Do you sometimes feel unusually tired for no reason? Or do you feel very restless, like you're losing weight? Maybe there's a small swelling in the front of your neck, or something like that, like pain when you touch it? Sometimes behind these things there could be a problem with your thyroid gland. Today, we'll talk about this common, but not well-known condition called 'thyroiditis'.
First, let's see, what is this thyroid gland?
Simply put, the thyroid gland is a small butterfly-shaped organ located under the skin at the front of our neck. It is a very important part of our body's endocrine system. Many important functions in the body, such as heart rate, body temperature, and the rate at which we convert the food we eat into energy (metabolism), are controlled by the hormones produced by this small gland.
Now, what is Thyroiditis ? It is an inflammation or swelling of the thyroid gland. Just as when we get an injury somewhere on our body, the area becomes swollen and red, when the thyroid gland is damaged for some reason, it also swells. This swelling can disrupt the normal functioning of the thyroid gland. That is, it either starts producing too many hormones, or it can produce too little.
The three main stages of thyroiditis are:
In most cases of thyroiditis, your body can go through three main stages. It's like working in a factory.
1. Thyrotoxic phase: This is like a factory going out of control and suddenly releasing too much product into the market. When the thyroid gland swells, the hormones stored inside it are suddenly released into the bloodstream. This causes your thyroid hormone levels to rise dramatically for a few weeks or a month or two.
2. Hypothyroid phase: Now that the factory has released all the goods at once, they no longer have the raw materials to make them again. Also, after all the hormones have been released from the gland into the blood, a situation arises where new hormones cannot be made. As a result, the level of thyroid hormones in your body decreases significantly. In some types of Thyroiditis, for example, Hashimoto's thyroiditis, this low hormone level can become permanent.
3. Euthyroid phase: This is the recovery phase. Just as a factory starts working again and producing goods as usual, the thyroid gland heals and starts producing hormones normally again. Some people may enter this phase directly after the high hormone phase, or they may enter this phase after the low hormone phase.
What are the main types of thyroiditis?
Thyroiditis is not a single disease. It is a group of diseases that can be caused by various factors. Let's look at the main types.
| Type of thyroiditis | Simply put, this is what happens. |
|---|---|
| Hashimoto's thyroiditis | This is the most common type. What happens here is that our body's own immune system attacks its own thyroid gland. This is an autoimmune disease. Over time, the gland can become damaged and hormone production can be permanently reduced (Hypothyroidism). |
| Silent or painless thyroiditis | This is also an autoimmune condition. As the name suggests, there is no neck pain, but you can see phases of hormonal surges and declines. |
| Postpartum thyroiditis | This is a condition that can occur in mothers within the first year of having a child. The cause is autoimmune. Most of the time, it is temporary. |
| Radiation-induced thyroiditis | It can be caused by radiation therapy for cancer or radioactive iodine treatment to increase thyroid hormones. |
| Subacute thyroiditis | It is believed to be caused by a viral infection. It can occur after a sore throat or cold has passed. There may be severe pain in the neck. |
| Acute infectious thyroiditis | This is very rare. It occurs when a germ, such as bacteria, enters the thyroid gland and infects it. Here too, severe pain and fever can occur. |
| Drug-induced thyroiditis | It can occur as a side effect of some medications (e.g. Amiodarone, Lithium, Interferons). However, not everyone who takes these medications will develop it. |
What are the symptoms of Thyroiditis?
Symptoms depend on the type of thyroiditis you have and the stage (high or low hormones) you are in. Let's take a look at what symptoms can occur in these two stages.
| Symptoms of Thyrotoxicosis | Symptoms of low hormones (Hypothyroidism) |
|---|---|
| Feeling like your heart is beating fast | Feeling tired all the time (Fatigue) |
| Weight loss for no reason | Weight gain for no reason |
| Feeling hungry all the time | Constipation |
| Restlessness, irritability | Depression or a feeling of sadness |
| Insomnia | Dry skin |
| Excessive sweating, feeling hot | Intolerance of cold |
| Tremors | Muscle weakness |
| - | Difficulty concentrating |
Very important: In rare cases, untreated hyperthyroidism can lead to a life-threatening condition called 'thyroid storm'. If you have symptoms such as a high fever (over 104 F), a very fast heart rate (over 140 beats per minute), or confusion, go to the emergency room (ETU) of your nearest hospital immediately. This is a medical emergency.
How do you find this, Doctor?
If you have these symptoms, your doctor will first ask you about your symptoms and examine your neck. Then, if thyroiditis is suspected, they will order several tests, such as:
- Thyroid function tests: This is a blood test. It measures the levels of hormones TSH, T3, and T4 in your blood. This can tell you exactly whether you are in a high or low hormone phase.
- Thyroid ultrasound: This can check the shape and size of the thyroid gland, whether there are any lumps in it, and how the blood circulation is.
- Thyroid antibody tests: This blood test helps determine if your thyroiditis is caused by an autoimmune condition.
- ESR and CRP tests: These are also blood tests. They are important to determine if there is inflammation in the body. These are especially high in subacute and acute thyroiditis.
- Radioactive iodine uptake (RAIU) test: This involves giving you a small amount of radioactive iodine to drink and measuring how much of the iodine your thyroid gland has absorbed a few hours later. This uptake is very low during the hyperthyroid phase of thyroiditis.
What are the treatments for this?
Treatment depends on the type of thyroiditis you have and your symptoms.
Treatment for hormonal imbalance
Since this phase is usually temporary, your doctor may prescribe a medication, such as beta-blockers, to control symptoms such as palpitations and tremors. The medication is usually stopped when the symptoms subside.
Treatment for hormone deficiency
If you have a condition that causes permanent hormone deficiency, such as Hashimoto's thyroiditis, your doctor will prescribe external thyroid hormone pills (such as levothyroxine). This may need to be taken for the rest of your life.
In other types, if the hormone deficiency is temporary, these hormone pills are given for about 6 to 12 months, then stopped and the gland is seen to function again.
Other specific treatments
- For pain: Painkillers (NSAIDs) are given for painful conditions like subacute thyroiditis. If the pain is severe, steroid treatment may be necessary.
- For infections: Antibiotics are given for bacterial infections such as acute infectious thyroiditis. If an abscess has formed, it may need to be drained with a needle.
- Surgery: In very rare cases, such as Riedel thyroiditis, surgery may be necessary.
Can't this be prevented?
Unfortunately, there is no way to prevent most types of thyroiditis, as most of them are caused by our own immune system. However, if you are undergoing radiation treatment for a disease or taking a medication that can cause thyroiditis, you can talk to your doctor about it and be aware of the risks.
If you are diagnosed with thyroiditis, don't panic. This is a condition that can often be treated well, controlled, and even cured. The most important thing is to follow your doctor's instructions exactly and to return for regular checkups.
Take-Home Message
- Thyroiditis is an inflammation of the thyroid gland. It is not cancer.
- In this case, hormones may initially increase (hyperthyroidism), and then decrease (hypothyroidism).
- Pay attention if you have symptoms such as unexplained weight change, excessive fatigue, restlessness, neck pain, or swelling.
- This condition can be easily diagnosed through simple blood tests and scans.
- There are very effective treatments for many types of thyroiditis. Some are temporary, while others may require long-term treatment.
- If you have any questions or doubts about this, talk to your doctor openly about it.
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