Thyroiditis

Thyroiditis is an inflammation of the thyroid gland. There are several types of thyroiditis, but each of them generally produce three phases: overactive thyroid (hyperthyroidism), underactive thyroid (hypothyroidism), and return to normal. It usually takes one year to complete this cycle. Young to middle-aged women seem most at risk, although some forms of thyroiditis are seen in both men and women of all ages. With some forms, hypothyroidism may develop years later even if the thyroiditis has resolved.

Signs and Symptoms

Depending on the type of thyroiditis, the thyroid gland can have one of the following characteristics.

• Firm and enlarged, but not tender
• Enlarged and painful, with pain extending to the jaw or ears
• Enlarged but not painful; or enlarged on only one side, hard like a stone, and sticking to other neck structures

You may also have one or more of the following symptoms.

• Cool, dry skin, slow pulse rate (less than 60 beats per minute), swelling around the eyes, hoarseness, or slow reflexes
• No desire to eat, feeling tired and unenergetic, and a slight fever
• A rapid heartbeat, slight nervousness, anxiety, weight loss of 5 to 10 pounds, and increased sweating

What Causes It?

Thyroiditis can be caused by immune disorders, viruses, and fever disorders. Sometimes thyroiditis develops if you have Graves' disease (a thyroid disorder). In some cases, there is no identifiable cause.

What to Expect at Your Provider's Office

Your health care provider will feel your neck to see what the thyroid gland feels like and may order blood tests to check the levels of thyroid hormones and other factors. You may be given pain medication or something to help you feel more normal.

Treatment Options

Thyroiditis generally involves three phases: overactive phase, underactive phase, and return to normal. Treatment is individualized to type and phase.

Drug Therapies

Depending on the particular type of thyroiditis, a physician may prescribe one or some of the following treatments:

• Levothyroxine: 0.1 to 0.15 mg daily if hypothyroidism or large goiter present
• Aspirin: two tablets (325 mg) three to four times daily as needed to relieve pain and inflammation
• Corticosteroid medications (such as prednisone or dexamethasone): at lowest dose that relieves pain; gives relief in 24 hours, but continue 4 to 6 weeks after pain is gone; severe cases only
• Propranolol: 10 to 40 mg every six hours for thyrotoxic symptoms
• Thyroxine: 0.05 to 0.1 mg/daily for hypothyroidism symptoms
• Short-term beta-blockers: for hyperthyroid symptoms
• Antibiotics

Surgical and Other Procedures

Partial thyroid removal: to relieve pressure

Complementary and Alternative Therapies

Alternative therapies can help when used along with the medications your provider prescribes.

Nutrition

• Foods that depress thyroid activity are broccoli, cabbage, brussels sprouts, cauliflower, kale, spinach, turnips, soy, beans, and mustard greens. These foods should be included in the diet for hyperthyroid conditions and avoided for hypothyroid conditions.
• Avoid refined foods, sugar, dairy products, wheat, caffeine, alcohol.
• Essential fatty acids are anti-inflammatory and necessary for hormone production. Take 1,000 to 1,500 mg flaxseed oil three times per day.
• Calcium (1,000 mg per day) and magnesium (200 to 600 mg per day) help many metabolic processes function correctly.

Your health care provider may also recommend specific nutritional supplements for a hyperthyroid or hypothyroid condition.

Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

For hyperthyroid conditions:

• Bugleweed (Lycopus virginica) and lemon balm (Melissa officinalis) help normalize the overactive thyroid.
• Motherwort (Leonurus cardiaca) relieves heart palpitations, and passionflower (Passiflora incarnata) reduces anxiety. Combine two parts of bugleweed with one part each of lemon balm, motherwort, and passionflower in a tincture, 30 to 60 drops three to four times per day.
• Quercetin (250 to 500 mg three times per day) is an anti-inflammatory.
• Turmeric (Curcuma longa) makes the effect of bromelain stronger and should be taken between meals, 500 mg three times per day.
• Ginkgo biloba, 80 to 120 mg two times per day.

For hypothyroid conditions:

• A combination that supports thyroid function includes herbs rich in minerals. Combine the following for a tea (3 to 4 cups per day) or tincture (20 to 30 drops three times a day): horsetail (Equisetum arvense), oatstraw (Avena sativa), alfalfa (Medicago sativa), gotu kola (Centella asiatica), and bladderwrack (Fucus vesiculosus).

Homeopathy
Homeopathy may be useful as a supportive therapy for both "hyper" and "hypo" conditions of the thyroid.

Physical Medicine
For hyperthyroid conditions:

• Ice packs to the throat will help decrease inflammation.

For hypothyroid conditions:

• Contrast hydrotherapy. Alternate hot and cold applications to the neck and throat. Alternate three minutes hot with one minute cold. Repeat three times to complete one set. Do two to three sets per day.
• Exercise helps improve thyroid function.

Acupuncture
Acupuncture may be helpful in correcting hormonal imbalances and addressing underlying deficiencies and excesses involved in thyroiditis.

Massage
Therapeutic massage may relieve stress and increase the sense of well-being.

Following Up

Your health care provider may need to check you each year.

Special Considerations

If you are pregnant or just had a baby, you may develop Hashimoto's thyroiditis.

References

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