Inflammation of the thyroid gland

A Inflammation of the thyroid gland - also Thyroiditis called - is a disease of the thyroid gland and accounts for about one to three percent of all diseases of the organ. At around 80 percent, Hashimoto's thyroiditis, a chronic inflammation of the thyroid gland, is the most common form of thyroid inflammation.

What is Thyroid Inflammation?

At a Inflammation of the thyroid gland it is either a focal or diffusely distributed inflammation of the thyroid tissue. The course can be acute, subacute or chronic.

The different forms have completely different causes and thus each represent an independent clinical picture. The disease is further subdivided into painless and painful thyroid inflammation.

causes

Inflammation of the thyroid gland can have different reasons. Some forms are triggered by infections with bacteria or viruses, others by an injury to the organ or exposure to ionizing radiation.

However, autoimmune diseases can also be the cause of thyroid inflammation. In autoimmune diseases, cells of the immune system are not only directed against invading pathogens. In addition to foreign bodies, the body's own healthy cells are also combated. Due to the most diverse causes, the course of thyroid inflammation can also be different.

The causes for the development of a subacute thyroid inflammation, named after Fritz de Quervain, also called Quervain's thyroiditis, are still unknown. However, it has been observed that this form of thyroid inflammation often occurs in connection with airway infections.

Symptoms, ailments & signs

In the case of an acute inflammation of the thyroid, severe swallowing difficulties arise within a few hours or days. Sick people experience hoarseness, cough and increasing pain, among other things. In addition, a high fever develops, which is accompanied by chills, fatigue and other general symptoms.

The thyroid gland swells and can often be felt from the outside. If thyroiditis is treated early, further complications can usually be avoided. Drug therapy counteracts the symptoms mentioned, which usually subside within two to three days. The subacute thyroid inflammation sets in within two to three weeks.

During this period, the thyroid gland swells a lot and begins to hurt. A general malaise as well as fever and difficulty swallowing occur. The neck is usually very sensitive to pressure and the voice appears weakened or changed. With subacute thyroid inflammation, there is usually no swelling of the lymph nodes.

However, at the onset of the disease, there may be a slight hyperthyroidism, which is usually associated with restlessness, irritability and physical complaints. The subacute form also sounds quickly again with appropriate treatment. Most patients are free of symptoms after three weeks at the latest.

Diagnosis & course

In an acute one Inflammation of the thyroid gland the enlarged thyroid can often be felt. A blood test shows increased levels of white blood cells (leukocytes) and an accelerated blood sedimentation, which can be understood as general indicators of an inflammatory reaction in the body.

In the next step, an ultrasound examination (sonography) is used to determine the acute thyroid inflammation and to rule out another disease. A subacute thyroid inflammation shows an only slightly increased concentration of white blood cells in the blood count, but a significantly increased blood sedimentation.

In many cases, thyroid antibodies can also be found in the blood, but they are far below the values ​​of a chronic inflammation, such as that of Hashimoto's thyroiditis. Often times, the doctor can only confirm the diagnosis after a fine needle biopsy, which involves taking tissue from the thyroid gland. In the case of severe inflammation of the thyroid gland, the examination of the removed tissue reveals a severe reaction, often in connection with the formation of nodules.

An inflammation of the thyroid gland can take a different course, be painful or, as is often the case with chronic thyroiditis, extremely painless. The illnesses can occur acutely or insidiously almost unnoticed, so that a therapy has to be designed individually depending on the type of thyroid inflammation.

Complications

Depending on its shape, inflammation of the thyroid gland can cause a variety of complications. First, thyroiditis causes the thyroid to enlarge, which is associated with severe pain, fever, and a general feeling of illness. If the course is severe, the fever can develop into a life-threatening condition.

In addition, the illness can lead to restlessness, irritability and lack of sleep - a common trigger for accidents in everyday life. A bacterial thyroid inflammation can lead to the development of abscesses. The acute form often results in the connective tissue overgrowing into the actual glandular tissue. If the hormone-producing tissue is displaced, this can result in an underactive thyroid.

In the subacute form, scar tissue can form, which can also lead to an underactive thyroid. When treating thyroiditis with hormone therapy, sleep problems, extreme malaise and a decrease in sexual interest can occur. There is also an increased risk of osteoporosis and depression. In women, hormone therapy can cause menstrual disorders. The use of anti-inflammatory drugs and other preparations can also be associated with side effects and allergic reactions.

When should you go to the doctor?

