How to check for thyroiditis?

Written by Li Hui Zhi
Endocrinology
Updated on September 22, 2024
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Thyroiditis is a general term. Clinically, the most common type is subacute thyroiditis, and another is Hashimoto's thyroiditis, which are two different diseases. For subacute thyroiditis, the symptoms include fever, neck pain, and throat discomfort. Generally, the first step is to check thyroid function to see if there is hyperthyroidism or hypothyroidism. The second step is to suggest antibody tests, including anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies. The third suggestion is to conduct a routine blood test and erythrocyte sedimentation rate. Fourth, a thyroid ultrasound is recommended. If necessary, a thyroid fine-needle aspiration may be performed for a definitive diagnosis. If it's Hashimoto's thyroiditis, which is an autoimmune disease, a specific antibody, TPOAB or anti-thyroid peroxidase antibody, is used for diagnosis.

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Written by Zhang Jun Jun
Endocrinology
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There are several types of thyroiditis.

Thyroiditis primarily includes acute, subacute, and chronic forms. Acute and subacute thyroiditis are generally seen in bacterial and viral infections, while chronic thyroiditis mainly consists of autoimmune thyroiditis, painless thyroiditis, and postpartum thyroiditis. However, autoimmune thyroiditis itself encompasses five scenarios, including Hashimoto's thyroiditis, atrophic thyroiditis, painless thyroiditis, euthyroid thyroiditis, and Hashitoxicosis. These types of thyroiditis are mainly seen in chronic thyroid conditions and are all autoimmune diseases. Therefore, the type of thyroiditis should be determined based on the cause to develop appropriate treatment plans.

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Written by Li Hui Zhi
Endocrinology
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Initial symptoms of thyroiditis

If it is the early stage of subacute thyroiditis, the patient will experience a fever, mainly in the afternoon or at night. Secondly, there is pain when bending the neck forward, and many patients feel as if they have a sore throat and thus visit the otolaryngology department. Thirdly, in the early stages, the patient experiences transient hyperthyroidism, with symptoms such as palpitations, excessive sweating, weight loss, and insomnia. Therefore, with these symptoms, it is advisable to promptly visit an endocrinology specialist for further thyroid function tests and thyroid ultrasound, followed by a definitive diagnosis and comprehensive treatment.

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Written by Zhang Jun Jun
Endocrinology
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How is thyroiditis treated?

Thyroiditis is primarily divided into acute, subacute, and chronic types, along with some painless and postpartum thyroiditis. If it is acute or subacute thyroiditis, it is a self-limiting disease caused by viral infections, and there is no need to use drugs that adjust thyroid function. Treatment mainly involves the use of non-steroidal or hormonal medications, as well as drugs that control heart rate. If it is autoimmune thyroiditis, commonly referred to as Hashimoto's thyroiditis, it often presents with positive thyroid antibodies. In the early stages, thyroid function may be normal, but typically progresses to reduced thyroid function over time. When thyroid function tests reveal reduced thyroid function, timely supplementation of thyroid hormone levels can control this type of autoimmune thyroiditis within a normal range. Additionally, for painless thyroiditis and postpartum thyroiditis, particularly the latter, which is often related to the mechanism of postpartum immune changes, it primarily depends on whether thyroid function has changed. If there is no change in thyroid function, treatment is temporarily unnecessary. (Medication should be administered under the guidance of a doctor.)

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Written by Luo Juan
Endocrinology
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What are the symptoms of acute thyroiditis?

Acute thyroiditis generally refers to acute suppurative thyroiditis, a type of pyogenic infectious disease. For instance, many patients may exhibit symptoms of an upper respiratory tract infection or experience swelling, pain, or difficulty swallowing in the lateral aspect of the thyroid in the anterior neck following a fine needle aspiration biopsy of a thyroid nodule. The local skin over the thyroid may display erythema or heat, and some may also have systemic symptoms of a febrile disease, such as increased body temperature, generalized body aches, and fatigue, along with swelling and pain in the cervical lymph nodes. Thus, the primary symptoms of acute thyroiditis are infectious, accompanied by symptoms of compression pain due to thyroid enlargement.

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Written by Li Hui Zhi
Endocrinology
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Are people with thyroiditis afraid of heat?

Thyroiditis generally refers to subacute thyroiditis. It is a disease caused by the destruction of thyroid follicles due to a viral infection, leading to the release of thyroid hormones into the blood. In the early stages, some people may experience transient hyperthyroidism, with symptoms such as heat intolerance, excessive sweating, palpitations, insomnia, weight loss, and irritability. In addition to these symptoms, thyroiditis can also be accompanied by neck pain and fever, generally occurring in the afternoon or evening. Therefore, it is recommended that anyone with these symptoms should promptly visit an endocrinology specialist to complete thyroid function tests, erythrocyte sedimentation rate, routine blood tests, and thyroid ultrasound to confirm the diagnosis.