There are no unique symptoms of thyroiditis. In some cases, thyroiditis can cause slow and chronic cell damage and destruction, causing the thyroid levels to fall below normal, thus they suffer from hypothyroidism. Common symptoms of this group of patient are fatigue, constipation, depression, poor exercise tolerance, and weight gain.

When the thyroiditis causes rapid damage of the thyroid gland, the hormone (which is stored in the gland) leaks out, causing the level of hormone to increase, and the patients suffer from thyrotoxicosis, the symptoms of which are similar to hyperthyroidism such as anxiety, palpitations, fatigue, weight loss, insomnia and irritability.

In case of subacute and post-partum thyroiditis, there is a depletion of the hormone from the thyroid gland in the course of inflammation.

• Inflammation

  Thyroiditis is a general term that refers to “inflammation of the thyroid gland”. Thyroiditis includes a group of individual disorders causing thyroidal inflammation but presenting in different ways. [thyroid.org]

  Inflammation of the thyroid gland Inflammation of the thyroid gland. Inflammation of the thyroid gland. Thyroiditis may be an autoimmune disease that affects the thyroid gland over time, causing hypothyroidism (too little thyroid hormone). [icd9data.com]

  Definition (CHV) inflammation of the thyroid gland Definition (CHV) inflammation of the thyroid gland Definition (NCI) Inflammation of the thyroid gland. [fpnotebook.com]

  T lymphocytes, a type of cell involved in the inflammation process, invade the thyroid gland cause silent, painless inflammation that destroys it; ultimately, the individual produces little or no thyroid hormone and becomes hypothyroid. [medicinenet.com]

• Goiter

  (plunging) (substernal) E04.9 ICD-10-CM Diagnosis Code E04.9 Nontoxic goiter, unspecified 2016 2017 2018 2019 Billable/Specific Code Applicable To Goiter NOS Nodular goiter (nontoxic) NOS lymphadenoid E06.3 Hashimoto's disease or thyroiditis E06.3 Hashitoxicosis [icd10data.com]

  […] of thyroid tissue Goiter; symptoms of compression Surgery may be necessary because of compression. [amboss.com]

  EXAM: In most cases a small, nontender, firm goiter is present. [enotes.tripod.com]

  What is a goiter? Another manifestation of Hashimoto’s is a goiter, which appears as a swelling in the front of the neck. A lack of iodine is a common cause of goiter in places where there is not enough iodine in the diet. [medicalnewstoday.com]

• Asymptomatic

  Patients are initially asymptomatic or hyperthyroid, progressing to hypothyroidism as the organ parenchyma is destroyed. Diagnosis is based on a combination of specific antibodies, thyroid function tests, and sonography of the thyroid. [amboss.com]

  Asymptomatic Atrophic Thyroiditis Appendix: Pituitary Changes in Myxoedema and Chronic Thyroiditis 11. Diseases Associated with Autoimmune Thyroiditis 12. Atrophic Thyroiditis, Hypertension and Coronary Heart Disease 13. [elsevier.com]

  In asymptomatic AT, preventive thyroid replacement therapy is indicated in patients with elevated basal TSH levels. Overt hypothyroidism always requires hormonal substitution. [link.springer.com]

  After 5 months the patient remained asymptomatic and had returned to work. An atrophic thyroid gland was revealed at ultrasound. [elsevier.es]

• Short Stature

  Hashimoto's thyroiditis symptoms and signs These include goiter, menstrual disorders, short stature, constipation, nervousness, fatigue, and exophthalmos have been reported as the most recurrent clinical features of Hashimoto's thyroiditis. [raysahelian.com]

• Stridor

  On examination she had inspiratory stridor, with a respiratory rate of 25 breaths/min and an oxygen saturation of 94% in room air. A large neck mass (10 cm) was visible, predominantly on the right side (fig 1 ⇓ ). [bmj.com]

  Surgical Indications for surgery include: A large goitre with obstructive symptoms - eg, dysphagia or stridor. Presence of a malignant nodule. Presence of a lymphoma diagnosed on fine-needle aspiration. Cosmetic reasons for unsightly, large goitres. [patient.info]

  If both recurrent laryngeal nerves are affected, stridor can result. Involvement of the parathyroid glands can cause hypoparathyroidism. [endocrinologyadvisor.com]

  […] radiation Hyperthyroidism generally resolves within one month Self-limited, but symptoms may be treated with beta blockers and nonsteroidal anti-inflammatory drugs Riedel thyroiditis (fibrous thyroiditis) ‡ Very firm goiter or compressive symptoms (dyspnea, stridor [aafp.org]

