Methods of treatment of various forms of thyroiditis of the thyroid gland. Thyroiditis of the thyroid gland
The term thyroiditis includes diseases in which inflammation occurs. thyroid gland. These diseases differ in symptoms, features of occurrence and course. Before treating thyroiditis, it is worth understanding what form of the disease the patient and the doctor are faced with.
Treatment for these diseases will also vary depending on the degree of dysfunction of the thyroid gland. Violations not related to endocrine system.
Before starting treatment, an examination will be required. Which should accurately determine the type of disease, because only after this the treatment will be as effective and safe as possible. Currently, there are several types of thyroiditis.
Table No. 1. Main thyroiditis and their features:
| Type of thyroiditis | Features of the course of the disease |
| Acute non-purulent thyroiditis | Form acute course. Inflammation is focal or diffuse in nature. They occur due to injuries to the thyroid area or hemorrhages in the thyroid area. |
| Acute purulent thyroiditis | Inflammation is accompanied by the presence of pus or a purulent abscess. Infection causing this state often penetrates from the inflamed scalp, mouth, nose. |
| Inflammation is provoked by viral activity emanating from the upper respiratory tract. Possible damage to a healthy gland by a virus mumps or Epstein-Barr virus. The subacute form may manifest itself sharp pain, inability to swallow and move the head and fever. The silent form does not make itself felt with classic symptoms |
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| Autoimmune thyroiditis(AIT) | The disease occurs when there is a combination hereditary predisposition to autoimmune processes and provoking factors external environment. Provoking factors can be inflammatory diseases of the respiratory system, radiation and, in rare cases, lack of iodine in the diet. The disease often proceeds without specific symptoms, blurred, making itself felt by unpleasant sensations in the throat and a feeling of a lump. With a clear course, the condition changes from a hyperthyroid background to a hypothyroid one, and in the absence of treatment ends in a fibrous form. |
| Fibrous thyroiditis | Destructive form of the disease. Inflammatory processes destroy the organ, dead tissues are replaced by connective tissues with the loss of the gland’s ability to produce the necessary hormones. Fibrous tissue has a dense structure and begins to put pressure on surrounding organs, creating more and more problems. The patient has problems swallowing and hoarseness. Later he disappears completely. The fibrotic form can be the final stage of an autoimmune process or be an independent disease. In the latter case, the cause is considered to be a previous viral infection. |
Important: treatment of this disorder is carried out only after examination, as prescribed and under the supervision of an endocrinologist, since self-medication can aggravate the patient’s condition
How to treat thyroiditis of the thyroid gland will be decided by the attending physician. Depending on the type of thyroiditis, treatment is aimed at one or another factor contributing to the development of thyroiditis (etiological and pathological therapy), as well as at correcting the hormonal levels that arose during the underlying disease.
Medications for the treatment of thyroiditis
Conservative methods of treating thyroid disorders are carried out using several groups of drugs, each group is aimed at relieving a particular problem.
Thyroid drugs
Representatives:
- L-thyroxine.
- Levothyroxine.
- Euthyrox.
- Triiodothyronine.
- Thyroidin.
- Thyrotome.
- Novotiral
They carry a dose of thyroid hormones. Substitute hormone therapy– the main way to treat autoimmune thyroiditis at the stage.
At first, minimal doses are prescribed, and the dosage is increased every three weeks. The size of the individual dose depends on many factors that determine whether the drug will be lifelong.
Glucocorticosteroids
Representative - Prednisolone. Contains adrenal hormones. Works as a powerful anti-inflammatory agent that helps prevent the formation of antibodies to the thyroid gland.
Allows you to relieve intoxication of the body, relieve pain, and affect the functioning of metabolic processes in the body. Treatment begins with high dose, gradually, every six days, the dosage is reduced to a maintenance level. The drug should not be discontinued abruptly; the dose and number of uses are reduced gradually.
Antibiotics
Representatives:
- Cephalosporins.
- Penicillin drugs.
- Other agents with antibiotic activity.
The wide range of effects of these groups makes it possible to destroy the pathogenic pathogen that provokes the development of acute purulent form of thyroiditis.
Nonsteroidal anti-inflammatory drugs
Representatives:
- Methindol.
- Indomethacin.
- Indovis.
- Indotard.
- Indobene.
Fights inflammatory processes in the tissues of the thyroid gland. Reduces the likelihood of the appearance of antibodies to the thyroid gland, anesthetizes the thyroid gland area in the presence of pain. The standard course of treatment is 5 days, the maximum allowable is 7 days.
Local painkillers
Representative – Diclofenac ointment. Compresses on the thyroid area will help relieve inflammation and eliminate pain.
Beta blockers
Representatives:
- Propranolol.
- Inderal.
- Anaprilin.
- Obzidan.
The drugs help eliminate arrhythmia, reduce arterial pressure, reduce tremors, eliminate headaches. Normalize heart rhythms and improve blood supply to the vessels of the head.
For patients suffering from thyroiditis, they help cope with heart problems, increased heartbeat and other heart problems due to hypothyroidism. Reception begins with small doses, gradual increase is possible.
Immunomodulators
Representatives:
- Levamisole;
- Decaris.
They modulate the functioning of the immune system, stopping the production of antibodies to the own thyroid gland. They have the effect of generally strengthening the immune system.
Antihistamines
Representatives:
- Tavegil;
- Diazolin;
- Loratadine.
The drugs help relieve tissue swelling, which helps to quickly cure inflammation of the affected thyroid gland. Depending on the instructions, they can be taken once or twice a day. Photos and videos in this article will demonstrate the variety of drugs for the treatment of thyroiditis.
Treatment of thyroiditis
Important: with timely treatment autoimmune thyroiditis, the prognosis is quite favorable.
Treatment for each disease will be carried out according to its own scheme, depending on the main point of damage. The stage of the disease at which treatment was started is also important, for example, the answer to the question - how to cure autoimmune thyroiditis will depend on the stage of the disease.
Table No. 2. Types of disease and possible treatment regimen:
| Type of thyroiditis | Prescribed drugs |
| Acute purulent thyroiditis |
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| Acute non-purulent thyroiditis |
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| Subacute thyroiditis |
|
|
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| Chronic fibrous thyroiditis |
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Important: synthetic thyroid hormones prescribed for insufficient functioning of the gland provoke a lot of side effects, violations menstrual cycle in young women, problems with cardiovascular system in persons over 45 years of age.
