Several types of thyroiditis exist and the treatment is different for each. It is named after the Japanese physician, Hakaru Hashimoto, that first described it in 1912. The thyroid gland is always enlarged, although only one side may be enlarged enough to feel. As the disease progresses, the TSH increases since the pituitary is trying to induce the thyroid to make more hormone, the T4 falls since the thyroid can't make it, and the patient becomes hypothyroid. The sequence of events can occur over a relatively short span of a few weeks or may take several years.
Treatment is to start thyroid hormone replacement.
This prevents or corrects the hypothyroidism and it also generally keeps the gland from getting larger. In most cases the thyroid gland will decrease in size once thyroid hormone replacement is started. Thyroid antibodies may remain for years after the disease has been adequately treated and the patient is on thyroid hormone replacement. De Quervain's Thyroiditis. The thyroid gland generally swells rapidly and is very painful and tender.