Thyroiditis (inflammation of the thyroid gland)

Type of Thyroid Abnormality 


  • Consider measuring anti-thyroid antibodies and/or TSH-receptor autoantibodies (TRAB) to establish autoimmune etiology
  • If patient has not received IV iodinated contrast within 2 months, can consider a diagnostic thyroid uptake & scan
  • Acute thyroiditis usually resolves or progresses to hypothyroidism; thus, can repeat TFTs in 4–6 weeks
  • If TRAB high, obtain a thyroid uptake scan & refer to endocrinology
  • Short period of 1 mg/kg prednisone or equivalent may be helpful in acute thyroiditis
  • Consider use of beta blockers and immunotherapy hold for symptomatic patients (e.g., beta blockers for tachycardia/murmur and immunotherapy holds for patients who have acute thyroiditis threatening an airway). Therapy is often restarted when symptoms are mild/tolerable.
  • Repeat TFTs in 4–6 weeks
  • Begin thyroid replacement if symptomatic
  • May consider repeating levels in 2-4 weeks if asymptomatic
  • Levothyroxine dose 1.6 mcg per weight (kg) or 75–100 mcg daily
  • Repeat TSH in 4–6 weeks and titrate dose to reference range TSH
  • Consider radioactive iodine therapy or methimazole treatment
  • Consider use of beta blockers for symptomatic patients (e.g., for tachycardia or murmur)

Nursing Implementation:

  • Educate patient that hypothyroidism is generally not reversible
  • Assess medication compliance with oral thyroid replacement or suppression
  • History of thyroid disorders does not increase or decrease risk of incidence
  • Consider collaborative management with endocrinologist, especially if the patient is hyperthyroid, particularly if a thyroid scan is needed


  • Swelling of thyroid gland causing compromised airway