDITIS

Thyroiditis

    •  Swelling or inflammation of the thyroid gland that can lead to over and under production of thyroid hormones.

    The three phases:

  •  Thyrotoxic phase: thyroid is inflamed and releases too many hormones
  •  Hypothyroid phase: following excessive release, there is a decrease in thyroid hormone production.
  •  Euthyroid phase: hormone levels are normal.

    Types and causes:

  •  Autoimmune: caused be antibodies against the thyroid gland. More common in women. Hormone replacement is the treatment of choice. May result in permanent hypothyroidism. Another type of autoimmune thyroiditis is silent or painless thyroiditis, with antibodies against the thyroid tissue.
  •  Postpartum: after a woman gives birth. This is a reversible condition.
  •  Radiation induced while the patient is undergoing radiotherapy for cancer in another organ.
  •  Subacute thyroiditis: Painful, thought to occur following a viral infection. This is a reversible condition.
  •  Acute or suppurative thyroiditis: rare condition caused by bacterial infection.
  •  Drug induced: occurs following the use of patients who are on lithium or amioderone. This is very rare.

    Diagnosis:

  •  Thorough physical examination and neck examination
  •  Routine blood tests to confirm the diagnosis. An elevated ESR may be seen in patients suffering from thyroiditis
  •  USG neck to confirm the presence of inflammation of the thyroid gland and identify the presence of a nodule or growth in the thyroid.
  •  Thyroid profile
  •  Measurement of thyroid antibodies in the blood to identify the cause of thyroiditis

    Management:

  •  Depends on the type, phase and underlying cause.
  •  You may be started on steroids if you have an autoimmune disorder.
  •  Beta blockers are prescribed to patents who have associated palpitations, anxiety or tremors.
  •  Anti-inflammatory agents help in pain reduction
  •  Drug induced thyroiditis is reversed as soon as the causative drug is discontinued.