Thyroiditis is an inflammation of the thyroid gland. There are several types of thyroiditis. Most result in three phases: overactive thyroid (hyperthyroidism), underactive thyroid (hypothyroidism), and return to normal. When the thyroid is inflamed, it often releases an excess of thyroid hormone, resulting in hyperthyroidism. As the supply of thyroid hormone is depleted, the body has too little, and hypothyroidism the results. Young to middle-aged women seem most at risk, although some forms of thyroiditis occur in both men and women of all ages. With some forms, hypothyroidism may develop years later even if the thyroiditis has resolved.

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
• 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 - 10 pounds, and increased sweating

Immune disorders, viruses, and fever disorders can cause thyroiditis. Sometimes thyroiditis develops if you have Graves' disease (an autoimmune disorder that causes hyperthyroidism). In some cases, there is no identifiable cause.

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.

Natural medicine practitioners often take a different view of laboratory analysis of thyroid function. Many naturally oriented physicians pay particular attention to levels of T3 hormone, the active form of thyroid hormone that is converted in the body from T4, an inactive thyroid hormone. Conventional lab tests usually monitor T4 and thyroid stimulating hormone (TSH) without examining levels of T3. People with hypothyroidism may be treated with T4 to bring their levels of T4 to normal limits. Meanwhile, if you are unable to convert T4 to T3, your tests may be normal but you may still experience the symptoms of hypothyroidism. Talk to your doctor about including T3 lab tests in the treatment of hypothyroidism.

Thyroiditis generally involves three phases: overactive phase, underactive phase, and return to normal. Treatment is individualized to type and phase.

Drug Therapies

Depending on the particular type of thyroiditis, a physician may prescribe one or some of the following treatments:

• Levothyroxine, if hypothyroidism or large goiter present
• Aspirin, to relieve pain and inflammation
• Corticosteroid medications (such as prednisone or dexamethasone), to reduce inflammation in severe cases
• Propanolol, for hyperthyroidism
• Thyroxine, to replace thyroid hormone (in cases of hypothyroidism)
• Short-term beta-blockers, for hyperthyroid symptoms
• Antibiotics

Surgical and Other Procedures

Rarely, partial thyroid removal may relieve pressure.

Complementary and Alternative Therapies

Alternative therapies can help when used along with the medications your health care provider prescribes, but do not replace your conventional medications.

Nutrition and Supplements

• Foods that depress thyroid activity are broccoli, cabbage, brussels sprouts, cauliflower, kale, spinach, turnips, soy, beans, and mustard greens. You should include these foods in a diet for hyperthyroid conditions -- and avoid them if you have a hypothyroid condition. Use caution because people with thyroiditis can switch from hyperthyroidism to hypothyroidism very quickly.
• Avoid refined foods, sugar, dairy products, wheat, caffeine, alcohol.
• Essential fatty acids (1,000 - 1,500 mg three times per day), found in flaxseed oil, fish oil, and borage oil, are anti-inflammatory and necessary for hormone production.
• Bromelain (250 - 500 mg three times per day between meals), an enzyme from the pineapple plant, may reduce inflammation.
• Vitamin C (1,000 mg per day), vitamin A (10,000 - 25,000 IU per day), B complex [(50 -100 mg per day), augmented with vitamins B2 (riboflavin, 10 mg), B3 (niacin, 10 - 25 mg), and B6 (pyridoxine, 5 - 15 mg)], selenium (200 mcg per day), vitamin E (400 IU per day), and zinc (30 mg per day) are necessary for normal thyroid hormone production.
• Calcium (1,000 mg per day) and magnesium (200 - 600 mg per day) may help metabolic processes function correctly.
• If you take thyroid hormone medication, talk to your doctor before consuming soy products. Some evidence suggests that soy may interfere with absorption of thyroid hormone.
• Iron may also interfere with the absorption of thyroid hormone medication.

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

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Talk to your health care provider before taking herbs for thyroiditis, particularly if you are also taking prescription medication.

For hyperthyroid conditions:

• Bugleweed (Lycopus virginica) and lemon balm (Melissa officinalis) help normalize the overactive thyroid. Steep the following amount in one cup of boiling water. Strain and cool. For bugleweed, 1 - 2 g; for lemon balm, 2 tablespoons. These herbs may be combined.
• Motherwort (Leonurus cardiaca) can help regulate rapid heartbeat. Steep 2 g in one cup of boiling water. Strain and cool. Drink three times per day.
• Turmeric (Curcuma longa) makes the effect of bromelain stronger and should be taken between meals, 500 mg three times per day.
• Avoid ashwagandha (Withania somnifera) and bladderwrack (Fucus vesiculosus ), as they can stimulate hyperthyroidism.

For hypothyroid conditions:

• Coleus forskohlii (50 - 100 mg two to three times per day) may stimulate thyroid function to increase thyroid hormone.
• Herbs such as guggul (Commiphora mikul) (25 mg of guggulsterones three times per day) and hawthorne (Crataegus monogyna) (500 mg twice a day) are taken to counteract high cholesterol, which often accompanies hypothyroidism.

You should carefully monitor any treatment for lowering or raising thyroid function because thyroiditis may switch from hyperthyroidism to hypothyroidism very quickly.

Homeopathy

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

Physical Medicine

Exercise helps improve thyroid function for both hypothyroidism and hyperthyroidism..

Acupuncture

Acupuncture may help correct hormonal imbalances and address underlying deficiencies and excesses involved in thyroiditis.

Massage

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

You may need to see your health care provider each year.

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

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