Subacute thyroiditis, or thyroiditis of de Kerven, is a disruption of the thyroid gland as a result of the inflammatory process. Women suffer them 5 times more often than men. In childhood and among older people, the disease is almost never found.
Causes of
While the cause of the disease has not been accurately identified, but most often recognize the transfer of a viral infection in severe form, during which the patient experiences intestinal problems, general weakness, muscle pains against a high temperature.
Studies also indicate that there is a genetic predisposition that significantly increases the chances of getting sick. A significant decrease in immunity, including due to poor environmental conditions, is also a cause for concern.
As a result of the disease, small foci of inflammation appear on the thyroid gland, where tissues are destroyed, and thyroxine hormones enter the bloodstream. When the disease goes away, the tissues are scarred and gradually restored.
course Subacute thyroiditis in its course passes through 3 main stages, characterized by their distinctive features:
- Initial, thyrotoxic. It begins approximately 3-4 weeks after a viral disease. Lasts 4-8 weeks. At this time, the thyroid gland is painful to the touch, which is clearly manifested when palpation. Less iodine is absorbed. Cells of damaged tissues are massively destroyed, and therefore hormones enter the bloodstream. Symptoms include fever, increased heartbeat and pulse, nervousness, pain when swallowing and in the joints, tremor of hands, sleep disturbances and so on.
- Euthyroid. When accumulated hormones stop coming from the lesions, the total amount of hormones in the body is balanced, so most of the symptoms disappear, but the pain often remains.
- Hypothyroid. At this stage begins to affect the lack of work on the affected areas of the thyroid gland. They do not produce hormones, the body feels this deficiency. At this stage, much depends on how much of the thyroid gland has been destroyed. Sometimes, with weak destruction, the thyroxine level is restored independently, in other, more complex cases, it is necessary to take substitution therapy, which is prescribed by an endocrinologist.
Thyroiditis de Kerwena rarely has irreversible effects, but it also happens. The plots are so large that they are unable to undergo restoration and their work becomes unrecoverable. As a result, a person constantly feels a shortage of thyroid hormones and all his life they have to take substitution therapy. Fortunately, this happens very rarely and the body restores a maximum of six months.
Diagnosis
In order to survive subacute thyroiditis with minimal harm to the body and recover as soon as possible, it is necessary to diagnose the disease as soon as possible. This can be done by an endocrinologist, carrying out a number of studies. It is necessary:
- to perform palpation for the detection of pain syndrome and localization of tissue compaction;
- ultrasound and scintigraphic examination to determine the size of affected lesions and their characters;
- blood tests to the level of hormones thyroid and pituitary.
It is important to accurately establish the disease, because diffuse toxic goiter, acute thyroiditis have similar symptoms, the cause of compaction may be cancer. All these problems are eliminated by completely different methods.
It is interesting that the thyroiditis of de Kerven is a recurrent disease and can manifest again after full recovery. Therefore, it is important to periodically consult a doctor, especially when you see familiar symptoms.
Methods of treatment
How to treat the patient, the doctor chooses, guided by the data of analyzes about the patient's condition, the presence of concomitant diseases, the nature of the course. After the diagnosis of subacute thyroiditis, one or more of the following methods is selected:
- Steroid and non-steroidal anti-inflammatory drugs
Thyroiditis de Kervena is characterized by an inflammatory process. To remove inflammation, glucocorticoid drugs are most often used. In addition, they relieve pain and remove hormonal intoxication.
Most often, thyroiditis is prescribed treatment with prednisolone. Duration of admission, dosage is assigned individually. As the symptoms of the disease are eliminated, the dosage is gradually reduced. It is very important to follow the doctor's instructions accurately, and not to hope for improvement and throw in the treatment. Then the thyroid gland is gradually prepared for independent work, the body will be reconstructed into independent work, and will not receive drug dependence.
Nonsteroid drugs are prescribed simultaneously to relieve inflammation more quickly. Dexomethasone, deklofinak, indomethacin and kenalog injections are also used.
Usually treatment takes about 2 months, but in difficult cases it is possible to extend to 6.It is important to know that prolonged use can lead to increased sugar, weight and pressure. On the other hand, without steroid drugs, you can get by only in the lightest course of the disease.
