There are no unique symptoms of thyroiditis. In some cases, thyroiditis can cause slow and chronic cell damage and destruction, causing the thyroid levels to fall below normal, thus they suffer from hypothyroidism. Common symptoms of this group of patient are fatigue, constipation, depression, poor exercise tolerance, and weight gain.

When the thyroiditis causes rapid damage of the thyroid gland, the hormone (which is stored in the gland) leaks out, causing the level of hormone to increase, and the patients suffer from thyrotoxicosis, the symptoms of which are similar to hyperthyroidism such as anxiety, palpitations, fatigue, weight loss, insomnia and irritability.

In case of subacute and post-partum thyroiditis, there is a depletion of the hormone from the thyroid gland in the course of inflammation.

• Heat Intolerance

  Symptoms of thyroid hormone excess (hyperthyroidism) such as nervousness, rapid heart rate, and heat intolerance may be present early in the disease. [uclahealth.org]

  It does not occur in everyone, but a person may start out with: Heat intolerance Rapid heart rate Sweating Weight loss Tremors Anxiety The symptoms of Hashimoto's thyroiditis may resemble other conditions or medical problems. [entcolumbia.org]

  Symptoms are often mild, and may include: Fatigue, feeling weak Frequent bowel movements Heat intolerance Increased appetite Increased sweating Irregular menstrual periods Mood changes, such as irritability Muscle cramps Nervousness, restlessness Palpitations [medlineplus.gov]

  intolerance, diarrhea) is possible (hashitoxicosis) Late-stage Thyroid may be normal-sized or small if extensive fibrosis has occurred. [amboss.com]

• Cold Intolerance

  Symptoms may include: Goiter (benign enlargement of the thyroid gland, causing enlargement of the neck) Symptoms of underactive thyroid gland, which include: Fatigue Muscle weakness Weight gain Cold intolerance Depression Hair and skin changes Symptoms [entcolumbia.org]

  Weight loss Later symptoms may be of an underactive thyroid (hypothyroidism), including fatigue and cold intolerance, until the thyroid recovers. [medlineplus.gov]

  Later, symptoms of too little thyroid hormone (hypothyroidism) such as fatigue, constipation, or cold intolerance may occur. Eventually, thyroid gland function returns to normal. [uclahealth.org]

  Hypothyroidism (e.g., cold intolerance, constipation, fatigue) References:[3][6][2][1] Diagnostics Thyroid metabolism Antibody detection Anti-TPO antibody positive (; ↑ Anti-microsomal antibodies) Anti-Tg antibody positive See thyroid antibodies. [amboss.com]

  Hypothyroidism is when your thyroid gland doesn't produce enough thyroid hormone, and it can have some pretty nasty side effects: weight gain, sleepiness, cold intolerance, constipation, swelling, decreased heart rate, and heavy periods, to name a few [self.com]

• Anemia

  […] routinely performed, a severe hypothyroidism (for example due to autoimmune thyroiditis) can anyway occur early in life and the clinicians should consider this possibility; ii) hypothyroidism can have a misleading and multi-face clinical presentation; iii) anemia [ncbi.nlm.nih.gov]

  For example, having Hashimoto’s puts you at risk for other autoimmune conditions that contribute to fatigue, including: Vitamin B12 deficiency (pernicious anemia). Celiac disease, which can lead to iron deficiency anemia. [health.clevelandclinic.org]

  Hashimoto thyroiditis, like Graves disease, is sometimes associated with other autoimmune disorders, including Addison disease (adrenal insufficiency), type 1 diabetes mellitus, hypoparathyroidism, vitiligo, premature graying of hair, pernicious anemia [msdmanuals.com]

  • Pernicious Anemia, a type of anemia caused by not having enough vitamin B12 in the body. [physio-pedia.com]

• Malaise

  During the thyrotoxic phase, patients usually complain of fever, malaise, and goiter, which is tender in subacute granulomatous thyroiditis and painless in subacute lymphocytic thyroiditis. [amboss.com]

