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Silent thyroiditis

Definition

Silent thyroiditis is swelling (inflammation) of the thyroid gland, in which the person alternates between hyperthyroidism and hypothyroidism.

Alternative Names

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

Causes, incidence, and risk factors

The cause of this type of thyroiditis is unknown. The disease affects women more often than men.

Symptoms

The earliest symptoms result from an overactive thyroid gland (hyperthyroidism). These symptoms may last for 3 months or fewer. Later symptoms may be of an underactive thyroid (including fatigue and cold intolerance) until the thyroid recovers.

Symptoms are usually mild and may include:

Signs and tests

A physical examination may show:

Enlarged thyroid gland
Rapid heart rate
Shaking hands

Tests may show:

Decreased radioactive iodine uptake
Increased blood levels of the thyroid hormones T3 and T4
White blood cells (lymphocytes) on a thyroid biopsy

Treatment

Treatment is based on symptoms. Beta-blockers relieve rapid heart rate and excessive sweating.

Support Groups

Expectations (prognosis)

Generally, silent thyroiditis will go away on its own within 1 year. The acute phase will end within 3 months.

Some people may develop hypothyroidism over time. Regular follow-ups with a doctor are recommended.

Complications

Calling your health care provider

Call your health care provider if you have symptoms of this condition.

Prevention

References

AACE Thyroid Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;8:457-469.

Ladenson P, Kim M. Thyroid. In: Goldman L and Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007:chap 244.

Brent GA, Larsen PR, Davies TF. Hypothyroidism and thyroiditis. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 12.

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Thyroid gland

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Review Date: 4/19/2010

Review By: Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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