Surgical methods for treating thyroiditis
Important: replacement therapy does not solve the problem - does not restore the functioning of the organ; over time, the patient needs to increase the dosage.
Surgery may be required if various states thyroid gland.
Opening and draining the abscess
Manipulation is required for acute purulent thyroiditis with the formation of an abscess. Performed using local anesthesia. Damaged tissue are completely removed. The outflow of purulent masses is ensured by installing drainage. Local administration of antiseptic drugs is carried out.
Thyroidectomy or removal of the thyroid gland
Removal surgery is performed for the following indications:
- with a combination of chronic thyroiditis and second-degree hypertrophy of the gland, surgical intervention is sometimes the only method to treat chronic thyroiditis;
- with pressure from the altered gland on the trachea or esophagus;
- if therapy does not show adequate results and the growth of the affected thyroid gland continues;
- when particularly large nodular formations are detected on the body of the gland or there is a possibility of degeneration of formations from benign to malignant.
Before surgery, a comprehensive examination is necessary. If necessary, cardiovascular problems are treated before surgery, and glucose levels are normalized if they deviate from the norm.
Removal of the gland can be of several types:
- partial removal of the gland– hemithyroidectomy;
- subtotal removal– it preserves the upper parts of the gland;
- total removal of all tissue– strumectomy.
Important: after total removal of the organ, the patient will undergo lifelong hormone replacement therapy due to persistent hypothyroidism.
The thyroid gland is removed in accordance with the following steps:
- the patient is given general anesthesia;
- the doctor makes a transverse incision in the neck;
- the gland is exposed and the surgeon decides on the volume of manipulation;
- blood vessels and skin are sutured;
- The extracted tissues of the damaged gland are sent for histological examination.
Important: for treatment endocrine diseases The use of traditional medicine is not recommended.
Thyroiditis and folk remedies
Many sick people are afraid classical methods treatment, they begin to wonder whether autoimmune thyroiditis can be cured using traditional medicine. The remedies used in home treatments can have a very strong effect on hormonal metabolism.
It is quite difficult to determine the correct dosage of herbs from which compresses and lotions are made. Active components home medicine if used incorrectly, they can aggravate the disease and worsen the patient’s condition or negate all progress from traditional treatment.
Thus, it is not recommended to use traditional methods to treat thyroid diseases. Cost of use unconventional method treatment is too high. By starting the pathological process using an unprofessional approach, you can deprive the patient of the possibility of recovery and the ability to lead a full life.
Diet for thyroiditis
Proper nutrition is one of the components of successful treatment. Special diet- this is what can be used to treat thyroiditis of the thyroid gland, along with a well-chosen medication regimen.
Compliance therapeutic diet will help:
- improve the patient’s condition, a lighter diet eliminates unnecessary stress on the digestive organs;
- To bring recovery and normalization of the condition closer, a balanced diet will allow medications to be better absorbed by the body, providing maximum impact.
The basis of the diet for thyroid problems is the presence in the diet of what is necessary for normalization hormonal regulation and improving the well-being of the thyroid gland vitamins. So the patient’s food should be saturated with iodine, essential vitamins, calcium and fiber of plant origin.
Normal protein levels should be maintained while dietary fat and carbohydrates are reduced. In this case, the daily calorie content should be maintained at least 2000 kcal.
Sufficient water consumption is important; it should be at least two liters per day. Diet may have individual characteristics and instructions that their presence should be consulted with the treating endocrinologist before treating thyroid aitis or any other form of this disease.
You can create a healthy diet using the following products:
- seafood, but you need to make sure that there is no excess cholesterol content;
- seaweed;
- meat products with low fat content (turkey, rabbit, veal);
- products with bran;
- cereals;
- fruits and vegetables prepared by any method other than frying;
- dairy products;
- juices high in vitamins, freshly squeezed.
Prevention of recurrence of the disease
Most people think about the quality of their lifestyle only after receiving a diagnosis or after completing serious treatment. Preventive actions to prevent endocrinological diseases are no different from standard rules healthy lifestyle.
There is nothing complicated about them, but by following them you can protect yourself from a large number of health problems with your own hands and prolong your life.
So, you can protect yourself from the primary or recurrent occurrence of thyroiditis by the following actions:
- Compliance with the rules healthy eating and adequate physical activity.
- Maintaining sleep and wakefulness.
- Prevention and timely treatment of respiratory and colds. Vaccinations and seasonal intake of vitamin complexes.
- Quitting habits that harm the body. Elimination of promiscuity and prevention of sexually transmitted diseases.
- If you feel unwell or have any complaints, you should contact a specialist and not self-medicate. Uncontrolled use of iodine preparations, antibiotics, and drugs that affect the immune system can provoke the development of a serious disease.
- It is necessary to protect your body from being in potential hazardous areas. Avoid distribution area radiation exposure, severe pollution of air, water and food.
- Preventive examination of all organs and systems. The use of iodine-containing drugs only after they have been prescribed by an endocrinologist.
Any person after undergoing treatment for such a serious disease as thyroiditis needs to consult a specialist. Must be issued by a doctor individual instructions about the recommended lifestyle, based on the amount of therapy performed and the likelihood of relapse of the condition.
Thyroiditis is a condition that requires constant attention on the part of the patient to the function of his thyroid gland. If you suspect it, you should definitely visit an endocrinologist to find out how to treat thyroiditis.
Most commonly diagnosed inflammatory disease of the thyroid gland is called thyroiditis. That this is the most common thyroid disease in the world and the second most common among all diseases of the endocrine system (after diabetes mellitus), WHO publications also testify. However, there are no exact statistics, since the disease has a complex etiology. Some scientists believe that thyroiditis affects up to 50% of the population.
Thyroiditis of the thyroid gland - what is it?
Under common name“thyroiditis” is a group of inflammatory diseases of the thyroid gland. As a result of inflammation of the gland tissue, the production of thyroid hormones first increases significantly, hyperthyroidism occurs, and then the inflamed gland produces them less than normal (hypothyroidism occurs).
