Subacute Thyroiditis is an acute inflammation of the Thyroid gland characterised by tenderness, pain and discomfort of the Thyroid gland. The exact cause is unknown however theories lie around it being an autoimmune reaction to upper respiratory infections or even certain dental surgeries. The Thyroid gland is a butterfly-shaped gland which sits in the middle to lower end of the neck. It controls the human metabolism and as such regulates the following functions of the body, to name a few:
- How we breathe
- Our heart rate
- The central and peripheral nervous systems
- Our body weight
- The strength of our muscles
- Menstruation in females
- The body temperature
- Cholesterol levels
Courtesy of www.onhealth.com
The exact cause is unknown and it is not a very common condition. As stated above, it is thought to be the result of certain other conditions or procedures – one common cause being a viral infection of the ear, sinus or throat. It is more commonly seen in young to middle aged women who have experienced an upper respiratory tract infection in the immediate months prior to the onset of the Thyroiditis.
It is often noticed incidentally and the most common symptom is a painful frontal neck around the Thyroid gland. Upon touch, the Thyroid gland may be tender, swollen and inflamed. Sometimes, there may even be nodules (lumps) that may be felt by touching the Thyroid gland. In severely inflamed cases, the pain may spread to the jaws and/or ears. It is a condition which may last for weeks, or even months before it resolves itself.
Other symptoms include:
- Pain when gently touching the Thyroid gland
- Change in voice called hoarseness
- Difficulty swallowing
- Tiredness and fatigue with normal activities
- Fever, less commonly.
Fluctuation in the Thyroid hormone levels:
Thyroiditis is mostly self-limiting. In the process of resolving itself, the Thyroid gland experiences a fluctuation in its function. The inflamed Thyroid gland may release excessive Thyroid hormone, resulting in the symptoms of Hyperthyroidism (increased Thyroid activity) such as:
- Heart palpitations
- Weight loss
- Hair loss
- Frequent bowel movement
- Heat intolerance
- Mood swings, nervousness and tremors
- Sweating and irregular menstrual cycle
Once the Thyroid gland start healing, it slows down its activity and releases less Thyroid hormones causing Hypothyroidism (decreased Thyroid activity) such as:
- Weight gain
- Less frequent bowel movements and/or constipation
- Cold intolerance
- Mood changes
- Dry skin
Once the Thyroid gland has experienced the fluctuation, with time it neutralises to a normal level. In rare instances, it stays inactive indefinitely causing Hypothyroidism.
Exams and Tests
The doctor will generally do a physical test by examining the Thyroid gland to determine its size, firmness and whether there are any nodules present. If there is a nodule, then the next step would be to check the nodule through an Ultrasound test. The doctor will also order blood tests including (but not limited to):
- Thyroid stimulating hormone(TSH) level
- T4(thyroid hormone, thyroxine) and T3 level
- Erythrocyte sedimentation rate(ESR)
If the Ultrasound shows a suspicious nodule then you will be referred to a specialist where a biopsy may be performed.
Thyroiditis is mostly self-limiting, within weeks or months – it is generally estimated to resolve within 9 to 12 months. Long-term or severe complications are uncommon. While the inflammation self-resolves, it is important to manage the pain using Panadol or Ibuprofen (at low doses to assist in correcting the inflammation). If the patient is experiencing hyper or hypothyroidism then these symptoms will be treated accordingly.
Consult your GP if you are experiencing any of the above symptoms. A condition detected early, is a condition well-managed.
Davies, T. F., Laurberg, P., Bahn, R. S. (2016). Hyperthyroid disorders. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier.
Dr Sarkaw Mohammad (Chiropractor)