Thyroiditis Clinical Symptoms

Written by Li Hui Zhi
Endocrinology
Updated on February 04, 2025
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Thyroiditis usually refers to subacute thyroiditis in clinical terms, and its symptoms mainly include the following: Firstly, early stages of the disease typically involve neck pain accompanied by fever, which usually occurs in the afternoon or evening. If it coincides with hyperthyroidism, additional symptoms may include palpitations, weight loss, insomnia, tremors, excessive sweating, increased appetite, irritability, and mood swings commonly associated with hyperthyroidism. Therefore, if these symptoms are present, it is advised to promptly visit the endocrinology department of a hospital for a complete thyroid function test, erythrocyte sedimentation rate, blood routine, and thyroid ultrasonography to establish a clear diagnosis.

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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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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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Re-examination of thyroiditis includes checking for what?

Thyroiditis includes autoimmune thyroiditis and subacute thyroiditis. For patients with subacute thyroiditis, it is recommended to check thyroid function, erythrocyte sedimentation rate, and complete blood count among others to understand the control of the infection and the status of thyroid function. For autoimmune thyroiditis, it is advised to check thyroid function as well as thyroperoxidase antibodies and thyroglobulin antibodies to understand the function of the thyroid and the related antibody status. Additionally, a re-examination of thyroid ultrasound is recommended to assess the condition of the thyroid.

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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.

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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.