Headache and muscle pain, difficulty swallowing and tiredness are typical symptoms of thyroid inflammation. A doctor's visit is recommended if the symptoms persist for more than two to three days. If you experience pain in the thyroid area, it is best to consult a doctor immediately. Thyroiditis often occurs after trauma, radioiodine or radiation therapy, or bacterial infections in the ear, nose, and throat area. The subacute form results from an infection of the upper respiratory tract. Anyone who belongs to the risk groups must have the symptoms clarified quickly. People with an immune deficiency, the chronically ill, the elderly, pregnant women and children should see their family doctor if they suspect an inflammation of the thyroid gland.

In pregnant women, postpartum thyroiditis can also occur six to 24 weeks after delivery, which manifests itself as repeated infections and must be treated quickly. If the symptoms occur after taking certain medications such as interferon or amiodarone, a change in medication is necessary. An inflammation of the thyroid gland is treated by an internist or family doctor. Chronic and severe complaints should be clarified in a specialist clinic for thyroid diseases.

Treatment & Therapy

Depending on the form of the disease, the Inflammation of the thyroid gland various. Acute and subacute thyroid inflammation respond well to therapy and often heal after a few weeks or three to six months.

In the case of chronic thyroid inflammation, the situation is different. In the long run, the destruction of the hormone-producing tissue can be observed here, whereupon therapy with the missing thyroid hormone is prescribed, starting with a low dose, which must be adjusted again and again and maintained for life.

Thyroid infections need to be treated depending on the type of cause. Acute thyroid inflammation due to a bacterial infection can be treated well with antibiotics. In the case of a lighter course, tablets are sufficient, but in a more severe form of thyroiditis, infusions are given. In the case of a febrile illness, high fluid intake and strict bed rest are recommended. Until the symptoms have subsided, the throat can be supported by cooling.

The subacute thyroid inflammation often takes a rather mild course. This is where anti-inflammatory drugs, i.e. anti-inflammatory preparations with a slightly anesthetic effect, help. In the case of more severe symptoms, cortisone brings relief the very next day. Chronic thyroid inflammation has the consequence that the tissue is gradually destroyed and ultimately a non-functioning thyroid is left behind. Therefore, for example, Hashimoto's thyroiditis itself is incurable. However, thyroid hormone intake in the form of L-thyroxine must be substituted for a lifetime.

prevention

The prevention of a Inflammation of the thyroid gland is only possible insofar as care can be taken to treat bacterial and viral infections sustainably. An unhealed disease favors a second infection, which can favor or even cause a thyroid inflammation.

Aftercare

In most cases, thyroiditis is not an independent disease. The symptoms are often based on other diseases. Inflammation of the thyroid gland is often caused by autoimmune diseases. The doctor adjusts the follow-up care to the respective symptoms, their severity and the actual cause.

In addition, it must be differentiated whether a chronic or acute thyroid inflammation is present. The goal of aftercare is to alleviate and heal the inflammation. If another illness is causing the symptoms, it will be corrected during follow-up care. At the discretion of the specialist, a biopsy may be necessary for this.

The development of an over- or underactive thyroid should also be prevented. The patient is given medication to counter secondary symptoms such as tiredness. Pain relievers are also prescribed. As part of the aftercare, the doctor checks the healing progress. A healed acute inflammation does not require any further follow-up care.

In the chronic form, the controls extend over months or even years. Regular blood tests provide information about the hormone production in the thyroid gland. Deviating hormone levels are treated with appropriate medicine or require further examination.

If the inflammation is severe, pus can form on the thyroid gland. They are punctured or surgically removed. The specialist will end the follow-up care when the healing is satisfactory. At this point the treatment is complete.

You can do that yourself

Patients with an inflammation of the thyroid can strengthen their organism by taking various measures to stabilize the immune system. In addition to a balanced and healthy diet, the intake of vitamins and sufficient exercise, avoiding harmful substances is particularly important. Therefore, the consumption of alcohol, drugs, nicotine or non-prescribed medication should be completely avoided.

Sports activities and an optimal supply of oxygen support the body's immune system. Optimal sleep hygiene, sufficient rest and recovery phases as well as leisure activities geared towards the needs of the person concerned promote well-being and strengthen the organism.

If the course of the disease becomes chronic, mental strengthening is particularly important for coping with the disease. Mental techniques can be used to reduce stressors. Cognitive training, yoga or meditation are just a few of the possibilities that are used as part of self-help. They support the quality of life and contribute to a positive basic attitude.

It is important to ensure that a sufficient amount of fluid is consumed every day. Therefore, the fluid balance should be carefully monitored and adequately regulated. Since swallowing problems are common, the food ingested must be sufficiently chopped up in the mouth. The grinding process of the teeth should be used so that no large pieces of food are transported into the esophagus.