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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Written by Luo Han Ying
Endocrinology
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Is thyroiditis serious?

Thyroiditis, in simpler terms, refers to inflammation of the thyroid gland, making it easier for non-medical individuals to understand. Clinically, subacute thyroiditis and autoimmune thyroiditis are more common types of thyroid inflammation. These two have different causes and thus present different symptoms. Subacute thyroiditis might display severe symptoms as patients often experience significant thyroid pain and even general discomfort and muscle pain, which are relatively intense. However, if medications are administered during the acute phase, it might not necessarily have long-term effects on these patients. On the other hand, patients with autoimmune thyroiditis may not show obvious clinical symptoms, but they are prone to develop permanent hypothyroidism later, requiring lifelong thyroid hormone supplementation. (Specific medication use should be carried out 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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How is thyroiditis diagnosed?

Thyroiditis, clinically more commonly seen as subacute thyroiditis, is primarily caused by viral infections. The main clinical symptoms include pain in the anterior neck accompanied by fever, typically in the afternoon or evening. Upon examination, the thyroid is enlarged and tender. In terms of auxiliary examinations, blood tests reveal that some patients may have elevated white blood cells if there is a concurrent infection, and an increased erythrocyte sedimentation rate. Furthermore, initially, there might be mild signs of hyperthyroidism. Thyroid ultrasound may suggest signs of subacute thyroiditis, and the iodine uptake rate is decreased. If further examination is desired, a fine needle aspiration of the thyroid can be performed to help comprehensively consider and confirm the diagnosis.

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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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Where is the best place to perform moxibustion for thyroiditis?

Thyroiditis is relatively common in clinical practice, but we have not yet found that moxibustion directly helps with thyroiditis, so we do not recommend using moxibustion for treatment. Especially for types of thyroiditis that may cause an increase in thyroid hormone release, such as the acute phase of subacute thyroiditis. If moxibustion is applied directly near the thyroid region, it could potentially cause an increase in thyroid hormone release, exacerbating existing symptoms and hindering recovery. When we suffer from thyroiditis, we should choose appropriate treatment plans according to different types. For autoimmune thyroiditis, we can use treatments that regulate immunity, provide symptomatic relief, and supplement or replace hormone levels. Some painless thyroiditis may only require regular follow-ups. For cases of thyroiditis that also involve thyroid enlargement, treatment options like iodine-131 or surgery can be considered depending on the functional status.