Riedel's Thyroiditis: What Patients Need to Know

Learning More about Fibrous Thyroiditis / Invasive Thyroiditis

The term thyroiditis refers generally to any disorder that involves inflammation of the thyroid. Thyroiditis is typically divided into two broad categories -- painless and painful -- that involve the level of pain they cause to patients.

Among the category of painless types of thyroiditis is a form known as Riedel's thyroiditis. It is also known as Riedel's struma, fibrous thyroiditis, and invasive thyroiditis.

In Riedel's thyroiditis, the normal thyroid tissue is replaced by what's known as fibrosis -- excessive amounts of connective tissue. This fibrosis can also extend beyond the thyroid into other parts of the neck, and cause the thyroid to become abnormally attached within the neck.

The cause of Riedel's thyroiditis is not known, but experts theorize that the condition is autoimmune, given that in a number of studies, the majority of patients with the condition tested positive for antithyroid antibodies.

Diagnosing and Treating Riedel's Thyroiditis

To determine how Riedel's thyroiditis is diagnosed and treated, I consulted an overview of thyroiditis on UpToDate -- an electronic reference used by many physicians and patients that presents in-depth medical information.
"Affected patients have neck discomfort or tightness, sometimes dysphagia or hoarseness, and a diffuse, although occasionally asymmetric, goiter that is very hard, fixed, and often not clearly separable from the adjacent tissues. Most patients are euthyroid, but a few are hypothyroid, and serum antithyroid antibody concentrations are often high. The diagnosis is established by thyroid biopsy.

"Prednisone therapy may alleviate local symptoms. In a small case series, tamoxifen appeared to be effective in delaying, or perhaps even helping resolve, the progression of disease. Surgery should only be undertaken after contemplation of the risks and benefits. However, surgery may be indicated to relieve tracheal or esophageal compression and occasionally to exclude carcinoma."

Signs that you might have Riedel's thyroiditis, include, therefore:
  • Tightness or discomfort in the neck
  • Difficulty swallowing
  • Hoarseness
  • An enlargement in the thyroid (known as a goiter), especially one that feels hard to the touch.
You doctor will likely run blood tests to check for imbalances in thyroid hormone levels, and elevated antibodies.
But to confirm diagnosis, a fine needle aspiration biopsy is needed.

In some cases, your doctor will prescribe the corticosteroid drug prednisone to help to relieve symptoms. The estrogen-blocking drug tamoxifen is also a new drug treatment that has shown effectiveness in delaying or resolving progression of Riedel's thyroiditis.

Rarely, the diseased thyroid can interfere with your ability to swallow or breathe, and surgery may be necessary.

Want to learn more? See UpToDate's topic, "Overview of thyroiditis," for additional in-depth, medical information


Burman, Kenneth. Ross, Douglas. Martin, Kathryn. "Overview of thyroiditis." UpToDate. Accessed: August 22, 2008.

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