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Silent thyroiditis

Silent thyroiditis is an immune reaction of the thyroid gland. The disorder can cause hyperthyroidism, followed by hypothyroidism.

The thyroid gland is located in the neck, just above where your collarbones meet in the middle.

Causes

The cause of the disease is unknown. But it is related to an immune attack against the thyroid by the immune system. The disease affects women more often than men.

The disease can occur in women who have just had a baby. It can also be caused by medicines such as interferon and amiodarone, which affect the immune system.

Symptoms

The earliest symptoms result from an overactive thyroid gland (hyperthyroidism). These symptoms may last for up to 3 months.

Symptoms are often mild, and may include:

Later symptoms may be of an underactive thyroid (hypothyroidism), including fatigue and cold intolerance, until the thyroid recovers. Some people only notice the hypothyroid symptoms and do not have symptoms of hyperthyroidism.

Exams and Tests

The health care provider will examine you and ask about your symptoms and medical history.

A physical examination may show:

  • Enlarged thyroid gland that is not painful to the touch
  • Rapid heart rate
  • Shaking hands (tremor)

Tests that may be done include:

Treatment

Treatment is based on symptoms. Medicines called beta-blockers may be used to relieve rapid heart rate and excessive sweating.

Outlook (Prognosis)

Silent thyroiditis often goes away on its own within 1 year. The acute phase ends within 3 months.

Some people develop hypothyroidism over time. They need to be treated for a while with levothyroxine, a medicine that replaces thyroid hormone. Regular follow-ups with a provider are recommended.

When to Contact a Medical Professional

Call your provider if you have symptoms of this condition.

Alternative Names

Lymphocytic thyroiditis; Subacute lymphocytic thyroiditis; Painless thyroiditis; Postpartum thyroiditis; Thyroiditis - silent; Hyperthyroidism - silent thyroiditis

References

Davies TF, Laurberg P, Bahn RS. Hyperthyroid disorders. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016:chap 12.

Pellitteri PK, Ing S, Jameson B. Disorders of the thyroid gland. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 122.

Update Date 2/3/2016

Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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