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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:
- Frequent bowel movements
- Heat intolerance
- Increased appetite
- Increased sweating
- Irregular menstrual periods
- Irritability
- Muscle cramps
- Nervousness, restlessness
- Palpitations
- Weakness
- Weight loss
Signs and tests
A physical examination may show:
- Enlarged thyroid gland
- Rapid heart rate
- Shaking hands
Tests may show:
- Decreased radioactive iodine uptake
- 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.
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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