What is postpartum thyroiditis?
Postpartum thyroiditis is a relatively rare condition that affects some women after pregnancy. An estimated 5% of women may experience this in the year after giving birth.
The thyroid is a butterfly-shaped endocrine gland that is located in the lower front of the neck. The thyroid makes hormones that help the body use energy, stay warm, and keep organs such as the brain, heart, and muscles working.
Postpartum thyroiditis can result in hyperthyroidism (high thyroid hormone levels in the blood) and sometimes hypothyroidism (low thyroid hormone levels in the blood). Hyperthyroidism occurs first, followed by hypothyroidism.
Who gets postpartum thyroiditis?
Women who have Type 1 diabetes or those who have a history of thyroid dysfunction are at higher risk for postpartum thyroiditis. Women with a family history of thyroid dysfunction are also at higher risk of developing postpartum thyroid. Presence of microsomal antibodies (thyroid specific antibodies) also makes women more susceptible to thyroid dysfunction including postpartum thyroiditis.
Symptoms and Causes
What causes postpartum thyroiditis?
Postpartum thyroid is caused by antithyroid antibodies attacking the thyroid. This attack causes the thyroid to become inflamed.
It is not known why the antibodies attack the thyroid. However, it is believed that women who develop the condition may have had an underlying autoimmune thyroid condition, without symptoms.
What are the symptoms of postpartum thyroiditis?
In the first phase of postpartum thyroid - hyperthyroidism - most women will not notice any symptoms. This phase usually takes place between 1 to 6 months after giving birth.
If a woman does notice unusual symptoms within this phase, they may include:
- Weight loss.
- Feeling warm.
- Feeling anxious.
- Rapid heart rate.
- Excessive hair loss.
It is not until the second phase of postpartum thyroid — hypothyroidism — that most women will notice symptoms. This phase usually takes place 4 to 8 months after giving birth. It can last as long as a year and then resolve by itself. A small group of women continue to stay hypothyroid for the rest of their lives.
These symptoms may include:
- Weight gain.
- Dry skin.
- Muscle pain.
- Aversion to the cold.
You should seek prompt medical attention if you notice any of these symptoms.
Diagnosis and Tests
How is postpartum thyroid diagnosed?
Your doctor will begin your exam with a history of your symptoms. He or she will then take a blood sample to test the levels of thyroid hormones in your blood. This test is usually enough to diagnose postpartum thyroiditis.
Management and Treatment
How is postpartum thyroiditis treated?
Treatment for postpartum thyroiditis will vary depending on the severity of your condition:
- Women with mild symptoms will be watched, but usually not prescribed any medication unless their symptoms worsen.
- Women with more severe symptoms will be prescribed treatment that varies during each phase of the condition.
- Women experiencing hyperthyroidism will be treated with beta-blockers to reduce their symptoms.
- Women in the hypothyroid phase are usually treated with thyroid hormone replacement therapy.
Outlook / Prognosis
Is this a permanent condition?
For most women it is a temporary condition. It is important to allow your doctor to continue to monitor your thyroid levels during treatment. Eventually, the doctor may be able to taper off your medication as your thyroid returns to normal functioning levels. Eighty percent of patients should eventually be able to be taken off medication. Those with positive thyroid antibodies are more likely to continue in the hypothyroid phase and would need lifelong thyroid hormone replacement.