In some cases, the inflammatory process affects a small part of the thyroid gland, which happens rarely, the entire lobe (most often) or the entire gland. With a complicated course of thyroiditis, suppuration occurs, it can break through the skin, which is fraught with the penetration of pus into the blood and the development of sepsis.
Important. The most common type is autoimmune thyroiditis (Hashimoto's). In this form, the body begins to perceive healthy thyroid tissue as foreign and produces antibodies to it.
At initial examination It is quite difficult to establish the type and cause of thyroiditis of the thyroid gland. What it is can be said with certainty only after a series of tests.
Causes
The most common causes of thyroiditis are infectious diseases: tuberculosis, syphilis, influenza, hepatitis A, measles, etc.
Some scientists consider endemic goiter to be one of the reasons for the development of thyroiditis.
In autoimmune forms, the cause is a malfunction of the immune system. This form of thyroiditis occurs much more often in women than in men. The most likely age range is considered to be 40–50 years. However, doctors are increasingly detecting the disease in people much younger than this age.
Among the causes of inflammatory processes in the thyroid gland are also called:
- long stay in an area with a high radioactive background;
- frequent irradiation of the head;
- living in an area poor in iodine;
- consuming too much iodine in food;
- frequent colds and infectious diseases, etc.
Types, forms of thyroiditis and their symptoms
Thyroiditis has many classifications according to various characteristics:
- Depending on the etiology, they are distinguished: syphilitic, septomycosis, tuberculosis and other types.
- Based on age, it can be divided into juvenile, senile, postpartum, etc.
- Inflammation can be classified as autoimmune thyroiditis or fibrotic thyroiditis.
The most widely used classification is according to the course of the disease: acute, subacute and chronic.
Acute form
This form of thyroiditis occurs rarely, it is considered the most severe, and can affect both the entire gland and part of it. With this disease, the lymph nodes in the neck become enlarged.
Acute thyroiditis can be purulent or non-purulent (aseptic).
Acute purulent thyroiditis
An abscess occurs in the thyroid gland. At the same time, body temperature rises to 39 ⁰C. It is painful for the patient to swallow. The pain intensifies when turning the neck and head, radiating to the back of the head, ears, and jaw. A strong headache and irritability against the background of general intoxication of the body.
The thyroid gland itself becomes dense at first, and then, after the formation of an abscess, soft, swollen and painful. Pain occurs when touching the organ.
Important. With purulent thyroiditis, the patient’s condition in most cases is assessed as extremely serious.
Acute non-purulent thyroiditis
With this type of thyroiditis, suppuration does not occur, only inflammation in a certain area of the thyroid gland. Symptoms of non-purulent acute thyroiditis are less pronounced. The patient's condition is assessed as moderate.
Subacute form
This form of thyroiditis is characterized by a slow, gradual increase in symptoms. At first, the pain in the neck area is minor. Swallowing only causes discomfort. Gradually, the symptoms intensify: the pain becomes severe, radiates to the ears, jaw, back of the head, it becomes more and more difficult to swallow, the body temperature rises to 38 ⁰C, while (not always) the cervical lymph nodes become enlarged.
The course of the disease is long: up to 1.5–2 months. A study of hormonal levels reveals a decrease in radioactive iodine in the body, thyrotoxicosis, and a decrease in hormone levels.
Subacute thyroiditis responds well to treatment and usually results in recovery.
Chronic form
It has a very long period of occurrence: up to 6–8 months. The most common chronic form is autoimmune thyroiditis (Hashimoto's thyroiditis). It affects approximately 6, and according to some data, up to 15 times more often women than men.
However, chronic inflammation of the thyroid gland causes more severe symptoms in men. With a long course, a decrease in body temperature, a slowdown in metabolic processes in the body, memory loss, lethargy, fatigue, bad dream, digestive disorders, decreased fertility.
In invasive fibrous goiter (Riedel's disease), inflammation of the thyroid gland also occurs chronically. Among some scientists there is an opinion that the chronic form almost always occurs when there is various types endemic goiter.
Once again about the symptoms
Important! IN initial stage Symptoms of thyroiditis are vague, they can be characteristic of diseases of other organs of the neck, and of other diseases of the thyroid gland. Acute thyroiditis manifests itself most clearly.
Common symptoms of thyroiditis include:
- enlargement of the thyroid gland or part thereof;
- redness of the skin of the throat;
- pain when swallowing and turning the head.
At acute inflammation thyroid symptoms will appear sharply:
- pain in the neck, even when turning the head;
- problems with swallowing;
- increased body temperature, chills;
- enlarged cervical lymph nodes.
In subacute thyroiditis, symptoms appear gradually, pain in the neck increases slowly. There is a constant headache, weakness, sweating and a feeling of heat. There is tremor of the fingers. The skin over the thyroid gland turns red and swells, and the thyroid gland is painful on palpation.
In chronic autoimmune thyroiditis, the symptoms described above are accompanied by weight loss, tachycardia, tinnitus, and pain in the back of the head.
Autoimmune inflammation of the thyroid gland in women has less pronounced symptoms; in men, the disease is acute and the symptoms are pronounced.
Treatment of thyroid inflammation
Treatment of thyroiditis has several directions:
- it is important to restore hormonal balance, if one is violated. For this purpose, treatment is carried out with tyrostatics (Mercazolil, Thiamazol).
- Non-steroidal anti-inflammatory drugs for thyroiditis (Metindol, Voltaren, Indomethacin) will help relieve inflammation, reduce swelling and soreness of the gland.
- Corticosteroid drugs (Prednisolone) for thyroiditis are used if its subacute form develops. They relieve inflammation, swelling and pain well.
- Also prescribed vitamin complexes, immune stimulants, adaptogens.
Acute purulent thyroiditis will require surgical treatment. Here, when an abscess occurs, it is opened and drained. In parallel, intensive detoxification therapy and antibiotic injections are prescribed.
For autoimmune inflammation of the thyroid gland in women, treatment is carried out for a long time. Thyroid hormones are often prescribed for life.
In case of development of compression of the neck organs in chronic or subacute thyroiditis, surgical removal glands (thyroidectomy).
