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Thyroiditis treatment is aimed at reducing the symptoms depending on their severity: pain, thyrotoxicosis (high levels of thyroid hormones in the blood), or hypothyroidism. Antibiotic treatment may also be necessary if there is infection. The autoimmune cause cannot be addressed as the triggering agent is unknown and the consequences of thyroid disease are minor, and treatable, compared to the side effects of lifelong immunosuppressive treatment.
Pain. The pain associated with subacute thyroiditis is usually controlled with anti-inflammatory drugs, such as aspirin or ibuprofen (gastric protection is advised). Severe pain requires treatment with corticosteroids (prednisone). The medication is reduced progressively. If the patient has required corticosteroid treatment, the dose should be reduced slowly over a period of 1-3 months to avoid relapse.
Thyrotoxicosis. If the thyrotoxicosis produces symptoms of hyperthyroidism, non-selective beta-blocker drugs such as propranolol are recommended. Antithyroid drugs are not used routinely because the symptoms of thyrotoxicosis are due to hormones being released into the blood from the inflamed thyroid and not a result of increased hormone production from the thyroid gland itself. The medications are gradually phased out, because this stage of the disease is temporary and only lasts 1-3 months.
Hypothyroidism. In cases of Hashimoto's thyroiditis, chronic hormone replacement therapy with levothyroxine is started. In the hypothyroid stage of subacute thyroiditis and postpartum hypothyroidism, hormone replacement therapy with thyroxine is given for approximately 6-12 months if there are symptoms or significant analytical alterations. After this, the dose is gradually reduced to assess whether or not thyroid hormone is needed on a permanent basis. In most patients, the thyroid function recovers.
Mireia Mora PortaEndocrinologistNutrition and Endocrinology Department
Published: 14 June 2021
Updated: 14 June 2021
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