• Vomiting

  We report a case of a 50-year-old woman who was admitted initially with vomiting, hiccups and paraesthesias but was not diagnosed with NMO and presented with a severe progression of the disease. [ncbi.nlm.nih.gov]

  You may need treatment with an intravenous (IV) antibiotic if your doctor is concerned that your infection is progressing rapidly, if you can't swallow oral medication, or if you are vomiting so much that you can't absorb oral medication. [thyroid.about.com]

  There was no vomiting, nausea, or blurring of vision. On physical examination, his heart rate was 82 beats per minute. He had daily spikes of temperature between 38°C and 39°C. A small right‐sided neck swelling was nontender to palpation. [onlinelibrary.wiley.com]

• Nausea

  There was no vomiting, nausea, or blurring of vision. On physical examination, his heart rate was 82 beats per minute. He had daily spikes of temperature between 38°C and 39°C. A small right‐sided neck swelling was nontender to palpation. [onlinelibrary.wiley.com]

  […] neck veins • Extreme fatigue • Fainting • Fast, slow, irregular, pounding, or racing heartbeat or pulse • Fever • Heat intolerance • Hives or welts • Increased blood pressure • Increased pulse • Irregular breathing • Irritability • Menstrual changes • Nausea [physio-pedia.com]

  Fever was intermittent, associated with chills at night and occasional occipital headaches, without any nausea, vomiting, visual changes, photophobia, phonophobia, or rash. He also had intermittent dizziness with multiple falls. [hindawi.com]

  […] other generic symptoms which may accompany thyroiditis symptoms listed below: General malaise or body aches Immune dysfunction Fever or chills Generalized or non-specific fatigue Pain in the thyroid gland or thyroid enlargement Loss of appetite Headache Nausea [restartmed.com]

  Weight loss or difficulty gaining weight, despite a good appetite Insomnia (sleeplessness or sleep disturbances) Racing heart or palpitations (pronounced awareness of one’s heartbeat)[4] High blood pressure[5] Increased frequency of bowel movements Nausea [ada.com]

• Osteoporosis

  If the dose is too strong, it can cause symptoms of hyperthyroidism, creating excessive strain on the heart and an increased risk of developing osteoporosis. [thyroidawareness.com]

  Undiagnosed thyroid disease may put patients at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis and infertility. (1) Approx 1 in 182 people in the US will develop a thyroid disease known as Hashimoto’s Thyroiditis. [vega-licious.com]

  Patients can be extremely thyrotoxic during this period and can appear extremely ill, but concerns regarding left ventricular hypertrophy and osteoporosis are not as great as those associated with conditions of permanent hyperthyroidism. [emedicine.medscape.com]

• Hyperactivity

  In Graves', the body's hyperactive immune system produces an antibody that attaches to the TSH receptors on the thyroid gland. [study.com]

  Its antioxidant content might help improve your thyroid hyperactivity. Postpartum thydroiditis Following pregnancy in some women, some antibodies may remain in the body that attack the thyroid. [steptohealth.com]

  (Etiology) The exact cause of Postpartum Silent Thyroiditis is unknown It is believed to develop due to an immune attack against the thyroid gland due to hyperactivity of the individual’s own immune system; it is an autoimmune disorder What are the Signs [dovemed.com]

  Younger patients tend to exhibit more sympathetic activations (eg, anxiety, hyperactivity, tremor), while older patients have more cardiovascular symptoms (eg, dyspnea, atrial fibrillation) and unexplained weight loss. [emedicine.medscape.com]

  Some scholars believed the thyroid itself possessed a lymphogenic secretory capability that became hyperactive in these patients. Others viewed the goiter as secondary to constant anxiety and emotional unrest. [intechopen.com]

Acute thyroiditis: The laboratory data of the patients with acute thyroiditis is similar to acute systemic illness. Leukocytosis, increased sedimentation rate, and thyroid function test within the normal reference range.

Subacute thyroiditis: The data from the patients with subacute thyroiditis is similar to those with abnormal thyroid functions. Though initially the thyroid-stimulating hormone (TSH) level is decreased, sometimes, permanent hypothyroidism may also develop. White blood cell count in such patients is within the normal or slightly elevated reference range. C-reactive protein levels are also elevated in such patients.