About folk remedies
He also offers his own recipes on how to treat thyroiditis. ethnoscience. The most common is rubbing the goiter with infusions. For this they use alcohol infusion green pine cones or extracts from their collection of herbs: cocklebur, celandine, chamomile and meadowsweet.
Juice therapy is also used; lemon, beet and carrot juices are used to treat pathology.
Symptoms of thyroiditis usually occur after an acute respiratory infection.
Subacute thyroiditis
Subacute thyroiditis (De Quervain's thyroiditis, or granulomatous thyroiditis) is an inflammatory disease of the thyroid gland, most likely caused by a viral infection. The viral nature of this thyroiditis is evidenced by the presence of mumps viruses, Coxsackie viruses and adenoviruses in biopsies of the thyroid gland or an increase in the titer of antiviral antibodies in the blood of patients. In a moderately enlarged thyroid gland there are signs of lung inflammation involving the capsule. Histological examination reveals destruction of the gland parenchyma and a large number of large phagocytes, including giant cells. Subacute thyroiditis most often develops in the summer months, in women and in carriers of the HLA-Bw35 antigen.
Symptoms and signs of subacute thyroiditis of the thyroid gland
Subacute thyroiditis begins with the appearance of malaise, asthenia, fever, and pain in the suprathyroid area. Subacute thyroiditis is characterized by high ESR. Its manifestations decrease after about 2 weeks. The duration of the disease is 8-12 weeks.
Patients usually have a fever, malaise and pain in the front of the neck, spreading to the angle of the jaw and up to the ear on one or both sides. Initially, patients may complain of palpitations, irritability and sweating; Clinical examination reveals tachycardia, tremor and hyperreflexia. There is no ophthalmopathy. The gland is so painful that the patient does not allow him to touch it. However, signs local abscess(redness and increased skin temperature) are also absent.
Diagnosis of subacute thyroiditis
Laboratory test results change as the disease progresses. Initially, the levels of fT 4 and T 3 increase, and the concentration of TSH in the serum and in the thyroid gland decreases sharply. Since the increased content of thyroid hormones in the blood is due to the release of their ready reserves from the gland, the ratio of FT 4 and T 3 in the serum exceeds the norm. Significant increase in ESR, which, when determined by the Westergren method, sometimes reaches 100 mm/hour or more. Antithyroid autoantibodies are usually absent in serum. As the disease progresses, fT4 and To levels decrease, TSH levels increase, and symptoms of hypothyroidism develop. Later, the thyroid gland increases, which reflects the restoration of its function after acute damage.
Subacute thyroiditis differs from other viral diseases by affecting the thyroid gland. It is distinguished from Graves' disease by gland tenderness, low PR against the background of elevated levels of T 3 and fT 4 in the serum and decreased TSH levels, as well as the absence of antithyroid autoantibodies.
Treatment of subacute thyroiditis of the thyroid gland
In many cases it is only necessary symptomatic treatment(eg, aspirin or other non-steroidal anti-inflammatory drugs). In case of severe disease or no effect non-steroidal drugs Glucocorticoids may be required (eg, prednisone 20 mg/day three times a day for 7-10 days). To alleviate the symptoms of hyperthyroidism in the initial phase of the disease, β-blockers are used. If symptoms of hypothyroidism appear, T 4 can be prescribed at 0.1-0.15 mg once a day. Treatment with T4 prevents the increase in TSH levels, which contributes to exacerbation inflammatory process in the thyroid gland.
Course and prognosis of subacute thyroiditis of the thyroid gland
Subacute thyroiditis usually resolves spontaneously after a few weeks or months. Sometimes the disease progresses in waves, and improvement is replaced by repeated exacerbation. In some cases, one lobe of the gland is first affected, and then the second (migrating, or “creeping” thyroiditis). An exacerbation can occur against the background of a decrease in the level of FT4, when the TSH level begins to increase and the function of the thyroid gland begins to recover. Sometimes the disease continues for years with repeated outbreaks of inflammation. Up to 90% of patients recover completely, but in approximately 10% of cases persistent hypothyroidism remains, requiring long-term treatment T 4.
Acute thyroiditis
Acute inflammation of the thyroid gland. Divided into primary and secondary.
Causes of acute thyroiditis
Primary thyroiditis is caused by primary damage to the thyroid gland by infection, secondary thyroiditis is a complication after infectious diseases (sore throat, influenza, typhoid fever, etc.). The process begins in one of the lateral lobes and gradually spreads to the entire gland.
Symptoms and signs of acute thyroiditis
Painful swelling of the thyroid gland; its consistency is dense, the pain radiates behind the ears. General weakness, neutrophilic leukocytosis, accelerated ROE, low-grade or heat. With purulent melting of the gland, hectic temperature; fluctuation can be detected by palpation in the area of the enlarged thyroid gland.
Diagnosis usually uncomplicated. Difficulties may arise when differential diagnosis between acute thyroiditis and hemorrhage into the thyroid gland (or goiter), in which similar symptoms. Hemorrhage is characterized by a more rapid reverse development of the process and less pronounced general disorders.
Forecast favorable for life; more serious with the development of a purulent process if surgical treatment is not undertaken in a timely manner. A possible complication of acute thyroiditis is fibrosis of the thyroid gland with the development of hypothyroidism.
Treatment of acute thyroiditis
Bed rest. Local and general treatment, as with any local bacterial inflammation. Treatment with antibiotics in combination with prednisolone is recommended.
Chronic thyroiditis
In the USA, chronic thyroiditis (Hashimoto's thyroiditis, lymphocytic thyroiditis) is the most common cause hypothyroidism and goiter. It is likely the leading cause of goiter in children and young adults and is responsible for “idiopathic myxedema,” which is the final stage of Hashimoto's thyroiditis with complete destruction of the thyroid gland. Riedel's thyroiditis may be a very rare variant of Hashimoto's thyroiditis, characterized by extensive fibrosis extending into adjacent tissue. Riedel's goiter, which has a stone-dense consistency, should be distinguished from thyroid cancer. This disease is also associated with fibrosis of other tissues, including the mediastinum and retroperitoneum.
