Subacute thyroiditis post viral vector vaccine for COVID-19
The disease process may reach its peak within 3 to 4 days and subside and disappear within a week, but more typically, onset extends over 1 to 2 weeks and continues with fluctuating intensity for 3 to 6 weeks. The thyroid gland is typically enlarged, smooth, firm and tender to palpation, sometimes exquisitely so.
Approximately one-half of the patients present during the first weeks of the illness, with symptoms of thyrotoxicosis. Subsequently patients often experience hypothyroidism before returning to normal see figure 1. This painful condition lasts for a week to a few months, usually demonstrates a very high erythrocyte sedimentation rate ESR , elevated C- reactive protein CRP levels and has a tendency to recur.
Painless silent, autoimmune subacute thyroiditis PLSAT occurs spontaneously or following pregnancy when it is referred to as postpartum thyroiditis [PPT].
Autoimmune thyroiditis is histologically similar to Hashimoto's thyroiditis and occurs following 3. The combination of thyroid enlargement usually without discomfort and, positive anti-thyroid antibodies, associated with typical thyroid function test abnormalities see figure 1 , over a month course should alert the clinician to the presence of PLSAT.
In both forms, clinical thyroid symptoms result from either the initial release of thyroid hormone from the inflamed tissue during the thyrotoxic phase or the lack of circulating thyroid hormones in the hypothyroid phase See figure 1.
Medications associated with SAT outlined in table 4. Figure 1. Anterior neck pain, preceded by an upper respiratory inflammation, alerts the clinician to the classic PFSAT.
Thyroid function tests see table 3 during the painful initial phase of SAT often reveal a suppressed TSH and elevation of total T4 and T3 levels consistent with the thyrotoxic state.
This condition is differentiated from other causes because it is often associated with a thyroid gland which is very painful. Subacute lymphocytic thyroiditis 7 - This condition is also referred to as "painless thyroiditis" and can be immediately differentiated from granulomatous thyroiditis by this factor alone.
This condition has an overlap between subacute thyroiditis and Hashimoto's thyroiditis and may represent a condition on the autoimmune spectrum of thyroid disease. Subacute postpartum thyroiditis 8 - Subacute postpartum thyroiditis can be differentiated from the other two forms of thyroiditis because it tends to occur in the postpartum period after pregnancy. This condition, like lymphocytic thyroiditis, may be on the autoimmune spectrum as they share similar findings when evaluated under a microscope.
Don't let these types discourage you or scare you because, regardless of which type you have, they almost always go away on their own and without treatment. Subacute Thyroiditis vs Graves' Disease Subacute thyroiditis should be differentiated from the autoimmune condition Graves' disease at the time of diagnosis. Both of these conditions may present with similar clinical symptoms but they can be differentiated on a few important points.
The first is that subacute thyroiditis is usually associated with thyroid pain and Graves' disease is not. The second is that subacute thyroiditis is NOT associated with positive antibodies in the serum while Graves' disease usually is 9.
These points must be checked and evaluated early on in the progression of your symptoms because these two conditions are treated differently. Graves' disease is a condition which is progressive meaning it gets worse over time whereas subacute thyroiditis will almost always naturally improve without any therapies. Graves' disease also may require treatment such as the use of thyroid blocking medications, thyroid surgery or radioactive iodine ablation of the thyroid gland.
Because of the overlap between these two conditions your Doctor should take caution when testing and diagnosing your condition. Natural Treatment Options Is there any way to reduce the amount of time it takes to heal your thyroid if you have subacute thyroiditis?
The answer is maybe, but these therapies have not been "proven" through clinical studies. Even though they are not "proven" there is anecdotal evidence meaning opinions from others who have had the disease that they may provide relief in some cases.
If you want to take a natural approach to treat your condition you should focus on supplements and therapies designed to enhance your immune system and those which may be effective in killing off viruses. Therapies that fit this category include: Zinc - Zinc is known to play a role in regulating your immune system 10 and can be used during acute illness to potentially help improve your healing time. Many people in the US are also deficient in this mineral which makes supplementing a no-brainer for many people.
