The term thyroiditis means an inflammation of the
thyroid gland. This butterfly-shaped gland is found in front of the
windpipe just above the collarbone, and when inflamed it can become
swollen and tender. Most cases of thyroiditis are the result of one of
The most common cause is an autoimmune disease called Hashimoto’s thyroiditis. In this condition, the body’s immune system produces antibodies which attack thyroid cells. The cells become less able to produce thyroid hormone, resulting in hypothyroidism. The gland swells to compensate for its loss of function, which can cause pain and tenderness. Diagnosing Hashimoto’s requires a blood test for distinctive antibodies which are found in 95% of patients. If further determination is needed, a needle biopsy of the gland shows invasion by lymphocytes. The disease is treated with thyroid hormone replacement to control hypothyroidism and to reduce the swelling. In exceptional cases where the goiter cannot be reduced or it causes difficulty in breathing or swallowing, it may be reduced by surgery.
De Quervain's thyroiditis is far less common than Hashimoto’s disease. It is usually a short-lived condition that does not cause permanent damage. The thyroid swells quickly and becomes very painful and tender, while producing increased amounts of thyroid hormone (hyperthyroidism). The gland also stops taking up the iodine necessary to keep up thyroid production, so the hyperthyroidism generally fades and hormone levels return to normal over several weeks. No specific causative agent has been found for this type of thyroiditis, but recurrences of the disease are uncommon. The usual treatment consists of bed rest and aspirin to reduce the fever and pain until the disease runs its course.
The least common type of thyroiditis generally occurs in young women following pregnancy. This silent thyroiditis is marked by a high level of thyroid hormone in the blood (hyperthyroidism) and low iodine uptake as in De Quervain’s, but there is no pain and little or no swelling of the thyroid. The result of a needle biopsy resembles Hashimoto’s. Treatment generally consists of bed rest and beta blockers to prevent rapid heart rate associated with hyperthyroidism.