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What Is Thyroiditis?

Written by: Consultant Dietitian Emily Cheng

 Thyroiditis is the swelling (inflammation) of the thyroid gland. The thyroid is a butterfly-shaped gland in the neck. It’s part of your endocrine system and controls many of your body’s important functions by producing and releasing hormones that regulate growth and metabolism [1]. It can cause either unusually high or low levels of thyroid hormones in the blood [2].

These hormones affect several processes such as heart rate and body temperature, and convert food into energy to keep the body functioning [2].

Thyroiditis typically has three phases:

  • Thyrotoxic phase: The thyroid is swollen and releases too many hormones, causing temporary thyrotoxicosis [3].

  • Hypothyroid phase: After a few weeks or months, the gland may become depleted of hormones, leading to hypothyroidism [3].

  • Euthyroid phase: Thyroid levels return to normal. This may occur temporarily after the thyrotoxic phase before progressing to hypothyroidism or at the end, once swelling has subsided [3].

What are the symptoms of thyroiditis?

Symptoms of thyrotoxicosis: [3]

  • Anxiety

  • Insomnia

  • Palpitations (fast heart rate)

  • Fatigue

  • Unexplained weight loss

  • Irritability

  • Muscle weakness

  • Intolerance to heat

Symptoms of thyrotoxicosis: [3]

  • Fatigue

  • Weight gain

  • Constipation

  • Dry skin

  • Depression

  • Poor exercise tolerance

  • Muscle aches

  • Intolerance to cold

What causes thyroiditis?

There are many reasons why your thyroid may swell. You might have a viral or bacterial infection, be taking medications like interferon or lithium, or have an autoimmune disorder. One type of thyroiditis also develops after childbirth, as the thyroid is significantly affected by pregnancy [3].

In addition, research has shown that occupational exposure and environmental pollutants may impact the thyroid gland and increase the risk of developing thyroid disease [4].

Types of thyroiditis

  • Hashimoto’s thyroiditis: A common autoimmune disease where the immune system attacks the thyroid, weakening it and reducing its ability to produce hormones [3].

  • De Quervain’s (subacute) thyroiditis: A painful swelling of the thyroid gland, often triggered by viral infections such as mumps or flu [2].

  • Postpartum thyroiditis: An autoimmune condition that occurs within one year after childbirth, especially in women with a history of thyroid issues. It causes a temporary rise in thyroid hormone levels (thyrotoxicosis) [1,2].

  • Silent (painless) thyroiditis: An autoimmune condition similar to postpartum thyroiditis but can affect both men and women. It begins with a phase of high thyroid hormone levels [1,2].

  • Drug-induced thyroiditis: Caused by medications such as amiodarone, interferons, lithium, and cytokines, which can damage the thyroid [1,2].

  • Radiation-induced thyroiditis: Damage to the thyroid caused by radiation therapy or radioactive iodine treatment for hyperthyroidism [1-3].

  • Acute or infectious thyroiditis: A rare condition typically caused by a bacterial infection, more common in individuals with a weakened immune system or, in children, developmental issues of the thyroid [1,2].

  • Riedel thyroiditis: A rare disease involving chronic inflammation and fibrosis (thickening or scarring) of the thyroid gland [3].

How is thyroiditis diagnosed?

  • Blood test: A thyroid function test checks hormone levels in the blood. Abnormal levels may indicate an overactive or underactive thyroid [5].

  • Thyroid ultrasound: Used to examine the thyroid’s structure. It can detect nodules, blood flow changes, and tissue density [1].

  • Thyroid scan: Involves taking radioactive iodine. While lying face-up, a device captures images of your thyroid [3].

  • Erythrocyte sedimentation rate (ESR): Measures inflammation by how quickly red blood cells settle in a test tube [3].

  • Radioactive iodine uptake test (RAIU): Measures how much radioactive iodine the thyroid absorbs over 24 hours [1].

Can thyroiditis be treated?

Yes. Treatment depends on the type and symptoms of thyroiditis. A doctor may prescribe medication [1]. In some cases, surgery or radioactive iodine treatment may be necessary [5].

