- peak incidence 30-50 years, women affected 3 times more common than men
- during initial phase of follicular destrution, there is release of Tg and thyroid hormones, leading to increased circulating T4 and T3 and suppression of TSH (during this stage, radioactive iodine uptake is low or undetectable)
- after several weeks, the thyroid is depleted of stored thyroid hormone and a phase of hypothyroidism typically occurs
- finally thyroid hormone and TSH levels return to normal as disease subsides
- presents with painful and enlarged thyroid, sometimes fever
- malaise and URTI may precede the thyroid related features by several weeks
- patient typically complained of sore throat and pain is often radiated to jaw or ear
- ESR and CRP are markedly elevated
- treatment: NSAIDs (eg: aspirin 600mg QID), or prednisolone 40-60mg gradually tapered over 6-8 weeks
- thyroid function should be monitored every 2-4 weeks using TSH and unbound T4 levels
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