Silent Thyroiditis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Silent Thyroiditis, Diagnosis and Treatment and Related Diseases

Recently I have a female patient who has enlarged thyroid but no other symptoms.
Her blood thyroid hormones (T3 and T4) were normal but her thyroid-stimulating hormone (TSH) is increased.
Her Thyroid auto-antibodies were very high indicating an autoimmune disease.
Her Erythrocyte sedimentation rate was normal indicating inflammation is low; however this test may be normal in the early stages of the disease.
Her Thyroid peroxidase (TPO) is normal.
It is an enzyme made by the thyroid and high levels normally indicate the presence of Hashimoto thyroiditis, an autoimmune disease.
Hashimoto thyroiditis is the most common cause of autoimmune thyroid disease other than Graves’s hyperthyroidism.
The thyroid gland uses TPO along with iodine to generate the thyroid hormones triiodothyronine (T3) and thyroxine (T4).
Further investigations include ultrasound of the thyroid and biopsy of the thyroid to find the cause of the disease.
However the patient had refused these tests and will be followed by an endocrinologist specializing in thyroid conditions.

Silent thyroiditis is a form of inflammation of the thyroid gland, sited in the neck.

Silent thyroiditis is due to an immune response of the thyroid gland.

The disorder can produce hyperthyroidism, followed by hypothyroidism.

The thyroid gland is present in the neck, above where the collarbones meet in the middle.

Alternative Names
Sub-acute lymphocytic thyroiditis; Sub-acute granulomatous thyroiditis; Painless thyroiditis; Postpartum thyroiditis;

It is often a short-term disorder but can be distressing for the patient.

Signs involve symptoms and thyroid blood test results that show swinging between both hypothyroidism and hyperthyroidism.

The term ‘silent’ indicates to the absence of tenderness of the thyroid gland, in contrast with sub-acute thyroiditis, which normally produces tenderness or pain.

While the autoimmune thyroid disease Hashimoto’s Thyroiditis can apparently produce thyroid hormone levels to move up and down and even swing between hypo and hyperthyroidism, Silent Thyroiditis is normally short-lived, compared to the lifelong disorder of Hashimoto’s.

Those with silent thyroiditis normally go through a stage of thyrotoxicosis (excessive thyroid hormone – hyperthyroidism) for a brief period of one to three months, before a longer hypothyroid phase, which normally lasts around six months.

The precise cause of this disorder is not known.

But it is linked to an attack against the thyroid by the immune system.

The disease involves women more often than men.

The disease can also happen in women who have just had a baby (postpartum).

It can also be induced by medicines such as interferon and amiodarone, and some types of chemotherapy, which have an effect on the immune system.

It is theorized that silent thyroiditis could be an autoimmune disorder in its own right.

Silent Thyroiditis normally indicates no symptoms but there may be an enlarged thyroid.

The earliest symptoms happen from an overactive thyroid gland (hyperthyroidism).

These symptoms may persist for up to 3 months.

Symptoms are often mild, and may be:
1. Fatigue
2. Tremors
3. Over-sensitivity to heat

Later symptoms may be more of an under active thyroid (hypothyroidism), such as:
1. Weak
2. Constipation
3. Dry skin

Thyroid function tests gauge the quantities of hormones (thyroid-stimulating hormone or TSH, T3, and T4) in the blood.

TSH secretes from the pituitary gland and stimulates the thyroid gland to produce T4 and T3.

Thyroid antibody tests involve thyroid peroxidase antibodies and thyroid auto-antibodies
TABLE OF CONTENT
Introduction
Chapter 1 Silent Thyroiditis
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Hypothyroidism
Chapter 8 Thyroiditis
Epilogue