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Postpartum Thyroiditis

Postpartum thyroiditis is a condition where the thyroid gland becomes inflamed after pregnancy. The symptoms appear within the first year after giving birth, having a miscarriage, or having an abortion. It often occurs in people who have never had a thyroid problem.

Postpartum thyroiditis is an autoimmune disease, which means the body wrongly attacks itself. Autoimmune diseases can occur in any part of the body. With postpartum thyroiditis, the body attacks the thyroid gland.

The thyroid gland is located on the front of the neck. Its main job is to make thyroid hormone. Thyroid hormone helps with metabolism (the body’s energy use) as well as growth and development.

There are three types of postpartum thyroiditis:

  • Transient hyperthyroidism – a brief period where there is too much thyroid hormone in the body
  • Transient hypothyroidism – a brief period where there is too little thyroid hormone in the body
  • Transient hyperthyroidism, then transient hypothyroidism, then back to normal thyroid function – the thyroid hormone goes too high, then too low, then goes back to normal function

Symptoms

The symptoms of postpartum thyroiditis depend on whether there is too much or too little thyroid hormone.

In women who have a transient increase in thyroid hormone, symptoms may not show at all. Those that do are often mild and include:

  • Feeling nervous or anxious
  • Irritability
  • Heart beating fast
  • Weight loss
  • Tremor
  • Feeling too warm

Women who have a transient decrease in thyroid hormone usually have symptoms such as:

  • Constipation
  • Hair thinning
  • Fatigue
  • Feeling too cold
  • Weight gain
  • Memory problems
  • Dry skin

Causes

Scientists aren’t sure exactly what causes the body to mistakenly attack itself in autoimmune disease. There is a genetic part, but not everyone who has the gene gets the disease.

Risk Factors

Some risk factors for developing postpartum thyroiditis include:

  • Having had it with an earlier pregnancy
  • A family history of postpartum thyroiditis
  • Having diabetes mellitus type 1
  • A personal or family history of thyroid problems unrelated to pregnancy

Higher risk pregnant women should be screened during pregnancy and after giving birth.

Diagnosis

Postpartum thyroiditis is diagnosed using a blood test of thyroid hormone levels.

Complications

Most women’s thyroid function will return to normal after 12 to 18 months. However, in some women, the thyroid stays underactive. These women will remain on treatment. Even in women whose thyroid does eventually return to normal, having had postpartum thyroiditis increases their risk for developing permanent low thyroid function in the future.

Treatment

For women who have a temporary increase in thyroid hormone, treatment isn’t usually required, as symptoms are mild. In a few cases, they may need a tablet to help with symptom control until the thyroid returns to normal.

For women who have a temporary decrease in thyroid hormone, treatment with artificial thyroid hormone can be started. Their healthcare provider will periodically check their thyroid levels.

Prevention

It’s not always possible to predict which women will get postpartum thyroiditis. Women with risk factors should be screened with blood tests during and after pregnancy. Any woman who gets postpartum thyroiditis should continue with annual screening even if her thyroid eventually returns to normal.

 
 
 

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