Causes of chronic thyroiditis
Hashimoto's thyroiditis is classified as an autoimmune disease characterized by sensitization of lymphocytes to thyroid antigens and the production of autoantibodies that interact with these antigens. The most important role in Hashimoto's thyroiditis is played by autoantibodies to thyroglobulin and TPO, as well as antibodies that block TSH-R. In the early stages of the disease, the titer of autoantibodies to thyroglobulin is increased to a greater extent than the titer of antibodies to TPO. Antithyroglobulin antibodies may disappear later, but TPO antibodies persist for many years. In patients with atrophic thyroiditis and myxedema, as well as in mothers whose children are born with athyroid cretinism (i.e., absence of thyroid tissue), thyroid-blocking autoantibodies may be present in the serum. In the thyroid gland with Hashimoto's thyroiditis, pronounced lymphocytic infiltration is detected, disrupting normal structure organ. Lymphoid follicles and germinal centers often form. The surviving epithelial cells are usually enlarged and contain eosinophilic cytoplasm (Hurthle cells). Destruction of the gland is accompanied by a decrease in T 3 and FT 4 levels and an increase in the concentration of TSH in the serum. Initially, increased secretion of TSH, leading to the development of goiter, compensates for the deficiency of thyroid hormones, but often the size of the thyroid gland begins to decrease, and the process ends in hypothyroidism.
Hashimoto's thyroiditis occupies an intermediate position on a spectrum of diseases, with Graves' disease at one end and idiopathic myxedema at the other. It is a familial disorder and may be associated with other autoimmune disorders, including pernicious anemia, adrenal insufficiency, idiopathic hypoparathyroidism, myasthenia gravis, and vitiligo. The combination of Hashimoto's thyroiditis with idiopathic adrenal insufficiency and (often) type 1 diabetes mellitus is called Schmidt's syndrome, or autoimmune polyglandular syndrome.
Symptoms and signs of chronic thyroiditis of the thyroid gland
Hashimoto's thyroiditis usually presents as a goiter; In patients with this, euthyroidism remains or there is mild hypothyroidism. This disease occurs 4 times more often in women than in men. There is no pain, and patients sometimes pay attention to the goiter only if it is very large sizes. In older patients with severe hypothyroidism, the thyroid gland may be small and dense (idiopathic myxedema).
Diagnosis of chronic thyroiditis
Studies reveal multiple disorders of iodine metabolism. Due to the decrease in the activity of TPO, its organization is disrupted, which is proven by the positive results of the test with perchlorate. The thyroid gland can be either high, normal or low. Serum thyroid hormone levels are usually normal or slightly decreased; in the latter case, the TSH concentration is increased.
Most a clear sign is a high titer of autoantibodies to thyroid antigens. Most patients have serum autoantibodies to thyroglobulin or TPO. Diagnostic value also has FNA, which detects lymphoid infiltration of the thyroid gland and the presence of Hürthle cells in it.
Hashimoto's thyroiditis is distinguished from non-toxic goiter caused by other causes, by determining antithyroid autoantibodies in the serum and (if necessary) using FNA.
Complications and consequences of chronic thyroiditis of the thyroid gland
The main complication of Hashimoto's thyroiditis is progressive hypothyroidism. Most patients initially experience a small goiter and “subclinical hypothyroidism,” characterized by normal level fT, and T 3 in the serum against the background slightly high content TSH (usually less than 10 mU/l). Such shifts distinguish subclinical hypothyroidism from “overt” hypothyroidism, which is characterized by a decrease in the level of FT 4 . The question of the need to treat subclinical hypothyroidism remains open. In some patients it can be found lung symptoms hypothyroidism, elevated lipid levels and other risk factors for coronary heart disease. Over time, overt hypothyroidism may develop, especially with a high titer of antithyroid autoantibodies in the serum. On the other hand, most patients have no symptoms of hypothyroidism (especially when TSH levels are below 10 mU/L), and the increased risk of atherosclerosis in these cases is not recognized by everyone.
One type of Hashimoto's thyroiditis is called "silent" or "painless." If it develops into postpartum period(approximately 5% of cases), it is called “postpartum thyroiditis.” Most patients have symptoms and signs of hyperthyroidism, which are difficult to distinguish from mild Graves' disease. Eye symptoms are absent, and the thyroid gland, unlike subacute thyroiditis, is painless on palpation. The level of fT4 in the serum is increased to a much greater extent than the level of T3, which is typical for all forms of thyroiditis, accompanied by the leakage of ready-made thyroid hormones into the blood. In contrast to subacute thyroiditis, ESR remains normal, and the titer of autoantibodies to TPO is increased. It is important to emphasize that the thyroid gland in 24 hours is not increased, but decreased, and by this indicator it is easy to distinguish Hashimoto's thyroiditis from Graves' disease. “Silent” thyroiditis, like subacute thyroiditis, occurs in three phases: the hyperthyroidism phase, which lasts 1-3 months, is followed by a hypothyroidism phase of approximately the same duration. The hyperthyroid phase of postpartum thyroiditis usually begins 3-4 months after birth. Most patients recover completely, but approximately 25% of women develop subclinical hypothyroidism after childbirth, which over time (sometimes after many years) can progress to overt hypothyroidism. Therefore, such patients require long-term observation. Recurrences of “silent” thyroiditis are also possible, especially during subsequent pregnancies.
In rare cases, patients with Hashimoto's thyroiditis develop thyroid lymphoma. Although its causes are unknown, Hashimoto's thyroiditis is certainly a risk factor for this disease. It is possible that thyroid lymphoma develops as a result of the expansion of an abnormal clone of intrathyroid lymphocytes capable of unlimited division. Thyroid lymphoma is characterized by rapid growth despite T4 therapy. Diagnosis requires surgical biopsy.
There is no data on an increase in the incidence of thyroid cancer in patients with Hashimoto's thyroiditis, but both processes can develop simultaneously in the same gland. Cancer should be suspected in cases rapid growth node or the absence of its regression under the influence of T 4 doses that reduce TSH level in serum. Essential in such a situation acquires TAB.
Treatment of chronic thyroiditis of the thyroid gland
Indications for treatment of Hashimoto's thyroiditis include goiter or overt hypothyroidism. The mere presence of antithyroid autoantibodies in serum does not require treatment. Surgery Hashimoto's thyroiditis is performed only in cases where the goiter does not decrease and symptoms of pressure on surrounding tissues persist. The need for treatment of subclinical hypothyroidism remains controversial.
