Guest Author - Jim Lowrance

In corresponding with a number of autoimmune hypothyroid patients, also called “Hashimoto’s Thyroiditis”, they have reported being told by their Doctors, that their hypothyroid condition is “just a temporary case of thyroiditis” and should resolve in a relatively short period of time. I was also told this, by a Doctor who was listed as an Endocrinologist, who was responding to my test results, showing both TPO (anti-Thyroid Peroxidase) and TG (anti-Thyroglobulin) antibodies being highly elevated and my thyroid hormone levels being below normal, “hypothyroid”.

I had done just enough research at that time, to know that elevated antibodies, that had been present long enough to begin lowering my thyroid hormone levels, was not a temporary condition, that was going to resolve itself with a little time! Once the thyroid begins to under-function, due to damage from autoimmune attack from antibodies, it cannot be reversed and the patient will have to begin thyroid hormone replacement medication, that will most likely be a lifelong treatment. In very rare cases, Hashimoto’s will reverse and the antibodies will diminish, before permanent damage to the thyroid has occurred but for the vast majority of Hashimoto’s patients, the autoimmune process continues to damage the thyroid, eventually resulting in the need for hormone replacement therapy. The point being, that Hashimoto’s is not a temporary form of Thyroiditis but a chronic, permanent form.

There is a temporary form of Thyroiditis, called “Sub-acute
Thyroiditis”, “deQuervain’s Thyroiditis” and “Viral Thyroiditis” and this is very likely the type Thyroiditis Doctors are referring to, as being what they sometimes mistakenly believe Hashimoto’s patients have. It is much more rare than Hashimoto’s and it also has characteristics that differentiate it from Hashimoto’s. There are also other very rare types of temporary Thyroiditis as well, such as “Silent Thyroiditis”, which occurs in women, post-partum but it is relatively rare.

The confusion between Sub-acute Thyroiditis and Hashimoto’s, I believe, is in these Doctors seeing highly elevated thyroid antibody levels on these patient’s lab results. According to medical resources however, Sub-acute Thyroiditis, usually causes only mild elevation of thyroid antibodies and in most cases, no elevation of these antibodies at all. This temporary form of Thyroiditis, also only lasts up to approximately four weeks, before it completely resolves. The major symptom with this temporary form of Thyroiditis, is rapid onset of severe pain and inflammation, in the thyroid area. This sudden onset of inflammation, in most cases of this form of temporary Thyroiditis, will cause “hyperthyroidism” and not “hypothyroidism” and in those in whom it does cause hypothyroidism, it is a mild, temporary form. This means patients will more often complain of hyperthyroid symptoms, such as nervousness and sweating than they will of hypothyroid ones, with this temporary type of Thyroiditis.

While Hashimoto’s Thyroiditis, is an autoimmune disease, Sub-acute Thyroiditis, is caused by a viral infection, such as “Mumps” or “Upper-respiratory Infections“, that settle into the thyroid gland. With Hashimoto’s, patients will have elevated antibodies against the thyroid gland itself, while with Sub-acute Thyroiditis, patients will have elevated antibodies against the virus causing the Thyroiditis.

To add to the confusion, Hashimoto’s patients at times, will have attacks of Thyroiditis but this does not take away from the fact that they also have autoimmune disease as the root cause of their thyroid condition and the Thyroiditis flare-ups, are only a feature of it, that does not occur in all patients with Hashimoto’s.

To sum up the differences, if a patient does not complain of severe pain in the thyroid gland area and they have highly elevated thyroid antibody levels, it is much more likely Hashimoto’s Thyroiditis and not Sub-acute Thyroiditis. Also, if their condition is ongoing for more than a few weeks, this should also reveal to the patient and Doctor, that it is Hashimoto’s Thyroiditis and not Sub-acute (temporary) Thyroiditis.