What is it about ?
The thyroid is a small, butterfly-shaped gland that sits at the base of the neck, just below the Adam’s apple.
It produces thyroid hormones (T3 (triiodothyronine) and T4 (thyroxine)). These hormones play an important role at all stages of life. They allow
- normal growth and development,
- the regulation of many processes, including metabolism (they stimulate the metabolism),
- and that the pregnancy is proceeding normally.
The thyroid can experience several types of problems:
- abnormal operation:
- it makes too little thyroid hormone (hypothyroidism). It slows down your metabolism,
- it makes too many thyroid hormones (hyperthyroidism). It boosts your metabolism,
- an abnormal shape (too big and / or formation of nodules),
- sometimes both types of problems at the same time.
Subacute thyroiditis or De Quervain’s thyroiditis is a subacute inflammation of the thyroid gland caused by a reaction of the immune system, usually after a common viral infection. The inflamed thyroid releases a quantity of thyroid hormones, which increases the level of these hormones in the blood.
Where and how often?
Subacute thyroiditis is a relatively rare cause of overactive thyroid (hyperthyroidism). Every year, in 100,000 people, 12 people are diagnosed with subacute thyroiditis1. The condition occurs three to five times more frequently in women than in men, and more often in adolescents and middle-aged individuals.
How to recognize it?
A few weeks before you had subacute thyroiditis, you may have had an upper respiratory infection. The disease can be recognized by the sudden and intense pain it causes in the neck, in the thyroid gland, the pain is usually accompanied by pain in the neck. You have a fever, with or without chills, and you generally feel unwell. You may have pain when swallowing and have a hoarse voice.
The release of thyroid hormones causes symptoms of an overactive thyroid such as fatigue, weight loss despite a good appetite, diarrhea, nervousness and palpitations.
How is the diagnosis made?
The doctor will examine the area of the thyroid. This is sensitive to local pressure. A blood test is also carried out. A slight temporary increase (a few weeks to a few months) in the amount of thyroid hormones and a slight decrease in the thyroid stimulating hormone (TSH) produced by the brain indicate the presence of the condition. There is also an increase in inflammatory parameters.
In general, additional examinations are superfluous. The disease heals on its own. The amount of thyroid hormones in the blood decreases in 20% of people before recovery; the effect is permanent in 2 to 3% of the individuals concerned.
What can you do ?
To relieve the pain, you can take an anti-inflammatory drug (ibuprofen for example).
What can your doctor do?
Subacute thyroiditis resolves spontaneously. Medicines to slow down thyroid activity are not necessary. In case of palpitations, the doctor may temporarily prescribe a beta blocker. In very severe symptoms, corticosteroids help reduce the swelling of the thyroid gland. Usually, complaints go away quickly with this treatment. You should take them for 6 to 12 weeks and reduce the dose gradually before stopping.
If symptoms persist and indicate an excess or a deficiency of thyroid hormones in the blood, the activity of the thyroid gland should be monitored by a blood test. Temporarily reduced thyroid function can be treated with thyroid hormones to be taken for 6 to 12 months. If there are still symptoms after a year, you will eventually be referred to a specialist.
Find out more
Sources
Foreign clinical practice guide ‘Subacute thyroiditis’ (2000), updated 08.08.2017 and adapted to the Belgian context on 15.04.2019 – ebpracticenet
1 www.uptodate.com/contents/subacute-thyroiditis