Changes in thyroid hormones by treatment with aspirin and prednisolone in subacute thyroiditis with hyperthyroidism

Thyroid functions were studied in 11 patients with subacute thyroiditis accompanied by signs and symptoms of hyperthyroidism, and were compared with 13 patients with untreated thyrotoxicosis in which serum T4 was elevated to the identical level. Serum T3 was also elevated in subacute thyroiditis but to a significantly lower extent than in thyrotoxicosis. Therefore the ratio of T4/T3 was significantly higher in subacute thyroiditis than in thyrotoxicosis. Although duration of thyroid swelling was shorter in the group treated by prednisolone than by aspirin, the accelerated ESR, thyroid tenderness and fever subsided almost similarly in the two groups. Serum T4 and T3 levels declined more rapidly in treatment with prednisolone compared with aspirin. In patients treated by aspirin initial increase in T3 level occurred transiently with simultaneous decrease in the T4/T3 ratio. These changes suggest the increase in peripheral conversion of T4 to T3. Even in severe cases of subacute thyroiditis associated with hyperthyroidism, aspirin treatment is an effective therapy and there is no recurrence following withdrawal of the medication.