However, it is often carried out:
- in the presence of mild symptoms of the disease;
- with dyslipidemia, which they hope to eliminate with thyroid hormones;
- with high titers of antithyroid autoantibodies, threatening the development of overt hypothyroidism.
T4 is prescribed in doses that normalize serum TSH levels and cause regression of goiter.
Treatment of “silent” or postpartum thyroiditis depends on the patient’s thyroid status. In the hyperthyroidism phase, β-blockers can be used to eliminate symptoms such as tremor, palpitations and irritability, and T4 in the hypothyroidism phase, although usually the symptoms of hypothyroidism are so mild that treatment can be avoided.
Course and prognosis of chronic thyroiditis
With Hashimoto's thyroiditis, if left untreated, over many years, overt hypothyroidism develops, which severe cases can lead to myxedema or even myxedema coma. Treatment with T4 usually eliminates goiter (though not always completely) and symptoms of hypothyroidism.
Because Hashimoto's thyroiditis may be part of autoimmune polyglandular syndromes, patients should be evaluated for other autoimmune diseases, such as pernicious anemia, adrenal insufficiency and type 1 diabetes mellitus. Patients with Hashimoto's thyroiditis may also develop true illness Graves, sometimes with severe ophthalmopathy or dermopathy. In the setting of chronic thyroiditis, thyrotoxicosis is usually less severe, and patients may have eye or skin symptoms without significant thyrotoxicosis. This syndrome is often called euthyroid Graves' disease. Treatment of ophthalmopathy and dermopathy in these cases is carried out in the same way as for Graves' disease with thyrotoxicosis.
Autoimmune thyroiditis
Symptoms and signs. Autoimmune thyroiditis develops gradually with subclinical manifestations of thyroid insufficiency. Complaints of weakness.
Diagnostics. High titers of anti-thyroglobulin or anti-microsomal antibodies are important.
Other forms of thyroiditis
For septicemia, acute infective endocarditis or local spread of pharyngeal infection, abscesses may form in the thyroid gland. People with weakened immune systems sometimes develop an opportunistic infection in the thyroid gland (aspergillosis, mycobacterial and pneumocystis infections). Abscesses are accompanied by symptoms purulent infection: local pain and tenderness, swelling and redness of the skin over the gland. The diagnosis is confirmed microbiological examination aspiration biopsy. Antibiotics are used, and sometimes an incision is used to drain the inflammation. Acute purulent thyroiditis can be a consequence of infection of the glossothyroid duct cyst. In such cases, antibiotics or drainage of the inflammatory focus are also used.
This disease is more common in people aged 30 to 50 years. Women, unfortunately, are more susceptible to autoimmune thyroiditis.
Autoimmune thyroiditis: symptoms and treatment
Autoimmune thyroiditis (AIT) is an autoimmune disease and the main cause of hypothyroidism.
This disease causes significant inflammation of the thyroid gland, which leads to low production of its hormones and gradually - to hypothyroidism.
AIT is called an autoimmune disease because the immune system produces antibodies that attack the thyroid tissue.
Traditional medicine does not treat autoimmune thyroiditis, but treatment with folk remedies may well help some people completely get rid of this disease or at least improve the condition and prolong life.
This disease is more common in people aged 30 to 50 years. Women, unfortunately, are more susceptible to autoimmune thyroiditis.
Symptoms of AIT may vary depending on the stage of the disease.
Symptoms of autoimmune thyroiditis in the early stages:
weight gain
fatigue
joint pain
muscle pain
cold intolerance
pale skin
hair thinning
constipation
depression
Symptoms of autoimmune thyroiditis in the later stages:
decline taste sensations and sense of smell
swelling of the face, arms and legs
a sore throat
dry skin
irregular periods
eyebrow loss
slow speech
Symptoms that can be observed at different stages of AIT:
loss of appetite
swelling in other parts of the body
drowsiness
hair loss
joint stiffness
dry hair
decreased coordination of body movements
muscle atrophy, pain and cramps
In medicine, it is prescribed for the treatment of hypothyroidism hormone replacement therapy – patients accept synthetic hormones thyroid gland for the rest of your life. This is due to the fact that over time the thyroid gland produces less and less hormones T4 and T3, which the body desperately needs.
Diagnostic procedures for detecting hypothyroidism are often unreliable, and multiple consecutive tests often produce different results. This is why some people start taking hormonal medications for a condition that they don't actually have until they start the medication regimen.
People who take pharmaceutical hormones are much more difficult to treat than those who do not start taking them or those who immediately start using traditional medicine.
There are many ways to control the symptoms of autoimmune thyroiditis naturally. Many folk remedies can help those who suffer from this disease.
Coconut oil is one of the most powerful healers in the world of natural remedies. If you suffer from autoimmune thyroiditis or hypothyroidism, enriching your daily diet with coconut oil will be one of the best things you can do for your body.
Treatment of autoimmune thyroiditis with coconut oil
Coconut oil is saturated fat, which is mainly composed of medium chain fatty acids. These fatty acids in oil are known as medium chain triglycerides (MCTs). These medium chain fatty acids help speed up metabolism, increase your basal temperature body, weight loss and increased energy.
Lauric acid makes up more than 50% of MCTs. It is an essential fatty acid and is used by your body to build and maintain the immune system. All these factors together have a positive impact on the thyroid gland.
There are several other equally important fatty acids present in coconut oil that help keep the body healthy. high level. Linoleic acid- polyunsaturated fatty acid, which is one of the main products used in the production of weight loss products, sold in capsules as food additives entitled conjugated linoleic acid(CLA). This "good" fat has been found in several clinical studies, helps reduce fat mass.
Another important connection is oleic acid, which is an omega-9 unsaturated fatty acid. Besides coconut oil, this acid is also a basic compound olive oil, which is also very useful to use for autoimmune thyroiditis. This acid has been found to increase lipoprotein levels high density(PAP - " good cholesterol") and at the same time reduces the level of low-density lipoproteins (LDL - “bad cholesterol”).