Low levels of Vitamin D have been linked to autoimmune disease Fish oil - Fish oil is a potent anti-inflammatory agent 12 which may help to "calm down" the inflammation in your thyroid gland. Using up to grams per day may help. Ginger - Garlic is known for its ability to fight off both bacterial and viral infections 13 and is used in many at home remedies. Allicin, found within garlic, may be responsible for these benefits. Oregano - Oregano can be used both as an anti-bacterial and anti-viral remedy 14 and may be as potent as some antibiotics at killing off certain bugs.
Oregano contains carvacrol which may help kill off viruses, such as those which trigger thyroiditis. While these treatments have not been proven to work they may be both effective and inexpensive remedies which have the potential to help. During the hypothyroid phase, you can also consider using certain combination supplements such as this , which may help promote thyroid function by providing your body with vitamins and nutrients.
These points must be checked and evaluated early on in the progression of your symptoms because these two conditions are treated differently. When the diagnosis is uncertain, fine-needle aspiration biopsy is useful. Initial hyperthyroidism is common, sometimes followed by a transient period of hypothyroidism. This painful condition lasts for a week to a few months, usually demonstrates a very high erythrocyte sedimentation rate ESRelevated C- reactive protein CRP levels and has a tendency to recur. The thyroid gland becomes increasingly tender, and the person usually develops a low-grade fever 99 to ° F [37 to 38º C].
Subacute Thyroiditis Guide: Recovery Time, Treatment, Diagnosis & More
These points must be checked and evaluated early on in the progression of your symptoms because these two conditions are treated differently. Remember: In the beginning you will experience thyroiditis symptoms of hyperthyroidism, then you will experience the symptoms of hypothyroidism and lastly, you will return to normal thyroid function. When corticosteroids are discontinued abruptly or too early, symptoms often return in full force. This is important because all 3 may have some overlap in how they present. Subacute thyroiditis post subacute is relatively straightforward to manage, with some patients requiring non-steroidal anti-inflammatory drugs and beta-blockers, while more severe cases may require corticosteroid therapy. Allicin, found within garlic, may be responsible for these benefits.
Fever and symptoms of thyrotoxicosis were present in two thirds of subjects. We also review the literature on the proposed mechanisms behind this adverse effect. Painless silent, autoimmune subacute thyroiditis PLSAT occurs spontaneously or following thyroiditis when it is referred to as postpartum thyroiditis [PPT]. The thyroid gland becomes increasingly tender, and the person usually develops a low-grade fever 99 to ° F [37 to 38º C]. Urine iodine measurement can quantify the degree of iodine contamination present. Bothersome hyperthyroid symptoms may be treated with a short course of a beta-blocker. The presence of antibodies to your thyroid gland indicates an autoimmune disease subacute as Graves' disease or Hashimoto's.
Many people with subacute thyroiditis feel extremely tired. The thyroid gland becomes increasingly tender, and the person usually develops a low-grade fever 99 to ° F [37 to 38º C]. The pain may shift from one side of the neck to the other, spread to the jaw and ears, and hurt more when the head is turned or when the person swallows. Subacute thyroiditis is often mistaken at first for a dental problem or a throat or ear infection. The two halves lobes of the gland are connected Sometimes, it may difficult to differentiate subacute thyroiditis from Graves disease Graves disease Hyperthyroidism is overactivity of the thyroid gland that leads to high levels of thyroid hormones and speeding up of vital body functions.
Graves disease is the most common cause of hyperthyroidism Because of the inflammation, little or no radioactivity is taken up by the thyroid gland in subacute thyroiditis while uptake is increased in Graves disease. Endocrinology Subacute thyroiditis is a form of thyroiditis that can be a cause of both thyrotoxicosis and hypothyroidism. The most common form, subacute granulomatous, or de Quervain's , thyroiditis manifests as a sudden and painful enlargement of the thyroid gland accompanied with fever , malaise and muscle aches.
Indirect evidence has implicated viral infection in the etiology of subacute thyroiditis. This evidence is limited to preceding upper respiratory tract infection , elevated viral antibody levels, and both seasonal and geographical clustering of cases.
There may be a genetic predisposition.
This has to do with the fact that you may present at different times in the progression of your disease. There is more lassitude and prostration than in other thyroid disorders. Because of the overlap between these two conditions your Doctor should take caution when testing and diagnosing your condition. Laboratory markers for thyroid inflammation and dysfunction typically peaked within one week of onset of illness. Upper respiratory tract infections in the month preceding presentation were reported in only 1 in 5 subjects.