Thyroiditis 101: A Patient’s Guide To Causes, Symptoms, Treatments

Key takeaway: Thyroiditis, the medical term for an inflamed thyroid, can be tricky to nail down since there are numerous causes and symptoms—and some people experience no symptoms at all. No matter where you fall on the thyroiditis gamut, treatment options, and lifestyle changes can help.

On paper, thyroiditis sounds easy to understand: It’s the inflammation of the thyroid gland, which sits in the front of your neck. The reality can be hard to decipher, thanks to the various causes, triggers, and symptoms. Thyroiditis can manifest as hyperthyroidism (an overactive thyroid gland), hypothyroidism (an underactive gland), or with no symptoms at all. To make sense of this condition, let’s unpack the most common types, treatment options, and lifestyle changes to manage or prevent thyroid inflammation.

Understanding thyroiditis

While the thyroid is a small gland, it plays a crucial role in metabolism and your body’s development, thanks to the hormones the thyroid produces. Thyroid hormones control your body’s energy levels and indirectly impact other bodily functions such as your mood, heart rate, and breathing.

If the thyroid becomes inflamed, thyroid hormone production can be interrupted. As you can imagine, that disruption causes a ripple effect throughout the body, similar to how a car accident causes traffic for miles. To make matters more confusing, thyroiditis can manifest as hyperthyroidism or hypothyroidism. Typically, it takes the form of hypothyroidism.

Causes and risk factors

“Generally speaking, autoimmune diseases, infections, medications, and all sorts of environmental or opportunistic triggers can cause thyroiditis,” says Cory Rice, DO, an internist based in Dallas, Texas. Some triggers cause temporary thyroid dysfunction while others create more permanent changes.

Margaret Eagan, MD, an endocrinologist and founder of Rousia Thyroid Health, notes that most thyroiditis cases also have a genetic component. While our genetics are predetermined, that doesn’t mean it’s game over if you have a genetic predisposition. “Our genetics cannot be changed but we can attempt to prevent the activation of the antibodies,” explains Dr. Eagan, “Following good lifestyle habits may prevent activation of autoimmune  antibodies or help quiet activation of autoimmune antibodies associated with thyroiditis.”

That said, even with good habits, other factors can trigger immune system fluctuations that lead to thyroiditis. These conditions include pregnancy, certain medications, viral and bacterial infections, a leaky gut, radiation therapy, gut dybiosis, and iodine treatment. “Having one autoimmune disease also puts you at risk of having many other autoimmune diseases,” adds Dr. Rice.

Types of thyroiditis

There are multiple types of thyroiditis, each with its own symptoms and triggers. The six below are the most common.

Hashimoto’s thyroiditis

Hashimoto’s thyroiditis, the most common type, occurs when the autoimmune system mistakenly attacks the thyroid. This attack slows hormone production, causing hypothyroidism. “Hashimoto’s thyroiditis is influenced by genetics, the immune system (especially gut health), and environmental triggers such as toxins, chemicals, or pollutants, hormonal problems, and food sensitivities,” says Dr Rice.

Subacute thyroiditis

Also known as De Quervain’s thyroiditis, this condition is often triggered by a viral infection. While it typically resolves on its own, it may cause temporary hyper or hypothyroidism. Dr. Eagen points out that subacute thyroiditis often feels like having a cold in your thyroid.

Postpartum thyroiditis

About 5% of new moms experience postpartum thyroiditis within the first six months. It may present as hyperthyroidism, hypothyroidism, or both in different phases of the postpartum journey. Typically, this type resolves within a year, but some women may experience permanent hypothyroidism.

Silent thyroiditis

Silent thyroiditis is a painless form that often mimics postpartum thyroiditis, making it difficult to differentiate between the two. Dr. Eagan explains that silent thyroiditis occurs when antithyroid antibodies attack the thyroid gland. She adds, “As with any autoimmune disorder, patients will usually note a stressor like the flu or a job change, a few months before symptoms appear.”

Infectious (suppurative) thyroiditis

Infectious thyroiditis is a rare bacterial infection of the thyroid gland. It can cause severe thyroid pain, fever, and life-threatening complications, meaning anyone with this type should seek medical attention ASAP.

Drug-induced thyroiditis

Certain medications, such as amiodarone, lithium, and certain cancer treatments, may inflame the thyroid. Symptoms vary based on what medication caused thyroiditis and treatment often consists of managing symptoms or finding an alternative medication.