If you have autoimmune thyroiditis or hypothyroidism, you should consume at least 4 tablespoons of coconut oil per day. This may seem like a lot of coconut oil to you, but it really isn't.
For autoimmune thyroiditis and hypothyroidism Special attention needs to be addressed in your diet.
Other folk remedies for the treatment of autoimmune thyroiditis
The following folk remedies can also help you improve your condition and reduce the symptoms of autoimmune thyroiditis.
Essential oils
Essential oils can help you in the treatment of autoimmune thyroiditis and hypothyroidism:
- myrtle,
- myrrh,
- peppermint,
- spearmint,
- carnations.
You can apply them directly to your skin or inhale their vapors using an essential oil diffuser.
Bach flowers
This is a flower essence treatment that is used to control many of the symptoms of autoimmune thyroiditis and hypothyroidism. The following three essences are the most effective in treating patients with autoimmune thyroiditis.
Wild Rose. Take two drops of wild rose essence and mix them in water. Drink this water throughout the day. This remedy relieves fatigue and depression associated with autoimmune thyroiditis.
Elm. Take two drops of elm essence and mix them in water. Drink this water throughout the day. This remedy helps restore health in cases of autoimmune thyroiditis.
Wild apple tree. Take two drops of wild apple essence and mix it in water. Drink this water throughout the day to cleanse your body.
Milk thistle tea
Milk thistle tea is known for its powerful detoxifying properties. You can drink a cup of this tea daily to help your body eliminate toxins.
Pears and apples
The ancient Chinese discovered that pears were powerful natural remedy, balancing hormones, especially in women. Pears help normalize well hormonal background, if consumed together with apples (you can make pear-apple puree or pear-apple juice). published
The materials are for informational purposes only. Remember, self-medication is life-threatening; consult a doctor for advice on the use of any medications and treatment methods.
Among thyroid diseases, a special place is occupied by chronic illness, called chronic - chronic thyroiditis, which is the second most common disease among endocrine system diseases after diabetes mellitus. The autoimmune form is generally the most common autoimmune disease in the world. Medicine does not have accurate statistics on the incidence of chronic thyroiditis, although it believes that almost half of the entire globe has manifestations of varying degrees. What's happened ?
Thyroiditis is a chronic disease with a history going back centuries.
The first mentions of pathological changes in the gland are found in medical treatises Ancient China. Already in those days, people knew about such ailments as goiter, cretinism, and it was also known that the use of algae as a treatment helps to cure a chronic disease or prevent its occurrence.
Later, already in the 20th century, scientists began to conduct more scientific research on the thyroid gland and were able to prove the effect of iodine on its normal functioning and the elimination of some diseases of the organ, in particular goiter.
In 1912, a scientist from Japan by the name of Hashimoto proved that diseases of the thyroid gland, namely neoplasms in the organ, do not always depend on the quantitative content of iodine in the body, which later made it possible to draw a conclusion about completely different reasons for the development of diseases, in particular, thyroiditis. In the mid-20th century, a pair of scientists modeled the disease that Hashimoto had suggested in his studies in animals, which provided evidence of the autoimmune nature of the chronic disease. It was from this moment that the correct vector was laid in the research of thyroiditis, which continues to develop to this day.
Thyroiditis of the thyroid gland - what is it?
The term thyroiditis is understood as a collective image of a large number of inflammations in the thyroid gland, which relate to pathological processes. Each individual case included in the general array called “thyroiditis” has its own etiology and pathogenesis.
The general group is divided into three collective subgroups that characterize the main forms of the disease:
- acute thyroiditis. This type can have a purulent or non-purulent form, and most often the course of the disease is accompanied by the development of local foci of inflammation in the tissues of the organ;
- subacute thyroiditis. The main manifestation of this type is a focal lesion of the thyroid gland that has a long development period;
- chronic form. The last, third type of disease, which develops as a result of disorders of an autoimmune nature or under the influence of the destructive work of specific pathogens that cause the progression of the disease. Such pathogens include tuberculosis bacillus and syphilis. It is also common to see manifestations chronic form after the birth of the child or during hormonal changes organism at certain age stages. In these cases, diffuse damage to the soft tissues of the organ may develop.
Causes of thyroiditis
Among the reasons that can lead to the occurrence of thyroiditis are factors identical to any thyroid disease, except in cases of autoimmune manifestations of the disease. Among the main causes of gland pathologies are:
- suffered organ trauma, which led to hemorrhage inside the soft tissues of the gland. In this case, the cause and nature of the injury does not matter;
- treatment by exposure to ionizing radiation for a long time, which is associated with the characteristics of a person’s professional activity;
- a previous viral infection, in particular, the most dangerous ones in terms of the risk of developing further consequences in the thyroid area are influenza, measles or mumps viruses;
- destruction of the follicles present in the gland. This process occurs due to the destructive effects of antibodies, which may differ in structure. This reason most often leads to the development of autoimmune forms of chronic thyroiditis, since autoimmune antibodies take part in the destructive activity, “considering” hostile follicles to be “intruders” in the body;
- various bacteria that cause diseases;
- progression of lymphoid infiltration, which leads to the gradual destruction of the thyroid parenchyma, as a consequence of autoimmune changes. This cause leads to the occurrence of chronic Hashimoto's thyroiditis.
Signs of thyroiditis of the thyroid gland?
Signs of thyroiditis of the thyroid gland
Each type of disease is distinguished by its obvious symptoms, which appear immediately or may appear over a period of time.
The acute form of the disease is most often accompanied by severe pain in the neck, which gradually radiate to the area of the lower jaw and the back of the head and intensify when making head movements, as well as when swallowing. At the same time, visually noticeable swelling occurs lymph nodes in the affected area. The body temperature rises, and the patient begins to feel chills or has a fever, his health worsens, and weakness is observed. All these signs are the cause immediate appeal to a specialist.
In the autoimmune form of thyroiditis, along with other symptoms, brittle nails and hair are observed Non-purulent forms have less pronounced symptoms as clinical picture. At the very beginning of the development of the disease, a condition similar to thyrotoxicosis is observed, which is accompanied by increased sweating even at rest, tremors of the limbs, disturbance heart rate and significant weight loss. In progress diagnostic measures An increase in the amount of hormones produced by the thyroid gland is detected when TSH is within normal limits.