  She presented to our hospital with sudden-onset general malaise, edema, and hoarseness with an elevated thyroid-stimulating hormone (373.3 μIU/ml) level and very low triiodothyronine ( CONCLUSIONS: This case emphasizes that consuming health drinks that [ncbi.nlm.nih.gov]

  Definition / general Inflammation of thyroid gland that includes granulomas Rare, much less common than Hashimoto thyroiditis but most common cause of thyroid pain Painful swallowing (odynophagia), sore throat, thyroid region tenderness, fever, fatigue, malaise [pathologyoutlines.com]

  Other symptoms associated with De Quervian’s thyroiditis may include painful dysphagia, fever, malaise, anorexia, and myopathy. [news-medical.net]

  The symptoms also can develop slowly over time, causing people to blame aging or general feelings of malaise on their fatigue and weight gain, rather than a medical condition. if a person with thyroiditis does not have a family history of this condition [progressivehealth.com]

• Anorexia

  Other symptoms associated with De Quervian’s thyroiditis may include painful dysphagia, fever, malaise, anorexia, and myopathy. [news-medical.net]

  Anorexia nervosa and bulimia nervosa increase the risk, possibly because of malnutrition. The condition has also been linked to smoking and radiation exposure. [medicalnewstoday.com]

  Low-grade fever, fatigue, weight loss, anorexia/increased appetite, tremor, and palpitation can also be seen during the thyrotoxic phase. [hindawi.com]

• Stridor

  On examination she had inspiratory stridor, with a respiratory rate of 25 breaths/min and an oxygen saturation of 94% in room air. A large neck mass (10 cm) was visible, predominantly on the right side (fig 1 ⇓ ). [bmj.com]

  Surgical Indications for surgery include: A large goitre with obstructive symptoms - eg, dysphagia or stridor. Presence of a malignant nodule. Presence of a lymphoma diagnosed on fine-needle aspiration. Cosmetic reasons for unsightly, large goitres. [patient.info]

  If both recurrent laryngeal nerves are affected, stridor can result. Involvement of the parathyroid glands can cause hypoparathyroidism. [endocrinologyadvisor.com]

  […] radiation Hyperthyroidism generally resolves within one month Self-limited, but symptoms may be treated with beta blockers and nonsteroidal anti-inflammatory drugs Riedel thyroiditis (fibrous thyroiditis) ‡ Very firm goiter or compressive symptoms (dyspnea, stridor [aafp.org]

• Common Cold

  The condition often occurs a few weeks after a viral infection of the ear, sinus, or throat, such as mumps, the flu, or a common cold. [mountsinai.org]

  Various viral illnesses may precede the disease, including mumps, measles, influenza, infectious mononucleosis, adenoviral or Coxsackievirus infections, myocarditis, or the common cold. [emedicine.medscape.com]

• Constipation

  Typical hypothyroid symptoms include fatigue, weight gain, constipation, dry skin, depression and poor exercise tolerance. This would be the case in patients with Hashimoto’s thyroiditis. [thyroid.org]

  Symptoms of Hashimoto's thyroiditis are the same as hypothyroidism, and include feeling cold, depression, dry skin, constipation, fatigue, sleepiness, and weight gain. [medicinenet.com]

  Anyone who has a hoarse voice, constipation, a puffy and pale face, dry skin, and feels tired for no clear reason should see a doctor. Hashimoto’s disease is an inflammation of the thyroid gland. [medicalnewstoday.com]

• Dysphagia

  One patient in the study presented with dysphagia due to the goiter. The remaining patients presented with thyroid nodules. None presented with typical symptoms of the disease. [ncbi.nlm.nih.gov]

  ABSTRACT INTRODUCTION: Riedel´s thyroiditis is a thyroid inflammation with invasive fibrosis.CASE REPORT: Female 84 years old, studied by dysphagia to liquids and dysphonia, with cervical mass poorly demarcated and immobile. [pesquisa.bvsalud.org]

  Surgical Indications for surgery include: A large goitre with obstructive symptoms - eg, dysphagia or stridor. Presence of a malignant nodule. Presence of a lymphoma diagnosed on fine-needle aspiration. Cosmetic reasons for unsightly, large goitres. [patient.info]