Ways to prevent thyroiditis

  • Maintain a healthy, balanced diet:

    • Eat at least 5 portions of fruits and vegetables daily

    • Base meals on starchy foods

    • Include dairy or alternatives

    • Incorporate beans, pulses, fish, eggs, meat, and other proteins

    • Choose unsaturated oils/spreads and use them in moderation

    • Stay hydrated [6,7]

  • Consume enough selenium:
    Selenium is concentrated in the thyroid and plays a key role in thyroid hormone synthesis and metabolism, much like iodine. Research shows adequate selenium intake supports thyroid health [8,9].

  • Ensure adequate iodine intake:
    Iodine is essential for thyroid hormone production. While it’s important to get enough from your diet, excessive intake of iodine-rich foods may cause thyroid dysfunction [10].

  • Sufficient iron intake:
    Iron works with selenium and iodine to support thyroid function. Iron is essential for efficient iodine utilization and hormone synthesis [9].

  • Quit smoking:
    Smoking increases the risk of thyroid disease and other health problems [8,11].

  • Limit alcohol consumption:
    Alcohol abuse is linked to various health issues. Reducing alcohol intake can lower the risk of thyroid disorders [12].

Thyroiditis is an illness that causes the thyroid gland to become swollen and inflamed. The thyroid is responsible for producing hormones that regulate the body’s metabolism and energy use. When inflamed, the thyroid may produce too much or too little hormone. If you notice any symptoms mentioned above, consult a healthcare provider promptly for accurate diagnosis and proper treatment.

Reference List

  1. Thyroiditis: Types, Causes, Symptoms, Diagnosis & Treatment [Internet]. Cleveland Clinic [cited 12 September 2022]. Available from: https://my.clevelandclinic.org/health/diseases/15455-thyroiditis
  2. Thyroiditis – NHS [Internet]. NHS [cited 12 September 2022]. Available from: https://www.nhs.uk/conditions/thyroiditis/
  3. What is Thyroiditis? [Internet]. WebMD [cited 12 September 2022]. Available from: https://www.webmd.com/a-to-z-guides/what-is-thyroiditis
  4. Benvenga S, Elia G, Ragusa F, Paparo SR, Sturniolo MM, Ferrari SM, Antonelli A, Fallahi P. Endocrine disruptors and thyroid autoimmunity. Best Pract Res Clin Endocrinol Metab. 2020 Jan;34(1):101377.
  5. Thyroiditis: Definitions, Causes and Treatments. [Internet]. Endocrine Web [cited 12 September 2022]. Available from: https://www.endocrineweb.com/conditions/thyroid/thyroiditis
  6. Thyroid and diet factsheet. [Internet]. BTF [cited 12 September 2022]. Available from: https://www.btf-thyroid.org/thyroid-and-diet-factsheet
  7. Foods to avoid if you have thyroid issues – Cleveland Clinic [Internet]. Cleveland Clinic [cited 12 September 2022]. Available from: https://health.clevelandclinic.org/thyroid-issues-what-you-need-to-know-about-diet-and-supplements/
  8. Prevention and treatment of thyroid diseases for heart health [Internet]. Premier Heart and Vascular Center [cited 12 September 2022]. Available from: https://premierheartandvascular.com/prevent-treat-thyroid-disease-heart-health/
  9. Köhrle J. Selenium and the thyroid. Curr Opin Endocrinol Diabetes Obes. 2015 Oct;22(5):392-401.
  10. Leung A.M, & Braverman L.E. Consequences of excess iodine. Nature reviews. Endocrinology . 2014 Mar;10(3):136-42.
  11. Gruppen EG, Kootstra-Ros J, Kobold AM, Connelly MA, Touw D, Bos JHJ, Hak E, Links TP, Bakker SJL, Dullaart RPF. Cigarette smoking is associated with higher thyroid hormone and lower TSH levels: the PREVEND study. Endocrine. 2020 Mar;67(3):613-622.
  12. Azizi F, Mehran L, Hosseinpanah F, Delshad H, Amouzegar A. Primordial and Primary Preventions of Thyroid Disease. International Journal of Endocrinology and Metabolism. 2017 Oct 7;15(4):e57871.
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