Chronic thyroiditis: Laboratory data of patients with chronic thyroiditis are found to be abnormal with evidence of autoimmunity. In subclinical and overt hypothyroidism, TSH levels are increased, while in children with hyperthyroidism, this level is suppressed.

Elevated antithyroid peroxidase antibody levels are the most sensitive indicator of the autoimmunity.

Imaging Studies

Radioactive iodine thyroid scanning: Though this type of scanning is not necessary for acute suppurative thyroiditis and chronic thyroiditis, it can help to diagnose subacute thyroiditis.

Thyroid ultrasonography: Helps to reveal the formation of abscess patients with acute thyroiditis.

Degree of hyopoechogenicity on ultrasonography: Benefits are dependent on the degree of the thyroid dysfunction [7] [8].

The treatment of thyroiditis depends on the type of the disease as well as the clinical presentation.

Thyrotoxicosis: The symptomatic relief can be brought out depending on the symptoms. In order to decrease the palpitations, beta blockers are used. With the improvement of the symptoms, the medications are reduced as the thyrotoxic phase was temporary. Antithyroid drugs are not used for the thyrotoxic stage.

Hypothyroidism: Hormone replacement therapy for hypothyroidism induced by Hashimoto’s thyroiditis is common. In patients with thyroiditis (subacute, painless and post-partum), thyroid hormone therapy can be indicated. This treatment must continue for 6-12 months and then tapered depending on the requirements.

Thyroidal pain: Subacute thyroiditis can cause pain. In such cases, mild anti-inflammatory medications are indicated. When these pains become severe, steroid therapy with prednisone is indicated [9] [10].

The prognosis of thyroiditis depends on the cause of the disease. Patients with Hashimoto’s disease may progress to complete thyroid failure, causing permanent hypothyroidism. On correct and early diagnosis, hypothyroidism responds well to the treatment. Goiter following autoimmune thyroiditis may not resolve completely. Other types of thyroiditis can be managed well with treatment with total resolution of the disease.

Complications

Some of the complications of the disease are hypothyroidism, thyroid abscesses, severe chest pain, hyperthyroidism, neck pain and goiter.

Thyroiditis can be broadly classified into:

• Acute suppurative thyroiditis caused by bacterial infection
• Subacute thyroiditis caused by viral infection of the gland.
• Chronic thyroiditis is autoimmune in nature. 

The most common type of thyroiditis is Hashimoto’s thyroiditis named after the Japanese physician. This disease is an autoimmune lymphocytic thyroiditis [1] [2].

Depending on the screening procedures, the prevalence of chronic autoimmune thyroiditis varies. In some areas across the globe, the prevalence is as high as 12.5%. The region where the antibiotic use is less prevalent, acute thyroiditis is common.

Though there is no long-term mortality or morbidity due to thyroiditis, patients with autoimmune thyroiditis may develop hypothyroidism requiring treatment for life. Those patients, who suffer from subacute thyroiditis, may have hyperthyroidism, which may resolve on its own. Normal thyroid function is generally restored in patients with acute thyroiditis [5] [6].

Acute suppurative thyroiditis: This type of thyroiditis is rare among children. The most common organism that causes this type of thyroiditis belongs to genus Streptococcus; though some other aerobic and anaerobic bacteria may be involved.

Subacute thyroiditis: Viral infection is the cause of subacute thyroiditis. Some of the viral diseases that precede thyroiditis are mumps, influenza, adenoviral, malaria, myocarditis, measles or Q-fever.

Chronic thyroiditis: This type of thyroiditis is caused due to an autoimmune process [3] [4].

To avoid the complications of thyroiditis, the most important step that one can take is to maintain personal hygiene. As mentioned above, the etiology of the disease lies in the pathogens: bacteria and virus. These interactions with such pathogens are possible by maintaining hygiene. Early diagnosis of the autoimmune thyroiditis can help the patient to learn about the management of the manifestations that may ensue as the disease progresses.

Thyroiditis is a group of disorders which are characterized by an inflammation of the thyroid gland and may manifest in a number of different ways, such as Hashimoto’s thyroiditis (which is the most common form), postpartum thyroiditis, and subacute thyroiditis. In some patients, drugs such as interferon and amiodarone can also cause this inflammation and this is often referred to as secondary thyroiditis [1].

Thyroiditis is a group of disorders which are characterized by an inflammation of the thyroid gland. If there is consistent irritation, fatigue, anxiety, palpitations or sudden weight changes, it may be related to thyroid functioning. The altered levels of thyroxin (high or low) can cause such symptoms. Hence, meeting up the family physician is a good idea.