  Her serum anti-thyroid peroxidase (anti-TPO) value was also high (>600 kU/L; However, four months later she noticed a rapid increase in neck swelling associated with dysphagia for solid foods, hoarseness of voice, and difficulty with breathing, for which [bmj.com]

  […] fibrous) thyroiditis: rare inflammatory process involving the thyroid and surrounding cervical tissues; associated with various forms of systemic fibrosis; presents as a firm mass in the thyroid commonly associated with compressive symptoms (dyspnea, dysphagia [unboundmedicine.com]

• Loss of Appetite

  Symptoms include fatigue, cold intolerance, loss of appetite, weight gain, depression, dry skin, hair loss, constipation, heavier menstrual periods, and high cholesterol. [health.harvard.edu]

  […] and weight loss. [mythyroid.com]

  Symptoms of Thyroiditis which results in too much thyroid hormone include: Heart palpitations Rapid heart rate Increased appetite Rapid weight loss Increased anxiety Jittery or nervous sensation Increased sensitivity to heat Heat intolerance Fine brittle [restartmed.com]

• Heart Disease

  Diseases Associated with Autoimmune Thyroiditis 12. Atrophic Thyroiditis, Hypertension and Coronary Heart Disease 13. Thyroiditis and Chromosomal Anomalies 14. Heredity of Autoimmune Thyroiditis 15. [elsevier.com]

  This may be associated with increased serum cholesterol levels, possibly increasing the risk for atherosclerosis and heart disease. [thyroidawareness.com]

  Hashimoto's Thyroiditis Complications If it's not treated, Hashimoto's thyroiditis can cause complications, including: Heart problems: The disease can lead to high cholesterol, an enlarged heart, heart failure, or other forms of heart disease. [everydayhealth.com]

  The heart disease may be directly related to hypothyroid effects on the heart, causing changes in contraction and rhythm that may lead to subsequent heart failure. [emedicinehealth.com]

• Hypertension

  Atrophic Thyroiditis, Hypertension and Coronary Heart Disease 13. Thyroiditis and Chromosomal Anomalies 14. Heredity of Autoimmune Thyroiditis 15. The Significance Of Lymphocytic Thyroiditis Appendix. [elsevier.com]

  She was a non-smoker and her medical history included hypertension, for which she was prescribed amlodipine. At that time she was still taking thyroxine and her TSH concentration was normal (2.6 mIU/L). [bmj.com]

  Kent Wehmeier, MD Professor, Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, St Louis University School of Medicine Kent Wehmeier, MD is a member of the following medical societies: American Society of Hypertension [emedicine.medscape.com]

  ↩ Journal of Clinical Hypertension. “Hyperthyroidism: a secondary cause of isolated systolic hypertension.” August, 2006. Accessed February 3, 2018. ↩ Medscape. “Hyperthyroidism, Thyroid Storm, and Graves Disease.” April 10, 2017. [ada.com]

  His past medical history was significant for coronary artery disease, cerebrovascular accident with no residual deficit, corrected patent foramen ovale, diabetes mellitus type II, hypertension, hyperlipidemia, benign prostatic hyperplasia, and gout. [hindawi.com]

• Arthralgia

  Patients may also complain of malaise, fatigue, myalgia, arthralgia, and a mild to moderate swinging fever. Symptoms usually peak within 3-4 days and completely disappear typically within weeks. [endocrinologyadvisor.com]

  At presentation, dysphagia was present in 30 patients, arthralgia in 3, myalgia in 12, tremor in 19, sweating in 22, and weight loss (4.5–18.2 kg) in 15. Signs. [academic.oup.com]

• Dry Skin

  Typical hypothyroid symptoms include fatigue, weight gain, constipation, dry skin, depression and poor exercise tolerance. This would be the case in patients with Hashimoto’s thyroiditis. [thyroid.org]

  Symptoms of Hashimoto's thyroiditis are the same as hypothyroidism, and include feeling cold, depression, dry skin, constipation, fatigue, sleepiness, and weight gain. [medicinenet.com]

