The Highly Unusual Riedel Thyroiditis

In most cases of detected thyroid disease, a patient is found simply to have either an underactive thyroid gland – “hypothyroidism” or an over active thyroid gland – “hyperthyroidism”. Doctors detect these two opposite spectrums of thyroid disease by blood testing and blood test are usually prompted by a patient’s symptoms as examined by a doctor. With hypothyroidism, the “hypo means low” in the diagnosis-wording. To put it simply, hypothyroidism is an underactive thyroid gland and since thyroid hormone permeates the entire body from head to toe because it sets the metabolism (energy) of the body, a person will feel slowed down because of this condition – tired, needing more sleep, depression, dryness of skin and hair and constipation, plus the biggie – being weight gain. The culprit is usually “Hashimoto’s Thyroiditis”.

With hyperthyroidism, the “hyper” in the diagnosis-wording means exactly what it sounds like as well – a sped-up metabolism. Symptoms of hyper activity in the thyroid gland (BTW: It sits just below the Adam’s Apple and has a butterfly shape), are opposite of a hypo/under active gland. These include feeling sped-up, anxiety and nervousness, sweaty and oily skin, weight loss and chronic diarrhea with loss of nutritional absorption. Both conditions can cause goiters; meaning a swollen thyroid that causes mild, moderate or severe swelling in the neck, caused by enlargement of the gland. This aspect of symptomology is more prominent in people diagnosed with hyperthyroidism thyroiditis, also called “Grave’s Disease”.

While these are simple descriptions of these two conditions, they can be accompanied by strange manifestations such as a condition called “Riedel thyroiditis”. In many cases a person with this somewhat rare condition is euthyroid, but hypothyroidism is noted in approximately 30% of cases. The term “Euthyroid’ is used when a patient has normal levels of thyroid hormone; so, they are neither hypo or hyper thyroid. Riedel thyroiditis causes an underactive gland in approximately 1/3 of cases and hyperthyroidism in much rarer cases. The strange aspect however, is that normal thyroid tissue (parenchyma) is replaced by this inflammatory condition over time, into a fibrotic tissue that can grow and extent outside of the thyroid area, into areas of the throat. Some cases require surgery, especially those that make swallowing difficult or that begin to obstruct breathing. Otherwise the condition can be improved by cortisone steroid anti-inflammatory drugs being administered by a qualified thyroid doctor or endocrinologist.

Other complications include hoarseness of the voice due to vocal cord involvement and difficulty projecting with the voice (vocal weakness). Sometimes the parathyroid glands located behind the two lobes of the thyroid gland (there are 4 – two on each side), become unable to function properly, which is called “hypoparathyroidism”. The parathyroid glands are responsible for calcium metabolism in the body and when they are hindered by Riedel thyroiditis, hypoparathyroidism occurs, which can cause an array of symptoms itself.

So, we see that strange manifestations can occur with Riedel thyroiditis and it is very important to seek medical care if the condition is suspected by patients who have already been diagnosed with another thyroid disease – hypo or hyper thyroid function and even by euthyroid people who have not already been diagnosed with thyroid disease. Imaging tests ordered by a qualified doctor, can definitively diagnose this disease.

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