Thyroiditis
Thyroiditis is inflammation of the thyroid gland. Several distinct types exist, and many follow a characteristic pattern: a temporary overactive phase (as stored hormone leaks out) followed by a temporary underactive phase, before the gland usually recovers.
Identifying the type matters because management differs — some resolve spontaneously while others need treatment.
Last medically reviewed: 1 November 2025
Main types
Subacute (de Quervain’s) thyroiditis typically follows a viral illness and causes a painful, tender thyroid. Painless (silent) thyroiditis and postpartum thyroiditis occur without pain; postpartum thyroiditis develops within the first year after delivery.
Hashimoto’s thyroiditis is the chronic autoimmune form covered separately. Drug-induced thyroiditis can follow amiodarone or interferon. Rarer forms include infectious and radiation thyroiditis.
The typical course
Destructive thyroiditis releases pre-formed hormone, causing a thyrotoxic phase lasting weeks to months. The gland then often enters a hypothyroid phase before recovering — though a minority of patients remain permanently hypothyroid, particularly after postpartum thyroiditis.
Radioactive iodine uptake is typically very low during the thyrotoxic phase — a key feature distinguishing it from Graves’ disease.
Diagnosis and management
Diagnosis relies on thyroid function tests showing fluctuating TSH/T4, low iodine uptake (or low vascularity on ultrasound), and sometimes raised inflammatory markers or antibodies. Painful thyroiditis may need anti-inflammatory treatment.
The thyrotoxic phase is usually managed symptomatically with beta-blockers — antithyroid drugs do not help because the hormone is leaking, not being overproduced. Hypothyroidism, if it occurs, is treated with levothyroxine, often temporarily.
Frequently asked questions
Is thyroiditis contagious?
No. Although some forms follow viral infections, the thyroid inflammation itself is not contagious.
Will my thyroid recover after thyroiditis?
Many forms resolve completely. Postpartum thyroiditis leaves about 20% of women permanently hypothyroid, so follow-up testing for at least 12 months is recommended.
Why did my doctor not prescribe antithyroid medication?
In destructive thyroiditis the gland is leaking stored hormone rather than producing excess. Antithyroid drugs block production and therefore do not help; symptom control and monitoring are the correct approach.
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.
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