Thyroid Inflammation

Thyroiditis is an inflammation of the thyroid gland. There are several types of thyroiditis but each of them generally produce three phases: overactive thyroid (hyperthyroidism) underactive thyroid (hypothyroidism) and return to normal. It usually takes one year to complete this cycle. Young to middle-aged women seem most at risk although some forms of thyroiditis are seen in both men and women of all ages. With some forms hypothyroidism may develop years later even if the thyroiditis has resolved.

Signs and Symptoms

Depending on the type of thyroiditis the thyroid gland can have one of the following characteristics.

• Firm and enlarged but not tender
• Enlarged and painful with pain extending to the jaw or ears
• Enlarged but not painful; or enlarged on only one side hard like a stone and sticking to other neck structures

You may also have one or more of the following symptoms.

• Cool dry skin slow pulse rate (less than 60 beats per minute) swelling around the eyes hoarseness or slow reflexes
• No desire to eat feeling tired and unenergetic and a slight fever
• A rapid heartbeat slight nervousness anxiety weight loss of 5 to 10 pounds and increased sweating

What Causes It?

Thyroiditis can be caused by immune disorders viruses and fever disorders. Sometimes thyroiditis develops if you have Graves' disease (a thyroid disorder). In some cases there is no identifiable cause.

What to Expect at Your Provider's Office

Your health care provider will feel your neck to see what the thyroid gland feels like and may order blood tests to check the levels of thyroid hormones and other factors. You may be given pain medication or something to help you feel more normal.

Treatment Options

Treatment Plan

The treatment you receive depends on which of the three phases you are in and the type of thyroiditis you have. Treatment involves drugs both to treat the condition and to relieve pain. For certain types of thyroiditis or for severe cases surgery maybe necessary.

Drug Therapies

Prescription

• Levothyroxine—for large goiter or hypothyroidism with Hashimoto's thyroiditis
• Steroids—relieve pain for severe cases only; various side effects
• Propranolol—for people with too much thyroid hormone; various side effects
• Thyroxine—for symptoms of hypothyroidism; various side effects
• Beta-blockers—used short term for hyperthyroidism; various side effects
• Antibiotics—if there is also infection; various side effects

Over the Counter

• Aspirin—for inflammation and pain relief; various side effects

Complementary and Alternative Therapies

Alternative therapies can help when used along with the medications your provider prescribes.

Nutrition

• Foods that depress thyroid activity are broccoli cabbage Brussels sprouts cauliflower kale spinach turnips soy beans and mustard greens. These foods should be included in the diet for hyperthyroid conditions and avoided for hypothyroid conditions.
• Avoid refined foods sugar dairy products wheat caffeine alcohol.
• Essential fatty acids are anti-inflammatory and necessary for hormone production. Take 1 000-1 500 flaxseed oil mg three times per day.
• Calcium (1 000 mg per day) and magnesium (200 to 600 mg per day) help many metabolic processes function correctly.

Your health care provider may also recommend specific nutritional supplements for a hyperthyroid or hypothyroid condition.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

For hyperthyroid conditions:

• Bugleweed (Lycopus virginica) and lemon balm (Melissa officinalis) help normalize the overactive thyroid.
• Motherwort (Leonorus cardiaca) relieves heart palpitations and passionflower (Passiflora incarnata) reduces anxiety. Combine two parts of bugleweed with one part each of lemon balm motherwort and passionflower in a tincture 30 to 60 drops three to four times per day.
• Quercetin (250 to 500 mg three times per day) is an anti-inflammatory.
• Turmeric (Curcuma longa) makes the effect of bromelain stronger and should be taken between meals 500 mg three times per day.
• Ginkgo biloba (Ginkgo folium) 80 to 120 mg two times per day.

For hypothyroid conditions:

• A combination that supports thyroid function includes herbs rich in minerals. Combine the following for a tea (3 to 4 cups per day) or tincture (20 to 30 drops three times a day): horsetail (Equisetum arvense) oatstraw (Avena sativa) alfalfa (Medicago sativa) gotu kola (Centella asiatica) and bladderwrack (Fucus vesiculosis).

Homeopathy

Homeopathy may be useful as a supportive therapy for both "hyper" and "hypo" conditions of the thyroid.

Physical Medicine

For hyperthyroid conditions:

• Ice packs to the throat will help decrease inflammation.

For hypothyroid conditions:

• Contrast hydrotherapy. Alternate hot and cold applications. Alternate three minutes hot with one minute cold. Repeat three times. This is one set. Do two to three sets per day.
• Exercise helps improve thyroid function.

Acupuncture

Acupuncture may be helpful in correcting hormonal imbalances and addressing underlying deficiencies and excesses involved in thyroiditis.

Massage

Therapeutic massage may relieve stress and increase the sense of well-being.

Following Up

Your health care provider may need to check you each year.

Special Considerations

If you are pregnant or just had a baby you may develop Hashimoto's thyroiditis.

Supporting Research

Blumenthal M ed. The Complete German Commission E Monographs. Boston Mass: Integrative Medicine Communications; 1998:432.

The Burton Goldberg Group compilers. Alternative Medicine: The Definitive Guide. Tiburon Calif: Future Medicine Publishing Inc; 1997.

Ferri FF. Ferri's Clinical Advisor: Instant Diagnosis and Treatment. St Louis Mo: Mosby-Year Book;1999.

Hoffman D. The New Holistic Herbal. New York NY: Barnes & Noble Books; 1995:95.

Murray MT Pizzorno JE. Encyclopedia of Natural Medicine. Rocklin Calif: Prima Publishing; 1998:386–390.

Noble J ed. Textbook of Primary Care Medicine. 2nd ed. St Louis Mo: Mosby-Year Book; 1996.

Tierney Jr LM McPhee SJ Papadakis MA eds. Current Medical Diagnosis and Treatment. Norwalk Conn: Appleton & Lange; 1994.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.