As the disease progresses further, symptoms change, and the clinical picture begins to resemble hypothyroidism. At this time, there is a gradual replacement of damaged thyroid cells connective tissue, which is a sign of fibrosis occurring in the body. At this time the patient feels constant drowsiness And chronic fatigue. Skin become dry, swelling appears, primarily in the facial area, a person begins to suffer from constipation, and the frequency of contractions of the heart muscle decreases. When performing a blood test, a significant decrease in the amount of hormones synthesized by the gland is observed, while the level of thyroid-stimulating hormone shows an increase in dynamics. At this time, the thyroid gland itself increases in size and, during palpation, painful sensations.
The autoimmune form has the longest clinical picture, since in the presence of such a disease, obvious symptoms and signs and inflammation may not appear for several years. The thyroid gland gradually grows, and it begins to put pressure on adjacent organs, which leads to the appearance of corresponding symptoms. First of all, the patient begins to complain about an increase in the volume of the neck and associated inconveniences. Also, the autoimmune form leads to disruptions in the normal functioning of the gland, which is manifested in changes in the quantitative composition of hormone levels (T3, T4, TSH). At the very beginning of the obvious manifestation of the disease, all signs of hyperthyroidism are diagnosed, which are later replaced by signs of hypothyroidism. and men requires strict adherence to the doctor’s recommendations.
Chronic thyroiditis: treatment
This is a group of the most common forms of the disease, which includes postpartum chronic thyroiditis, autoimmune forms, latent chr thyroiditis, chr Riedel goiter or chr fibrous form, specific manifestations.
Postpartum thyroiditis appears a short time after birth and disappears after some time, and after several months it is impossible to detect signs of the disease. In rare cases of the development of a severe form, L-thyroxine is prescribed, which leads to healing.
Autoimmune thyroiditis is characterized by damage, for example, inflammation, to all tissues of the gland. The causes of this form are most often genetically determined changes in the body, and some chronic infectious diseases are also among the causes. When an autoimmune form of the disease occurs, autoimmune antibodies are produced in the body, which mistakenly mistake the soft tissue cells of the gland for foreign objects and begin their systematic destruction, with profuse inflammation occurring. Middle-aged women are predominantly at risk. A violation of this nature can be treated by prescribing therapy, the basis of which is drugs containing thyroxine.
Riedel's goiter or fibrous-invasive chronic thyroiditis is characterized by the presence of solid formations in the tissues of the gland, resulting from the proliferation fibrous tissue, capsules of which are capable of growing into nerves and blood vessels, which leads to gradual hardening of the gland. Symptoms indicating the presence of this form of the disease include a feeling of constriction in the throat, difficulty swallowing, hoarseness of the voice, and breathing problems. This occurs due to the fact that the thyroid gland does not move during swallowing processes. When palpating the iron, it feels like a very dense lump. Treatment similar shape performed exclusively surgically.
Subacute chronic thyroiditis: prevention and treatment
More often this type illness is a consequence of a viral infection, including influenza, measles, mumps or adenovirus infection. The first signs of the disease appear several weeks after the illness and are expressed in feelings of anxiety, increased irritability, excessive sweating and tremors of the extremities. Increased activity of the destructive process leads to an increase in colloid entering the blood, which leads to a more pronounced expression of the sign of thyrotoxicosis. Mostly at the beginning of the disease, one of the lobes is damaged, but gradually the chronic disease migrates, affecting the second one, causing its inflammation. Also, in addition to the pronounced symptoms of thyrotoxicosis, painful sensations localized in the thyroid gland may occur. Treatment of the subacute form is usually carried out with the use of glucocorticoids, since the use of thyreostatics is not justified due to the absence of true thyrotoxicosis. Moreover, each doctor has his own treatment.
Acute chronic thyroiditis - inflammation and treatment
There are two forms of acute chronic thyroiditis - purulent and non-purulent. The first form is caused by bacteria, most often cocci. It should be noted that in the modern world, thanks to the large number of antibiotics, purulent form is rare. If there is purulent chronic thyroiditis, the causes of its occurrence should be identified, or more precisely, the bacterium that has become the source of infection should be found. Most often, the acute form can develop as a complication after inflammation of the ear, nose or throat.
By consulting a doctor in time to carry out a full range of diagnostic measures, it is possible to avoid serious consequences Non-purulent chronic thyroiditis develops without the participation of bacteria and its causes are the consequences of injuries to the thyroid gland or unsuccessful treatment. Due to the resulting hemorrhages in soft fabrics glands, disturbances in the functioning of the thyroid gland occur.
Symptoms of the acute form are a significant increase in body temperature, the appearance of signs of intoxication, painful sensations in the neck area, which can gradually move to lower jaw And occipital part heads. Sometimes the acute form may be accompanied by the formation of an abscess, which, if not removed in a timely manner, ruptures on its own outside or inside the neck. It should be noted that in acute chronic thyroiditis, the functionality of the thyroid gland is not impaired.
Diagnosis of chronic and non-chronic thyroiditis
Correct diagnosis of the disease should include a complex of instrumental and laboratory studies. First of all, if chronic thyroiditis is suspected, a test is prescribed venous blood for the content of relevant hormones. Also held ultrasound examination an organ that allows you to determine the size, position and structure of the thyroid gland. The use of ultrasound is one of the most informative ways to study the thyroid gland, which can be used as a preventive measure.
Also included instrumental studies computed tomography and magnetic resonance imaging are available. The use of these research methods helps to assess the condition of not only the thyroid gland itself, but also the surrounding tissues.
“Monastic tea” will help to effectively cure the thyroid gland in a short time and most importantly. This product contains only natural ingredients that have a comprehensive effect on the source of the disease, perfectly relieve inflammation and normalize the production of vital hormones. As a result, all metabolic processes in the body will work correctly. Thanks to the unique composition of Monastic Tea, it is completely safe for health and very pleasant to the taste.
To determine the degree of malignancy of existing tumors, a fine-needle biopsy may be prescribed, which allows obtaining biological material for subsequent histological studies.
A timely visit to a doctor at the first signs of problems with the thyroid gland will avoid serious consequences in the future and will help prescribe correct and effective treatment if the disease is present.
