Thyroiditis

1. Big picture

Thyroiditis = inflammation and damage of the thyroid gland. The key exam concept is that many thyroiditides cause destructive thyrotoxicosis, meaning preformed thyroid hormone leaks out of damaged follicles. The gland is not truly overproducing hormone, so antithyroid drugs are usually not useful in classic destructive thyroiditis. The typical course is:

thyrotoxic phase → hypothyroid phase → recovery or permanent hypothyroidism

This triphasic pattern is especially typical of subacute de Quervain thyroiditis, painless/silent thyroiditis, and postpartum thyroiditis. Hashimoto thyroiditis usually presents as chronic autoimmune hypothyroidism, sometimes with a transient hyperthyroid phase called hashitoxicosis. ([AAFP][1])

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