  Anyone who has a hoarse voice, constipation, a puffy and pale face, dry skin, and feels tired for no clear reason should see a doctor. Hashimoto’s disease is an inflammation of the thyroid gland. [medicalnewstoday.com]

• Alopecia

  There is often hair loss (alopecia) and the skin becomes dry and flaky. [endocrinesurgeon.co.uk]

  Alopecia areata, totalis and universalis. Chronic active hepatitis. [ 10 ] Polymyalgia rheumatica and giant cell arteritis. Primary biliary cirrhosis. Rheumatoid arthritis, Sjögren's syndrome, systemic lupus erythematosus. [patient.info]

  The most frequent associated diseases are: alopecia, vitiligo, celiac disease and insulin-dependent type 1 diabetes. Other disorders such as Turner syndrome and Down syndrome can also be associated with HT [9]. [fortunejournals.com]

  Panhypopituitarism) Goiter Polyglandular Autoimmune Syndrome, Type I Goiter, Diffuse Toxic Polyglandular Autoimmune Syndrome, Type II Goiter, Lithium-Induced Thyroid Lymphoma Goiter, Nontoxic Goiter, Toxic Nodular Other possible issues include: [5] Addison disease Alopecia [physio-pedia.com]

• Dry Hair

  Hypothyroidism Symptoms associated with hypothyroidism are as follows: Fatigue Sleepiness Weight gain Depression Cold intolerance Dry skin Dry hair Puffy face Hoarseness Leg swelling Muscle aches Heavy or irregular menstrual periods Low heart rate Constipation [innerbody.com]

• Anxiety Disorder

  Conditions that may be confused with Hashimoto’s include chronic fatigue syndrome, depression, fibromyalgia, an anxiety disorder, pre-menstrual syndrome (PMS), and cyclothymia. [medicalnewstoday.com]

• Insomnia

  The thyrotoxic phase lasts for 1-3 months and is associated with symptoms including anxiety, insomnia, palpitations (fast heart rate), fatigue, weight loss, and irritability. [thyroid.org]

  […] of hypothyroidism may include: Fatigue Weight gain Cold intolerance Joint or muscle pain Constipation Dry skin and hair Heavy menstrual periods Difficulty conceiving Depression Impaired memory Bradycardia Symptoms of hyperthyroidism include: Anxiety Insomnia [news-medical.net]

  These symptoms include weight loss, irritability, anxiety, insomnia, fast heart rate, and fatigue. [thyroid.com.au]

• Asthenia

  CASE PRESENTATION: A 22-month-old white male patient with normal neonatal screening presented with a six-month history of asthenia and cutaneous pallor. [ncbi.nlm.nih.gov]

Acute thyroiditis: The laboratory data of the patients with acute thyroiditis is similar to acute systemic illness. Leukocytosis, increased sedimentation rate, and thyroid function test within the normal reference range.

Subacute thyroiditis: The data from the patients with subacute thyroiditis is similar to those with abnormal thyroid functions. Though initially the thyroid-stimulating hormone (TSH) level is decreased, sometimes, permanent hypothyroidism may also develop. White blood cell count in such patients is within the normal or slightly elevated reference range. C-reactive protein levels are also elevated in such patients.

Chronic thyroiditis: Laboratory data of patients with chronic thyroiditis are found to be abnormal with evidence of autoimmunity. In subclinical and overt hypothyroidism, TSH levels are increased, while in children with hyperthyroidism, this level is suppressed.

Elevated antithyroid peroxidase antibody levels are the most sensitive indicator of the autoimmunity.

Imaging Studies

Radioactive iodine thyroid scanning: Though this type of scanning is not necessary for acute suppurative thyroiditis and chronic thyroiditis, it can help to diagnose subacute thyroiditis.

Thyroid ultrasonography: Helps to reveal the formation of abscess patients with acute thyroiditis.

Degree of hyopoechogenicity on ultrasonography: Benefits are dependent on the degree of the thyroid dysfunction [7] [8].