- Thyroid treatment
Treatment of subacute thyroiditis after withdrawal of symptoms includes a decrease in the effect of the increased amount of hormones that the thyroid gland gives out from the foci of inflammation. Patients receive about one and a half months of thyroid, for example, thyrotoxic or triiodothyronine. This allows you to eliminate neoplasm and compacts of a benign nature.
Immunomodulators
With a prolonged process of recovery or relapse, the doctor will prescribe medications that will raise the body's immunity and help to fight the disease more successfully. They do not refer to the main therapy, but the auxiliary help a lot in the recovery. Thymalin, eleutherococcus, splenin and others can be prescribed.
Local treatment of
In the treatment of subacute thyroiditis, the use of a butane ointment or diclofenac sodium is effective for relieving inflammation. To do this, before bedtime, once a day, one of the medicines is applied to the neck with a thin layer, top with cellophane and a layer of cotton wool. From above you can tie a warm scarf made of natural fabric.
On the first day the compress is removed after 15 minutes, the second after 30 minutes, gradually bringing up to 2 hours, checking the skin for an allergic reaction. It is expected that the treatment will last 10 days. It is possible to compress in the morning from dimexide, in order to remove inflammation and improve the patency of ointments.
- Symptomatic treatment
Subacute thyroiditis is characterized by an increased heart rate, which can be a serious problem. Anaprilin is used to eliminate the symptom.
- Surgical method
Very rarely Thyroiditis de Kerven is treated surgically, but there are a number of indications when this method of treatment is extremely necessary:
- malignant neoplasms;
- nodes of large sizes;
- stenosis of the respiratory tract;
- a significant increase in the gland, in particular rapid growth and drug treatment;
- is a serious cosmetic defect.
It should be understood that during surgery, doctors are forced to remove the entire organ in order to eliminate its re-growth. This will seriously change the life of the patient forever.
Diet
Special complications with diet with thyroiditis in patients usually does not arise. Subacute thyroiditis requires regular nutrition every 3 hours, but the reduction in calories in this case just does not threaten. On the contrary, such a path leads to a worsening of the condition.
A lot of fiber works positively, so vegetables, fruits and berries are welcome. In addition to carbohydrates( all kinds of cereals, pasta and bakery products), fatty unsaturated acids( fatty fish) are needed. No vegetarianism and fasting, you need dairy and meat products for a sufficient amount of calcium in the body. This will help nuts, spinach, sesame, mustard, garlic.
The body during the inflammatory process requires a large number of fluids. The diet includes a large amount of drinking. It is better to choose mineral water without gas. In addition, there will be an infusion of rose hips, hawthorn, juices from lemon, beets, cabbage, carrots.
It is important to understand that a diet can not become a cure for this disease, and serves only as support for the body, and does not replace medical assistance.
Folk remedies
To use herbs in any form, you need to get permission from the doctor in charge. In addition, it is worth remembering that it can not be cured by phytotherapy. On the other hand, many herbs perfectly support the functioning of the thyroid gland, relieve inflammation and become a functional addition to traditional treatment. Subacute thyroiditis may require the use of the following herbal groups:
- Regulation of the thyroid gland - drok, hawthorn, zyuznik, motherwort.
- Against tumors and nodes - celandine, mistletoe, sage, sweet clover, marshmallow.
- Regulation of immunity - beet, leaves of walnut, strawberry, nettle.
- To reduce the development of autoimmune processes - St. John's wort, calendula, heather.
To use, you can independently make recipes depending on your personal preferences, taking the herbs from each group.
- For broth you can take dried and chopped herbs for 70 gr. Then 20 gr.mixture pour 0.4 liters of boiling water, boil for 5 minutes, insist 1 hour, strain, add 2 teaspoons of honey. Take 4 times before meals( last before bedtime) in equal parts. Take 6 weeks, then 2 weeks break and, if necessary, you can repeat.
- For fresh juice to grind in a meat grinder, squeeze, dilute with vodka( 3 parts of juice, 1 vodka), store in the refrigerator for no longer than a year. Use externally, for rubbing the thyroid gland.
- For a compress, you can take a decoction without the addition of honey, apply for 2 hours in a usual way for compresses.
It's important to remember that all these methods are good if used under the guidance of doctors, carefully following all their recommendations. In this case, subacute thyroiditis will pass with a minimal load on the body.
