Subacute thyroiditis is a rare type of thyroiditis that causes pain and discomfort in the thyroid area. People with this condition also experience symptoms of hyperthyroidism and later develop symptoms of hypothyroidism. Although subacute thyroiditis is often temporary, it can cause permanent complications if left untreated.
Thyroid hormones regulate body functions
The thyroid is a gland located in the front of the neck that secretes various hormones. These hormones help regulate metabolism, the process that converts food into energy. They also play an important role in our physical and emotional reactions such as fear, excitement and pleasure. Thyroiditis means inflammation of the thyroid. Most types of thyroiditis typically lead to hyperthyroidism or hypothyroidism. Hyperthyroidism is a disease in which the thyroid is overactive and produces too much hormone.
Hypothyroidism is a condition in which the thyroid is underactive and cannot produce enough hormones. Both of these conditions can cause weight changes, anxiety, and fatigue. Unlike other types of thyroiditis, subacute thyroiditis is thought to be related to a viral infection. It usually occurs after upper respiratory tract infections such as flu or mumps. The immune system formed in response to the virus negatively affects the thyroid, causing swelling (inflammation) and disruption of hormone production. This causes various symptoms.
Subacute thyroiditis presents with a painful infection
Subacute thyroiditis occurs slightly more frequently in women aged 40-50 than in men of the same age. Unlike other types of thyroiditis, subacute thyroiditis causes pain in the thyroid gland. In some cases, this pain may radiate to other areas of the neck, ears, or jaw. The thyroid may be swollen and painfully tender to the touch. Pain can usually persist for 1 to 3 months. Subacute granulomatous thyroiditis is the most common type of subacute thyroiditis. This is the type often seen after viral infections.[1]
Symptoms of subacute thyroiditis include: Fever, exhaustion, weakness, hoarseness, difficulty swallowing, palpitations and sweating, diarrhea, constipation, weight loss, sudden weight gain, irritability and anxiety. Here, the main determinant of symptoms is the patient’s thyroid hormone levels.
Manual examination and some blood tests are very important for diagnosis.
Palpation of the neck is very important to determine whether the thyroid gland is enlarged or inflamed. The thyroid gland is painful and tender during manual examination. Additionally, recent medical history should also be questioned. Subacute thyroiditis will be more likely to be diagnosed if there is a recent history of viral infection in the upper respiratory tract. Certain blood tests must be done to confirm the diagnosis of subacute thyroiditis. These tests will check the levels of certain hormones in the blood. Specifically, the tests; It should include CRP, sedimentation, free T3, free T4, and thyroid stimulating hormone (TSH).
Get treated early
In the treatment of subacute thyroiditis, medications should be used to help reduce pain and control inflammation. In some cases, this is the only treatment option needed for subacute thyroiditis. Nonsteroidal anti-inflammatory drugs (NSAIDs) are initially used to treat pain and suppress inflammation. Corticosteroids are used when NSAIDs are not sufficient to reduce inflammation.[2] If hyperthyroidism is present in the early stages, beta blocker drugs are included in the treatment.
These medications lower blood pressure and pulse rate to relieve certain symptoms, such as anxiety and palpitations. Treatment of hyperthyroidism is important at the beginning of the disease. However, this will not help when his condition progresses to the second stage. Hypothyroidism may develop in later stages of the disease. Perhaps in the future, due to damage to the thyroid tissue, the hormones that the body cannot produce may need to be taken externally.
References:
- Zornitzki T, Mildiner S, Schiller T, Kirzhner A, Ostrovsky V, Knobler H. Subacute Thyroiditis-Still a Diagnostic Challenge: Data from an Observational Study. Int J Environ Res Public Health. 2022 Jul 31;19(15):9388. doi: 10.3390/ijerph19159388. PMID: 35954746; PMCID: PMC9368122.
- What Are NSAIDs? – American Academy of Orthopaedic Surgeons (OrthoInfo)