Post partum thyroiditis

Question 1

What is postpartum thyroiditis?

Answer 1

Changes in thyroid function within 12 months of delivery affecting women without a history of thyroid disease. Over time, thyroid function returns to normal.

Question 2

What causes postpartum thyroiditis?

Answer 2

Not clear, but the leading theory is that pregnancy has an immunosuppressant effect on the mother’s body to prevent her from rejecting the fetus. After delivery, there is an increased immune system effect with increased antibodies, e.g., thyroid peroxidase antibodies.

Question 3

What are the stages of postpartum thyroiditis?

Answer 3

1. Thyrotoxicosis → usually in the first 3 months.
2. Hypothyroid → usually from 3-6 months.
3. Thyroid function gradually returns to normal (usually within 1 year).

Question 4

Signs & symptoms of hyperthyroidism?

Answer 4

Anxiety & irritability, sweating & heat intolerance, tachycardia, weight loss, fatigue, frequent loose stools.

Question 5

Signs & symptoms of hypothyroidism?

Answer 5

Weight gain, fatigue, dry skin, coarse hair and hair loss, low mood, fluid retention, heavy or irregular periods, constipation.

Question 6

What results would you expect in hyperthyroidism and hypothyroidism?

Answer 6

Hyper - Low TSH, high T3 and T4
Hypo - High TSH, low T3 and T4

Question 7

What is the management for postpartum thyroiditis?

Answer 7

Hyperthyroidism → propanolol Hypothyroidism → levothyroxine
Annual monitoring to check for those who develop long term hypothryoidism