Thyroiditis is a general term that refers to inflammation (not infection) or swelling of the thyroid gland. Thyroiditis can cause slow or rapid cell damage and destruction, that can cause a variety of symptoms.

Thyroiditis includes a group of individual disorders causing thyroidal inflammation but presenting in different ways. Examples of types of thyroiditis, include, but are not limited to: Hashimoto's thyroiditis, subacute thyroiditis, silent or painless thyroiditis, postpartum thyroiditis, drug-induced thyroiditis, radiation thyroiditis, acute or suppurative thyroiditis.

Thyroiditis is caused by an attack on the thyroid, causing inflammation and damage to the thyroid cells. Antibodies that attack the thyroid cause most types of thyroiditis. As such, thyroiditis is often an autoimmune disease or hereditary. Thyroiditis can also be caused by an infection, such as a virus, which works in the same way as antibodies to cause inflammation in the gland. Finally, drugs such as interferon and amiodarone, can also damage thyroid cells and cause thyroiditis.

Signs and symptoms of thyroiditis depend on the type of thyroiditis. There may be pain present in the thyroid gland. If the thyroiditis causes slow and chronic thyroid cell damage and destruction, leading to a fall in thyroid hormone levels in the blood. The patient can experience symptoms of hypothyroidism. These symptoms include, but are not limited to, fatigue, weight gain, constipation, dry skin, depression, and poor exercise tolerance.

If the thyroiditis causes rapid thyroid cell damage and destruction, the thyroid hormone that is stored in the gland leaks out, causing an increase of thyroid hormone levels in the blood (thyrotoxicosis). The patient can experience symptoms of hyperthyroidism. These symptoms include, but are not limited to, anxiety, insomnia, palpitations (fast heart rate), fatigue, weight loss, and irritability.

The most common test to diagnose thyroiditis is a blood test. The blood test checks the thyroid function, thyroid antibody, and sedimentation rate. Imaging such as an ultrasound or a thyroid scan may be completed. A radioactive iodine uptake test (RAIU)(thyroid scan) may be completed to check the thyroid's size, shape, position, and function. measure thyroid function. And finally, fine needle aspiration biopsy may be completed to look at the cells of the thyroid gland to make a proper diagnosis.

Treatment for thyroiditis depends on the specific type and the clinical presentation.

Treatment can include a thyroid replacement medication when there is not enough thyroid hormone being produced (hypothyroid).

When the thyroid is overactive, antithyroid medication can be used. Additionally, treatment such as beta blockers can be used when there is an elevation of thyroid hormone in the blood. This is to decrease heart palpitations and decrease tremors.

If the thyroid is painful, treatment with anti-inflammatory medications and/or steroids is prescribed.

Though less common, surgical removal of the thyroid or radioactive iodine therapy (to reduce the functioning of the thyroid or completely destroy it) may be needed when the condition is so severe.

Residuals of thyroiditis depend on the specific type of thyroiditis. Most of the symptoms caused by thyroiditis will go away following treatment or with continued treatment. In some cases, the thyroid will return to normal function after the onset of symptoms (12-18 months).

However, in cases where hypothyroidism developed (i.e Hashimoto's), this condition can be permanent and the patient will remain on medication for the remainder of their life.

Recurrence is also dependent on the type of thyroiditis.

• Consider service connection on a presumptive basis as a chronic condition (38 CFR §3.307; §3.309 (a)).  

•  Note: Manifesting as hyperthyroidism, evaluate as hyperthyroidism, including, but not limited to, Graves' disease (DC 7900); manifesting as hypothyroidism, evaluate as hypothyroidism (DC 7903).