Thyroid disorders often involve no pain even if the thyroid gland becomes swollen. However, subacute thyroiditis causes pain.
The word "subacute" indicates that the symptoms last longer than acute disorders, but they do not become chronic.
Although many are surprised by the swelling and pain in the thyroid gland, the disease can be treated easily. Recurrence is very rare.
Women are about 12 times more susceptible to this disease than men. It develops predominantly in women in their 30s and 40s.
The cause of subacute thyroiditis is unclear. However, as the disease often develops following an inflammation in the nose or throat, it is considered to be caused by a virus. When it comes to seasonal occurrences of the disease, the onset is most frequent in the summer, but it also can develop during cold months. Although the cause is considered to be a virus, you do not need to worry about the spread of the disease to others.
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Subacute thyroiditis is very easily differentiated from other diseases, because it involves both the swelling of the thyroid gland (goiter) and pain. The swelling of the thyroid gland is not as large as to become noticeable to the naked eye. The entire thyroid gland can become hard, swollen and painful, but in most cases one of the two lateral lobes of the thyroid gland becomes hard and swollen and causes pain when pressed. Sometimes, it can cause an agonizingly sharp pain when you touch it. The pain can be felt as an ache in your back teeth or behind your ear and may be considered to be an ear or dental problem. As the disease progresses, the location of the pain and swelling may move from the affected lobe to the unaffected lobe of the thyroid: from right to left or from left to right. Therefore, subacute thyroiditis is also referred to as "migratory thyroiditis." About one in five patients have a fever of 37-38 °C. |
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In many cases, the disease is associated with overactive thyroid functions. As a result, like in Graves' disease, symptoms such as palpitations (rapid, strong or irregular heartbeat), breathlessness, excessive sweating and sluggishness occur. The mechanism of hyperthyroidism, however, is different from Graves' disease. In Graves' disease, the thyroid gland synthesizes and secretes more and more thyroid hormones into the blood. In subacute thyroiditis, on the other hand, thyroid tissue is destroyed by inflammation and thyroid hormones stored in the thyroid gland start to pour into the blood, leading to an increase in hormone levels.
In subacute thyroiditis, therefore, hyperthyroidism will not last for a long time.
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It is relatively easy to diagnose subacute thyroiditis, because it causes obvious symptoms such as pain and fever. The results of blood tests indicate an abnormally low rate of erythrocyte sedimentation or increased CRP levels due to inflammation, which is one of the key diagnostic signs of subacute thyroiditis. The isotope (radioactive iodine) test shows the absence of iodine in the thyroid gland, which helps to differentiate subacute thyroiditis from Graves' disease even when the thyroid gland is overactive.
A very effective treatment is medication with adrenal hormone preparations. The day after medication begins, the pain goes away and the fever subsides in most cases. However, because the immediate interruption of medication may cause a relapse of the disease, the dosage is gradually decreased over about 2 months in accordance with the patient's condition. Antithyroid medication used for the treatment of Graves' disease has no effect on subacute thyroiditis.
The disease, by nature, is cured spontaneously and the condition is neither prolonged nor becomes chronic and recurrence is rare.
While severe symptoms are apparent, it is desirable to stay in bed and not to take a bath, if possible. There are no restrictions on food intake.
