Painless Thyroiditis

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Painless Thyroiditis
Body Parts: Neck
Medical Subjects: Endocrine
Overview

What Is Painless Thyroiditis?

Due to various reasons (such as drug influence, excessive iodine intake), thyroid autoimmune inflammation is triggered, thyroid follicular cells are destroyed, and thyroid hormones stored in the follicles are released into the blood, causing abnormal thyroid function And cause related symptoms, but it does not cause pain, this is painless thyroiditis.

What is the prognosis of painless thyroiditis?

Most patients can recover by themselves, and a few patients become permanent hypothyroidism.

Are there many people suffering from painless thyroiditis?

Not a lot. In patients with thyrotoxicosis, the proportion caused by painless thyroiditis is 0.5% to 5%.

Who is prone to painless thyroiditis?

Any age can suffer from the disease, with 30 to 50 years old as the majority, and women are more likely to develop the disease.

Cause

What Are The Common Causes Of Painless Thyroiditis?

Excessive iodine intake: For example, long-term, large intake of iodine-rich foods such as kelp and seaweed, long-term use of iodine-containing drugs.

Certain drugs: including interferon alpha, interleukin-2, amiodarone, lithium preparations, tyrosine kinase inhibitors (such as sunitinib), etc.

Symptom

What Are The Common Manifestations Of Painless Thyroiditis?

The clinical manifestations of this disease are generally divided into hyperthyroidism stage, hypothyroidism stage and recovery stage three, also some patients directly after the hyperthyroidism stage into the recovery stage:

  • Hyperthyroidism stage: The follicular cells of thyroid gland are destroyed by inflammation, and thyroid hormone is released into the blood, which causes such symptoms as palpitation, hand trembling, excessive sweating, and easy hunger similar to hyperthyroidism, which may be accompanied by thyromegaly. Thyroid function shows that free thyroxine FT4 is increased, and thyroid-stimulating hormone TSH is decreased. Hyperthyroidism generally lasts for 2 ~ 8 weeks.
  • Hypothyroidism stage: The thyroid hormone stored in the follicular cells is released completely, and new thyroid hormone has not been synthesized. The manifestations include fear of the cold, edema, constipation and other hypothyroidism. The thyroid function shows that FT4 is decreased and TSH is increased. The hypothyroidism lasts for 2–8 weeks.
  • Recovery period: The thyroid follicular cells repair themselves, and the function of thyroid hormone secretion of the thyroid gland returns to normal. The above-mentioned manifestations gradually disappear, and the thyroid function examination returns to normal. However, some patients may develop permanent hypothyroidism.

Can painless thyroiditis cause serious consequence?

There are generally no serious consequences. This disease may cause permanent hypothyroidism, which requires lifelong medication. If hypothyroidism is not well controlled, it is likely to cause hyperlipidemia, heart disease and other diseases.

Detect

What Check Does Painless Thyroiditis Need To Do To Diagnose?

  • Thyroid function: It is used to evaluate the thyroid function and determine the stage of the disease for symptomatic treatment.
  • Thyroid peroxidase antibodies and thyroglobulin antibodies: used to determine the presence of thyroid autoimmune disorders, these two antibodies are usually elevated in patients with painless thyroiditis.
  • Thyroid ultrasound: It is used to determine the location, size, morphology, presence or absence of nodules and abnormal echo of the thyroid gland, to assist in the diagnosis.
  • Thyroid radionuclide imaging: to assist in the identification of the causes of thyroid dysfunction.

Which diseases are easily confused with painless thyroiditis?

It is easily confused with Graves's disease, subacute thyroiditis, etc. Differentiation is made based on the patient's symptoms, history and examinations.

Prevention

Can Painless Thyroiditis Be Prevented?

It is preventable because it can be associated with excessive iodine intake or the use of certain medications.

Avoid long-term, large amount of food with high iodine, such as kelp, laver.

Thyroid function should be tested before and after taking medications that cause thyroiditis.

Treatment

How To Treat Painless Thyroiditis?

  • Removal of etiology: Iodine intake was limited and medications causing painless thyroiditis were discontinued under doctor's guidance.
  • Control symptoms in hyperthyroid period: β -receptor blockers such as propranolol or atenolol can be used to relieve the symptoms such as palpitation and hand shaking.
  • Supplement of thyroid hormone: In hypothyroidism, thyroid hormone can be supplemented for a short period of time if the symptoms are more severe. Long-term thyroid hormone replacement is required if permanent hypothyroidism occurs later.
  • Inhibition of immune response: Painless thyroiditis is an autoimmune inflammatory response of the thyroid, so glucocorticoids can be used to inhibit autoimmune inflammation in severe cases.
  • Very few relapsed patients can choose radioactive 131I therapy.

Patients with painless thyroiditis supplement thyroid hormone, what precautions?

The most commonly used thyroid hormone is the levothyroxine tablet.

Take 0.5–1 hour before breakfast.

Some foods or drugs can reduce the absorption of levothyroxine in the small intestine, such as coffee, soybean products, food fiber additives, and aluminum hydroxide, calcium agent (such as calcium carbonate, calcium citrate, calcium acetate), cholestyramine, sucralfate, ferrous sulfate, etc..

Levothyroxine should be taken at intervals of more than 4 hours from the time of administration of these foods or medications.

Does painless thyroiditis need reexamination after treatment?

Yes. Thyroid function should be reviewed every 4–6 weeks until it is completely restored to normal.

Can painless thyroiditis be cured?

Most patients can be cured. The disease recurs in 10% of patients and can be completely cured by radiation 131I therapy. Permanent hypothyroidism can also occur in 20%–30% of patients.

Life

What Should Painless Thyroiditis Patients Pay Attention To In Diet And Life?

  • Hyperthyroidism period appropriate more intake of food rich in energy, protein, vitamins, avoid drinking alcohol, drinking tea and coffee, non pregnant women should try to reduce the intake of iodine (including non-iodized salt, don't eat seaweed, etc.).
  • Quit smoking.
  • Ensure adequate sleep and be optimistic and relaxed.

Can patients with painless thyroiditis give birth normally?

As long as the thyroid function can be controlled in a range suitable for pregnancy, normal fertility can be.

However, painless thyroiditis often results in increased thyroid peroxidase antibody, which will lead to increased risk of abortion, premature birth, stillbirth and other adverse pregnancy outcomes. Therefore, adequate examination and evaluation should be conducted during pregnancy.

Will painless thyroiditis be inherited?

The disease is hereditary to a certain extent, but the offspring may not necessarily develop it.

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