What is postpartum thyroiditis?

Postpartum thyroiditis is inflammation of the thyroid following delivery of a baby. Postpartum thyroiditis can result in hyperthyroidism at first and ultimately produces hypothyroidism. The cause of postpartum thyroiditis is thought to be an autoimmune disease similar to Hashimoto's thyroiditis. The two entities cannot be distinguished pathologically. In the United States, a small percentage of pregnant women develop postpartum thyroiditis.

Who is at risk for postpartum thyroiditis?

Certain risk factors may help predict who is at an increased risk for developing postpartum thyroiditis, according to the American Thyroid Association (ATA). These include:

• The presence of antithyroid antibodies prior to pregnancy is a major risk factor. Changes in the immune system during pregnancy may make the symptoms of thyroiditis more severe.

• Type 1 diabetes

• History of prior thyroid dysfunction

• Family history of thyroid dysfunction

What are the symptoms of postpartum thyroiditis?

When the thyroid becomes inflamed, it will first emit large quantities of thyroid hormone into the bloodstream producing hyperthyroidism. During this phase, most women are unaware of any symptoms, which are often mild and short-lived. However, once this initial phase passes, a woman either recovers completely or has sustained damage to her thyroid. If the thyroid gland was damaged, this damage?together with a depleted reservoir of thyroid hormones?can lead to hypothyroidism (underactive thyroid). This condition, too, may also clear up or result in permanent hypothyroidism requiring hormone replacement.

The following are the most common symptoms associated with the hyperthyroidism or hypothyroidism that accompany postpartum thyroiditis. However, each individual may experience symptoms differently. Symptoms may include:

Hyperthyroidism
(overactive thyroid)

Hypothyroidism
(underactive thyroid)

Feeling warm

Feeling tired

Experiencing muscle weakness

Constipation

Feeling tremulous

Loss of memory

Experiencing anxieties

Cannot tolerate cold weather

Rapid heartbeat

Cramps in the muscles

Loss of concentration

Feeling weak

Weight loss

Weight gain

Postpartum thyroiditis symptoms may not appear until several months after childbirth. Symptoms are also often mistaken for normal signs of recovery from childbirth. Always consult your doctor for a diagnosis.

How is postpartum thyroiditis diagnosed?

Diagnostic procedures used to detect postpartum thyroiditis depend on the phase of the disease. A blood test to measure levels of thyroid hormones (T3 and T4) and thyroid-stimulating hormones (TSH) can usually determine whether the mother has hypothyroidism or hyperthyroidism. However treatment is based on severity of symptoms rather than lab values in this illness.

What is the treatment for postpartum thyroiditis?

Most women with postpartum thyroiditis do not need treatment during either the hyperthyroid or hypothyroid phases of their illness. Treatment depends on the phase of the disease and the degree of symptoms the woman is experiencing. Women with significant symptoms of hyperthyroidism are usually treated with beta blockers, medicines to slow down the heart rate and lessen symptoms. Women with significant symptoms of hypothyroidism are treated with thyroid hormone replacement. According to the ATA, it is very important for women to have ongoing thyroid monitoring since 80 percent of women with this diagnosis will have normal thyroid function within 12 to 18 months after the onset of symptoms and can stop treatment under your doctor's supervision.