Thyroiditis

The thyroid gland sits on the front of the neck and forms the hormone that controls the body’s metabolism. Viruses or bacteria can cause inflammation of the thyroid gland. If you get thyroid inflammation, you may need treatment with medicines, for example, against the inflammation.

Most people who get subacute thyroiditis are good again within about six months. If the thyroid function is impaired, you may need to take thyroid hormone in tablet form, sometimes for the rest of your life. Thyroid inflammation is also called thyroiditis.

symptoms

The most common is that the disease begins with a phase with high hormone levels for one to two months, which is due to the release of hormone stores in the circulation. When the layers are finished, the thyroid gland goes into producing too little hormone. The overall process usually lasts for six months. In almost everyone, the thyroid gland has the same function as before the disease. 

If the inflammation causes the thyroid to produce too little hormone, you may get hypothyroidism . If you get elevated hormone levels instead, it is called Thyotoxicosis. 

There are several types of thyroid inflammation. The symptoms of thyroid inflammation vary depending on the type of disease you have and what happens to the thyroid gland. Below is a description of some different types of thyroid inflammation.

Chronic thyroid inflammation

Chronic thyroid inflammation is an autoimmune disease, which means that antibodies are formed in the blood against cells in the body. The immune system, which is supposed to keep viruses and bacteria away, is wrong and in this disease destroys the body’s own thyroid cells.

It is common for chronic thyroid inflammation over time to lead to hypothyroidism.

Sometimes the thyroid enlarges, but it can also decrease in size. This form of the disease is usually divided into Hashimoto’s thyroid inflammation as the thyroid enlarges, and atrophic autoimmune thyroid inflammation which causes the thyroid to decrease in size.

Subacute thyroiditis

Subacute thyroiditis is common and is caused by viruses. Subacute means that the course of the disease is moderately rapid. The disease is also called the Quervain’s thyroid inflammation.

Typical symptoms are these:

  • The gland often hurts and is sore when you feel it.
  • You feel tired and sick and often have a fever.
  • You feel a bit restless and worried.
  • You may have heart palpitations, become dizzy and lose weight.

Acute thyroid inflammation

Acute thyroid inflammation is uncommon but severe and is caused by bacteria. Typical symptoms are these:

  • Your neck is sore, aching and may even be red.
  • You feel sick and have a fever.
  • You feel a bit restless and worried.
  • You get heart palpitations, get shaky and lose weight.

Acute thyroid inflammation can be life-threatening so it is important to seek care quickly.

Silent thyroid inflammation

There are also thyroid inflammations that do not cause sore throat, but only produce effects of altered hormone production. For example, you may feel shaky, anxious, restless, have a palpitations or lose weight. Silent thyroid inflammation is sometimes linked to the fact that you have been pregnant, but can also come without such a connection.

There are also medicines that can cause the thyroid to become inflamed.

When should I seek care?

If you suspect that the thyroid gland is not working properly, you should contact a health care center. This is true even if you feel a lump in or around the thyroid gland.

If you have a high fever and a lot of pain, you should seek care directly at a health center or emergency room.

You can  seek care  at any healthcare center you want throughout the country. You also have the opportunity to have a regular doctor’s contact at the health center. 

Investigations and investigations

A doctor does an examination and senses the thyroid to find out if it is enlarged, if there are hard areas and if it hurts.

You may also submit blood samples to show if there is evidence of an infection caused by viruses or bacteria.

It is also common for you to leave samples on thyroid hormone free thyroxine, FT4, and TSH, which is an abbreviation of thyroid stimulating hormone. It is the pituitary hormone that controls the functioning of the thyroid gland.

Blood tests are also taken to see if the immune system forms antibodies to the thyroid gland. You usually have to give blood for all the samples at the same time.

Other investigations

Finnel puncture is done if the doctor has known you have a lump in the thyroid. The examination is usually done by a specialist doctor at a hospital. With a thin needle, cells are aspirated to be examined under a microscope. In this way, the doctor can see if there is an inflammation of the gland or if there is any other cause for the thyroid enlargement. Finnel puncture feels much like leaving a blood sample.

If you have elevated thyroid hormone levels, you may need to undergo a thyroid scintigraphy to find out the cause of overproduction. Scintigraphy is usually done at a special hospital reception. Then a very small amount of weak radioactive solution is injected into the blood. The distribution of the solution in the body is then studied with a gamma camera

If the doctor has planned to do both a fine needle and a scintigraphy, the scintigraphy is usually done before the fine needle point.

Very small radiation dose

The radiation dose you get from this study is very small, about the same size as a regular X-ray examination. After about 20 minutes a picture is taken where the doctor can see how active different parts of the thyroid are and if there is any inflammation.

Just as with X-ray examinations, the doctor usually avoids doing this examination on someone who is pregnant. If you are breast-feeding, tell us before the examination.

No special preparation is needed

You do not need to prepare in any particular way for the examinations and sampling. Afterwards, you feel as usual and can go home at once.

Within a couple of weeks you usually get answers to what the surveys have shown.

You have the right to understand

In order for you to be able to participate in your care and make decisions, it is important that you understand the  information you receive  from the healthcare staff. Ask questions if you don’t understand. 

Treatment

If you have thyroid inflammation, you may need anti-palpitations during the phase when hormone levels are elevated. After entering the phase when the hormone level is lowered, you sometimes need to be treated with thyroid hormone for some time. In most cases, hormone levels return to normal levels within six months and then treatment is lowered. It may happen that the thyroid gland is damaged by the disease and that the malfunction becomes chronic. You will then need continued treatment with thyroid hormone, sometimes for the rest of your life.

Medicines relieve pain and inflammation

In case of subacute thyroid inflammation, you may also need medication to alleviate the inflammation and pain. Sometimes an analgesic may suffice, but often a time treatment with cortisone tablets is needed for the inflammation to pass. It is important for the doctor to know how it goes after you start such treatment as the symptoms of pain and fever should go on for one to two days. If you do not get better, you should contact the doctor again, who will continue the investigation.

An inflammation of the thyroid gland with fluctuating hormone levels can be painful, and it is common with sick leave for one to two months.

Cortisone can cause side effects

Since high dose cortisone therapy can cause side effects for a long time, the doctor usually tries to keep the dose as low as possible. Treatment begins with a higher dose which is then lowered every week. Common side effects of long-term, high-dose treatment are the risk of osteoporosis, rising blood pressure and impaired defense against infectious diseases. If you are seeking care, it is important to tell if you have received cortisone treatment, even if it has been a few months after you have stopped treatment.

Pregnancy and thyroid inflammation

The level of thyroid hormone may need to be checked

Minor abnormalities in hormone levels can also affect the ability to stay with children. Therefore, it is good to have the level of thyroid hormone in your blood checked if you yourself, or any close relative, have or have had any thyroid disease.

During pregnancy, the risk of contracting thyroid inflammation reduces where the body forms antibodies to the thyroid gland. But then the risk increases during the first year after childbirth.

You can usually breastfeed if you have or have had thyroid inflammation. Treatment with the usual doses of thyroid hormone or cortisone does not affect the baby during breastfeeding.

How is life affected?

If you get a subacute inflammation, you may feel sick with a fever and pain for a while. The stage when the thyroid produces too much hormone goes on for one to two months. How you feel in the phase when the thyroid produces too little hormone varies. But there are many who do not need thyroid hormone treatment and do not have much symptoms. There are also those who experience prolonged fatigue and degraded energy that it takes longer to recover from. Symptoms usually persist in individuals. The vast majority will feel good, although the need for thyroid hormone will become chronic.

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