• Hypercholesterolemia

  There may also be indirect influences, such as hypercholesterolemia (an increase in "bad" cholesterol is often seen with hypothyroidism). [emedicinehealth.com]

The treatment of thyroiditis depends on the type of the disease as well as the clinical presentation.

Thyrotoxicosis: The symptomatic relief can be brought out depending on the symptoms. In order to decrease the palpitations, beta blockers are used. With the improvement of the symptoms, the medications are reduced as the thyrotoxic phase was temporary. Antithyroid drugs are not used for the thyrotoxic stage.

Hypothyroidism: Hormone replacement therapy for hypothyroidism induced by Hashimoto’s thyroiditis is common. In patients with thyroiditis (subacute, painless and post-partum), thyroid hormone therapy can be indicated. This treatment must continue for 6-12 months and then tapered depending on the requirements.

Thyroidal pain: Subacute thyroiditis can cause pain. In such cases, mild anti-inflammatory medications are indicated. When these pains become severe, steroid therapy with prednisone is indicated [9] [10].

The prognosis of thyroiditis depends on the cause of the disease. Patients with Hashimoto’s disease may progress to complete thyroid failure, causing permanent hypothyroidism. On correct and early diagnosis, hypothyroidism responds well to the treatment. Goiter following autoimmune thyroiditis may not resolve completely. Other types of thyroiditis can be managed well with treatment with total resolution of the disease.

Complications

Some of the complications of the disease are hypothyroidism, thyroid abscesses, severe chest pain, hyperthyroidism, neck pain and goiter.

Thyroiditis can be broadly classified into:

• Acute suppurative thyroiditis caused by bacterial infection
• Subacute thyroiditis caused by viral infection of the gland.
• Chronic thyroiditis is autoimmune in nature. 

The most common type of thyroiditis is Hashimoto’s thyroiditis named after the Japanese physician. This disease is an autoimmune lymphocytic thyroiditis [1] [2].

Depending on the screening procedures, the prevalence of chronic autoimmune thyroiditis varies. In some areas across the globe, the prevalence is as high as 12.5%. The region where the antibiotic use is less prevalent, acute thyroiditis is common.

Though there is no long-term mortality or morbidity due to thyroiditis, patients with autoimmune thyroiditis may develop hypothyroidism requiring treatment for life. Those patients, who suffer from subacute thyroiditis, may have hyperthyroidism, which may resolve on its own. Normal thyroid function is generally restored in patients with acute thyroiditis [5] [6].

Acute suppurative thyroiditis: This type of thyroiditis is rare among children. The most common organism that causes this type of thyroiditis belongs to genus Streptococcus; though some other aerobic and anaerobic bacteria may be involved.

Subacute thyroiditis: Viral infection is the cause of subacute thyroiditis. Some of the viral diseases that precede thyroiditis are mumps, influenza, adenoviral, malaria, myocarditis, measles or Q-fever.

Chronic thyroiditis: This type of thyroiditis is caused due to an autoimmune process [3] [4].

To avoid the complications of thyroiditis, the most important step that one can take is to maintain personal hygiene. As mentioned above, the etiology of the disease lies in the pathogens: bacteria and virus. These interactions with such pathogens are possible by maintaining hygiene. Early diagnosis of the autoimmune thyroiditis can help the patient to learn about the management of the manifestations that may ensue as the disease progresses.

Thyroiditis is a group of disorders which are characterized by an inflammation of the thyroid gland and may manifest in a number of different ways, such as Hashimoto’s thyroiditis (which is the most common form), postpartum thyroiditis, and subacute thyroiditis. In some patients, drugs such as interferon and amiodarone can also cause this inflammation and this is often referred to as secondary thyroiditis [1].

Thyroiditis is a group of disorders which are characterized by an inflammation of the thyroid gland. If there is consistent irritation, fatigue, anxiety, palpitations or sudden weight changes, it may be related to thyroid functioning. The altered levels of thyroxin (high or low) can cause such symptoms. Hence, meeting up the family physician is a good idea.