Thyroiditis symptoms

If you’re wondering “What does thyroid pain feel like?” you probably won’t find a direct answer. Thyroiditis presents differently depending on the cause, severity, type, and someone’s age and gender.

If someone has Hashimoto’s or silent thyroiditis, there’s a chance they won’t experience thyroid pain at all. When thyroid pain is present, it ranges from mild discomfort to severe pain, often in the jaws or ears. Pain is most commonly associated with subacute thyroiditis or infectious thyroiditis.

But pain isn’t the only sign of thyroiditis. Others include fatigue, mood changes, and the development of a goiter, an enlarged thyroid that makes the neck appear swollen. Additional symptoms depend on if someone’s thyroiditis manifests as hypo or hyperthyroidism.

Diagnosing thyroiditis

Thyroiditis must be diagnosed by a medical professional, usually via a blood test and physical exam. A blood test will check for the levels of TSH (thyroid-stimulating hormone). Some blood tests capture only thyroxine (T4) and triiodothyronine (T3) levels, but a functional medicine provider will order a more comprehensive panel that measures TSH, free T3, free T4, reverse T3, and thyroid antibodies (TPO and TgAb). The latter provides a clearer picture of overall thyroid function. Imaging tests, such as a thyroid ultrasound or radioactive iodine uptake (RAIU) scan, are sometimes ordered too.

Along with ordering blood work, a doctor will check for swelling or tenderness around the thyroid gland (plus any other potential symptoms) in a physical exam. If you see a functional medicine provider like the ones at Parsley, they will also assess lifestyle factors that may trigger thyroiditis, allowing them to better identify and treat the root cause.

Treatment options for thyroiditis

After a thyroiditis diagnosis, a doctor will review treatment options (usually a mix of medications and lifestyle changes.) The exact medications a doctor recommends depend on if the condition results in hyper or hypothyroidism and symptom severity.

When symptoms manifest as hypothyroidism, a doctor may prescribe levothyroxine (synthetic thyroid hormone) to help manage thyroid hormone levels. Once on the medication, regular monitoring is required to adjust the dosage as needed.

Hyperthyroidism has three main medication types:

• Anti-thyroid medications: Prescriptions that reduce hormone production, though they are less commonly used for thyroiditis than for other causes of hyperthyroidism.
• Beta-blockers: Medications to prevent specific symptoms of hyperthyroidism, such as a rapidly beating heart or anxiety.
• Radioiodine therapy: Pills or liquid with radioactive iodine-131, which destroys the thyroid. Like anti-thyroid medications, this typically isn’t recommended for thyroiditis.

Since thyroid issues also stem from gut imbalances, functional doctors may also prescribe a medication called low-dose naltrexone, which can revamp gut bacteria and gut lining. Some will recommend herbs, probiotics, or dietary changes as well to boost overall gut health.

If thyroiditis is caused by a bacterial infection, a doctor will prescribe the short-term use of antibiotics. Sometimes, pain management medication like ibuprofen or corticosteroids is recommended, especially if pain and inflammation are severe.

Living with thyroiditis

“The best lifestyle habits for thyroiditis are what most of us were taught as children,” says Dr. Eagan, noting that those lessons included eating veggies, getting outside to play, and being in bed at a certain time. She adds that there are lifestyle pillars that can help heal thyroiditis or prevent the activation of autoimmune antibodies that cause this inflammation in the first place.

Nutrition

The right diet can help your thyroid function properly, reducing the symptoms of thyroiditis. One study looking at Hashimoto’s thyroiditis found the Mediterranean diet decreased symptoms. While we’ve probably all heard of this diet before, here’s a refresher on what it emphasizes:

• Vegetables
• Whole grains (think: quinoa, brown rice, and oats)
• Legumes (such as chickpeas or lentils)
• Oily fish, in moderation
• Olive oil
• Nuts and seeds

For Hashimoto’s specifically, the study’s authors recommended reducing meat consumption as much as possible and avoiding or limiting lactose or gluten.

Movement

Moving your body daily offers so many benefits, including ones for our thyroid. Exercise improves metabolic health and reduces inflammation in the body, both of which result in better thyroid functioning. While a weightlifting session or six-mile run offers these benefits, any form of movement helps, including less intense workouts like a walk or gentle yoga session.

