Silent thyroiditis

Lymphocytic thyroiditis; Subacute lymphocytic thyroiditis; Painless thyroiditis; Postpartum thyroiditis; Thyroiditis – silent; Hyperthyroidism – silent thyroiditis

Silent thyroiditis is an immune reaction of the thyroid gland. The disorder can cause hyperthyroidism, followed by hypothyroidism.

The thyroid gland is located in the neck, just above where your collarbones meet in the middle.

Causes

The cause of the disease is unknown. But it is related to an immune attack against the thyroid by the immune system. The disease affects women more often than men.

The disease can occur in women who have just had a baby. It can also be caused by medicines such as interferon and amiodarone, and some types of chemotherapy, which affect the immune system.

Symptoms

The earliest symptoms result from an overactive thyroid gland (hyperthyroidism). These symptoms may last for up to 3 months.

Symptoms are often mild, and may include:

• Fatigue, feeling weak
• Frequent bowel movements
• Heat intolerance
• Increased appetite
• Increased sweating
• Irregular menstrual periods
• Mood changes, such as irritability
• Muscle cramps
• Nervousness, restlessness
• Palpitations
• Weight loss

Later symptoms may be of an underactive thyroid (hypothyroidism), including fatigue and cold intolerance, until the thyroid recovers. Some people only notice the hypothyroid symptoms and do not have symptoms of hyperthyroidism.

Exams and Tests

The health care provider will examine you and ask about your symptoms and medical history.

A physical examination may show:

• Enlarged thyroid gland that is not painful to the touch
• Rapid heart rate
• Shaking hands (tremor)

Tests that may be done include:

• Radioactive iodine uptake
• Thyroid hormones T3 and T4
• TSH
• Erythrocyte sedimentation rate
• C-reactive protein

Many providers now screen for thyroid disease before and after starting medicines that commonly cause this condition.

Treatment

Treatment is based on symptoms. Medicines called beta-blockers may be used to relieve rapid heart rate and excessive sweating.

Outlook (Prognosis)

Silent thyroiditis often goes away on its own within 1 year. The acute phase ends within 3 months.

Some people develop hypothyroidism over time. They need to be treated for a while with a medicine that replaces thyroid hormone. Regular follow-ups with a provider are recommended.

When to Contact a Medical Professional

Call your provider if you have symptoms of this condition.