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Inflammation

Inflammation of the thyroid is called thyroiditis, and may cause symptoms of hyperthyroidism or hypothyroidism. Two types of thyroiditis initially present with hyperthyroidism and are sometimes followed by a period of hypothyroidism – Hashimoto's thyroiditis and postpartum thyroiditis. There are other disorders that cause inflammation of the thyroid, and these include subacute thyroiditis, acute thyroiditis, silent thyroiditis, Riedel's thyroiditis and traumatic injury, including palpation thyroiditis.

Hashimoto's thyroiditis is an autoimmune disorder in which the thyroid gland is infiltrated by the lymphocytes B cell and T cells. These progressively destroy the thyroid gland. In this way, Hasimoto's thyroiditis may have occurred insidiously, and only be noticed when thyroid hormone production decreases, causing symptoms of hypothyroidism. Hashimoto's is more common in females than males, much more common after the age of 60, and has known genetic risk factors. Also more common in individuals with Hashimoto's thyroiditis are Type 1 diabetes, pernicious anaemia, Addison's disease vitiligo.

Postpartum thyroiditis occurs sometimes following childbirth. After delivery, the thyroid becomes inflamed and the condition initially presents with a period of hyperthyroidism followed by hypothyroidism and, usually, a return to normal function. The course of the illness takes place over several months, and is characterised by a painless goitre. Antibodies against thyroid peroxidase can be found on testing. The inflammation usually resolves without treatment, although thyroid hormone replacement may be needed during the period of hypothyroidism.