Stress management

We could all do with a little less stress. This is especially true when managing thyroiditis because stress increases inflammation in the body. In turn, this inflammation can negatively impact the thyroid, says Dr. Eagan. Fortunately, there are steps to take to manage stress levels.

Popular stress management techniques include meditation, journaling, yoga, and mindfulness walks, to name a few. When done consistently, these techniques work quickly. In one study on women with Hashimoto’s disease, participants reported fewer thyroiditis symptoms and lower levels of stress, anxiety, and depression after eight weeks of a stress management program focused on guided meditations, breathwork, and progressive muscle relaxation.

Connecting socially

We won’t harp on the many benefits of social connection (such as better heart health, a lower risk of anxiety and depression, and a longer life expectancy), since you’ve probably heard them before.

But we do want to emphasize one unexpected benefit of social connection: Faster healing for hypothyroidism. A 2021 study found those who experienced a longer duration of hypothyroidism also reported higher levels of loneliness. While researchers are still exploring why this connection exists, it doesn’t hurt to spend more time with friends and family

Healthy sleep habits

Trouble falling or staying asleep can increase inflammation and disrupt thyroid hormones, making unhealthy sleep habits a potential trigger for thyroiditis. Plus, there’s a higher correlation between thyroiditis and sleep disorders like insomnia, obstructive sleep apnea, and restless leg syndrome. If you are suffering from a sleep disorder, you don’t have to suffer alone. A functional medicine provider can help you determine the root cause and create a treatment plan.

Whether you have a sleep disorder or not, we can all benefit from adopting healthy sleep habits:

• Go to bed and wake up at the same time, even on weekends
• Sleep in a cool, dark, and quiet room
• Create a relaxing bedtime routine
• Avoid screens for thirty minutes to an hour before sleeping
• Eliminate late afternoon or nighttime caffeine consumption

When to see a doctor

While lifestyle changes are effective, they’re best undertaken with the expertise of a functional medicine provider. That provider can determine what’s causing thyroiditis, prescribe treatment, and provide guidance on lifestyle changes.

The bottom line: If experiencing unexplained fatigue, weight changes, or persistent neck pain, three of the most common symptoms of thyroiditis, consult a doctor.

Frequently Asked Questions (FAQs)

What is the cause of thyroiditis?

There isn’t one cause of thyroiditis, though the condition does seem to have a genetic component. Many things can trigger the genes associated with thyroiditis, including stress, pregnancy, other autoimmune conditions, and viruses.

Does thyroiditis go away on its own?

Some forms of thyroiditis, such as subacute and silent thyroiditis, may disappear on their own. That said, treating thyroiditis is often more effective with a customized plan created by a functional medicine provider. Seeking medical treatment can also help you avoid serious complications, such as seizures or respiratory failure.

What does an inflamed thyroid feel like?

An inflamed thyroid feels different for everyone. Sometimes, it’s a dull ache radiating from the jaw or ear. Other times, thyroid pain is more severe or there’s no pain at all.

What happens if you have thyroiditis?

Thyroiditis occurs when your thyroid is inflamed, disrupting thyroid hormone production. This often leads to changes in energy levels, fatigue, weight changes, and mood disturbances. With the right medical treatment and lifestyle changes, thyroiditis can be managed successfully.

Is thyroiditis the same as hyperthyroidism?

Thyroiditis isn’t the same as hyperthyroidism. The former refers to an inflamed thyroid while the latter is when the thyroid is overactive. In rare cases, thyroiditis can cause hyperthyroidism, though it typically leads to an underactive thyroid (aka hypothyroidism).

Final thoughts

If experiencing any of the hallmark symptoms of thyroiditis, such as thyroid pain, fatigue, weight gain, or mood changes, seek out a functional medicine provider who can help you treat the root cause. Working with a functional medicine provider often looks like:

• Running diagnostic tests: Blood work and a physical exam are required to diagnose thyroiditis. A doctor will also determine what type is present.
• Recommending medical treatments: Depending on the severity, a doctor may recommend medication to control thyroiditis or manage symptoms.
• Implementing lifestyle changes: No matter the severity, lifestyle changes such as reducing stress or adopting the Mediterranean diet may help. If you don’t already have a functional medicine provider, reach out to our team.

A Parsley Health doctor can provide a consultation on thyroiditis and create a treatment plan that’s customized to your symptoms, triggers, and lifestyle.