How is thyroiditis treated?

Written by Zhang Jun Jun
Endocrinology
Updated on September 12, 2024
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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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Symptoms of thyroiditis

The symptoms of thyroiditis are related to the cause of the thyroid disease, and different causes lead to different symptoms of thyroiditis. Common subacute thyroiditis may cause pain in the neck and thyroid area, accompanied by fever and pain, and may present as migratory. The thyroid may appear locally enlarged and feel hard to the touch. If it is autoimmune thyroiditis, such as the most common Hashimoto's thyroiditis, there may be no symptoms in the early stages. As the disease progresses, transient symptoms of hyperthyroidism may occur, but these symptoms of hyperthyroidism can be cured and do not require special treatment. Then, as the disease progresses and more thyroid destruction occurs, symptoms of hypothyroidism may eventually develop.

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Is thyroiditis fever dangerous?

Fever symptoms in thyroiditis mainly refer to acute suppurative thyroiditis and subacute thyroiditis. Acute suppurative thyroiditis is a purulent infectious disease, often a mixed bacterial infection, commonly occurring after upper respiratory infections or fine-needle aspiration of thyroid nodules. Symptoms can include thyroid enlargement, pain, difficulty swallowing, fever, and other systemic symptoms. Broad-spectrum antibiotics can be used for initial treatment. If the pathogen is identified, the type of antibiotic can be adjusted. Some patients may require incision and drainage if an abscess is present, and in very rare cases, complications such as tracheal obstruction or mediastinitis may occur. Additionally, patients with subacute thyroiditis may also experience fever, usually a mild to moderate increase in body temperature, and in some cases, it can reach 40°C. The fever typically peaks around the third to fourth day and subsides in about a week. Patients with this type of fever can generally use non-steroidal anti-inflammatory drugs, and since subacute thyroiditis is a self-limiting disease, whether the fever in thyroiditis is dangerous depends on the situation.

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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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Causes of Acute Thyroiditis

We generally refer to acute thyroiditis as an acute suppurative thyroiditis, which is a type of purulent infectious disease, often caused by a mixed bacterial infection, such as staphylococcus, streptococcus, gram-negative bacilli, and anaerobes, etc. Patients with compromised or deficient immune functions, such as those with AIDS, leukemia, diabetes, can also have infections like fungi and pneumocystis. Some thyroid nodules, due to events like necrosis or cystic changes from punctures, can also cause a suppurative infection, and this condition is generally common among middle-aged and elderly patients. Therefore, the main cause of acute thyroiditis is mostly due to infections.

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What are the symptoms of thyroiditis?

The symptoms of thyroiditis, if in the early stages, include fever, particularly in the afternoon and evening, with some individuals' temperatures reaching 39 degrees Celsius. Secondly, there is neck pain, which is tender to touch. Thirdly, there may be mild symptoms of hyperthyroidism, such as palpitations, insomnia, irritability, weight loss, and increased frequency of bowel movements. If these symptoms are present, it is important to seek medical attention promptly and undergo diagnosis and treatment under the guidance of a doctor.