Reidel's Thyroiditis

[sweetie6803]

I have recently been told by my doctor that I have Reidel's Thyroiditis. However, for the past 10 months I have been under the impression that I had simply Hashimoto's although I have not officially been diagnosed of any condition. I have had severe tightness in my throat from the thyroid even though you can not see visibly a anterior goiter. This tightness has progressed over the past 10 months and for the most part it feels consistently tight. It feels VERY tight around my esophagus and at these times I have such nausea. I also experience fatique, at times anxiety and/or depression, constipation. How can a doctor tell the difference between the two thyroid conditions without biopsy, open or FNA? What is the difference between the two?  Are the terms interchangeable? How long can this tightness/compression last with treatment if it is Hashimoto's? I am presently hoping it is Hashimoto's and not the Reidel's Thyroiditis.

[Mark Lupo, M.D.]

You cannot tell the difference w/o biopsy.  The terms are not interchangeable - Hashimoto's is much more common and is an immune system attack against the thyroid causing inflammation and sometimes goiter.  If the TSH is high then levothyroxine is a useful treatment.  Sometimes surgery is indicated for compressive symptoms.

Reidels is a fibrosis of the thyroid -- severe scarring.  It can be a very difficult surgery.
If this is being considered, would do FNA biopsy to help determine.

[sweetie6803]

Thank you so much for the information. At this time my doctor feels it is Reidel's because of the way it is presenting and not responding to synthyroid. Plus goiter is diffused not nodular. My hypo symptoms have improved; however, the compression in my throat is becoming consistently tight/er. The goiter (thyroiditis) has been present x10 months and I have been told if it does not go away in another two months making it a total of a year, then he would consider Tamoxifen treatments. I will be sure to have the FNA before I start such a treatment. I trust that he will be suggesting the FNA be done, but just incase, thanks to you Dr. Lupo, I will be sure to ask for the FNA to be done before Tamoxifen just to be sure its Reidel' Struma. Thanks again!