Subacute Thyroiditis
Subacute thyroiditis — also called De Quervain thyroiditis — is a painful inflammation of the thyroid gland that typically follows a viral illness. It causes a predictable sequence of thyroid hormone changes as the gland becomes inflamed and then recovers.
It is self-limiting in most people, but the temporary hormone swings can be uncomfortable and need managing.
Last medically reviewed: 15 November 2025
The three phases
In the first phase, inflammation causes stored thyroid hormone to leak into the bloodstream, producing thyrotoxicosis with a tender, enlarged gland — but the radioactive iodine uptake is low because the gland is not overproducing.
This is followed by a hypothyroid phase as hormone stores are depleted, and finally a recovery phase in which most people return to normal thyroid function.
Symptoms and diagnosis
The classic symptom is a painful, tender neck swelling, sometimes with pain radiating to the jaw or ear, along with fever and malaise. Blood tests show raised inflammatory markers and the characteristic hormone pattern.
A low radioactive iodine uptake distinguishes it from Graves’ disease, which is important because the treatments are completely different.
Treatment
Treatment is supportive: anti-inflammatory painkillers, and sometimes a short course of steroids for severe pain. Beta-blockers ease the thyrotoxic symptoms. Antithyroid drugs are not used, because the gland is not overproducing hormone.
Levothyroxine may be given temporarily during the hypothyroid phase if symptoms are significant, but it is often possible to stop it once the gland recovers.
Frequently asked questions
Is subacute thyroiditis permanent?
No — most people recover normal thyroid function within months. A minority are left with lasting hypothyroidism and need long-term treatment.
Is it contagious?
No — it is not contagious. It is thought to follow a viral infection in a susceptible person but cannot be passed to others.
Will I need surgery?
No — surgery is not used for subacute thyroiditis. It is treated with anti-inflammatory medication and symptom control.
References & further reading
This page is based on established medical knowledge and guidelines from authoritative sources. Always consult a qualified clinician for personal medical advice.
Ready to discuss your thyroid health?
Book a specialist consultation — in person or by teleconsultation.