![]() ![]() 1, 3 During transition from hyperthyroidism to hypothyroidism, low TSH and free T 4 levels may be found, which may be mistaken for central hypothyroidism. However, in 10 to 15 percent of patients, hypothyroidism persists, requiring long-term levothyroxine therapy. Patients usually return to euthyroidism within six to 12 months. A triphasic sequence commonly is observed, in which patients have an initial phase of hyperthyroidism accompanied by elevated free T 4 and suppressed thyroid-stimulating hormone (TSH) levels, followed by a phase of hypothyroidism with low free T 4 and high TSH levels, which may last weeks or up to six months. This process usually is transient, lasting three to six weeks and ceasing when the thyroid stores are exhausted. Hyperthyroidism is seen in one half of affected individuals it occurs when activated cytotoxic T lymphocytes damage the thyroid follicular cells, resulting in the unregulated release of large amounts of thyroxine (T 4) and triiodothyronine (T 3) into the circulation. Interferon-alfa (Infergen Intron A, Roferon-A, Rebetron combination therapy) Treatment primarily is directed at symptomatic relief of thyroid pain and tenderness, if present, and restoration of euthyroidism.ฤก percent of those receiving 131I for Graves' disease In addition, the degree of radioactive iodine uptake by the gland is reduced in most patients with viral, radiation-induced, traumatic, autoimmune, or drug-induced inflammation of the thyroid. Diagnosis is by clinical context and findings, including the presence or absence of pain, tenderness, and autoantibodies. ![]() Patients may have euthyroidism, hyperthyroidism, or hypothyroidism, or may evolve from one condition to another over time. The most common forms are Hashimoto's disease, subacute granulomatous thyroiditis, postpartum thyroiditis, subacute lymphocytic thyroiditis, and drug-induced thyroiditis (caused by amiodarone, interferon-alfa, interleukin-2, or lithium). ![]() Most nodules are benign but a small percentage may be cancerous. They can be caused by either a low or high thyroid, but are also at times found in people with normal thyroid function. Nodules are solid areas of tissue or fluid under the skin. Thyroiditis is an inflammation of the thyroid gland that may be painful and tender when caused by infection, radiation, or trauma, or painless when caused by autoimmune conditions, medications, or an idiopathic fibrotic process. Thyroglobulin levels are usually slightly above normal levels in these cases. ![]()
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