Postpartum thyroiditis is an uncommon condition in which a previously normal-functioning thyroid gland — a butterfly-shaped gland located at the base of your neck just below your Adam's apple — becomes inflamed within the first year after childbirth.
Postpartum thyroiditis often lasts several weeks to months. But, postpartum thyroiditis can be difficult to recognize because its symptoms are often mistakenly thought to be the stress of having a newborn and postpartum mood disorders.
For most women who develop postpartum thyroiditis, thyroid function returns to normal within 12 to 18 months of the start of symptoms. But some women develop permanent complications.
During postpartum thyroiditis, you might experience two phases. The inflammation and release of thyroid hormone might first cause mild signs and symptoms similar to those of an overactive thyroid (hyperthyroidism), including:
These signs and symptoms typically occur one to four months after delivery and last one to three months.
Later, as thyroid cells become impaired, mild signs and symptoms of underactive thyroid (hypothyroidism) might develop, including:
These signs and symptoms typically begin four to six weeks after the symptoms of hyperthyroidism resolve and can last six to 12 months.
Keep in mind, however, that some women who have postpartum thyroiditis develop symptoms of only hyperthyroidism or only hypothyroidism.
The exact cause of postpartum thyroiditis isn't clear. However, women who develop postpartum thyroiditis often have high concentrations of anti-thyroid antibodies in early pregnancy and after childbirth. As a result, it's believed that women who develop postpartum thyroiditis likely have an underlying autoimmune thyroid condition that flares after childbirth due to fluctuations in immune function. This underlying condition appears to be very similar to Hashimoto's thyroiditis, in which the immune system attacks the thyroid gland.
You might be at increased risk of postpartum thyroiditis if you have:
While further research is needed, some studies have also shown a link between postpartum thyroiditis and postpartum depression. As a result, if you have postpartum depression your doctor will likely check to see how your thyroid is functioning.
For most women who develop postpartum thyroiditis, thyroid function eventually returns to normal — typically within 12 to 18 months of the start of symptoms. However, some women who experience postpartum thyroiditis don't recover from the hypothyroid phase. As a result, they develop hypothyroidism, a condition in which the thyroid gland doesn't produce enough of certain important hormones.
While you might not be able to prevent postpartum thyroiditis, you can take steps to care for yourself in the months after childbirth. If you have any unusual signs or symptoms after childbirth, don't assume they're related to the stress of caring for a newborn. If you're at increased risk of postpartum thyroiditis, talk to your health care provider about how to monitor your health.
If you have signs and symptoms of postpartum thyroiditis, your doctor will check to see how your thyroid is functioning. He or she will use blood tests that measure the level of thyroid-stimulating hormone (TSH) and the level of the thyroid hormone thyroxine.
If you have risk factors for postpartum thyroiditis, your doctor will likely test the functioning of your thyroid three and six months after delivery.
If your thyroid test results are abnormal, your doctor will likely recommend further testing within one to two weeks.
In addition, if you develop postpartum thyroiditis, your doctor will likely check your thyroid annually afterward to see if you develop hypothyroidism.
Most women who develop postpartum thyroiditis don't need treatment during the hyperthyroid or hypothyroid phases of their condition. However, your doctor will likely monitor how your thyroid is functioning through blood tests every four to eight weeks. This will help him or her track whether abnormalities resolve themselves or detect the development of hypothyroidism.
If you develop severe signs and symptoms of hyperthyroidism, your doctor will likely recommend treatment with a drug that blocks the effects of thyroid hormone on the body (beta blocker). Beta blockers typically aren't recommended for women who are breast-feeding. However, the beta blocker propranolol (Inderal) might be recommended because in breast milk it's not as concentrated as other beta blockers.
If you develop severe signs and symptoms of hypothyroidism, you'll likely need thyroid hormone therapy for six to 12 months. This treatment involves daily use of the synthetic thyroid hormone levothyroxine (Levo-T, Synthroid, others).
When you stop taking the medication your doctor will monitor you for the development of hypothyroidism. You might need blood tests after six weeks, three months, and then, if your test results remain normal, annually.
The postpartum period often brings physical discomfort as well as emotional ups and downs. If you're diagnosed with postpartum thyroiditis, work with your health care provider to determine how you can safely manage your condition and your role as the mother of a newborn.
You'll likely start by seeing your family doctor or a general practitioner. In some cases, you might be referred to a doctor who specializes in the body's hormone-secreting glands (endocrinologist).
Here's some information to help you get ready for your appointment and know what to expect from your doctor.
Preparing a list of questions will help you make the most of your time with your doctor. For postpartum thyroiditis, some basic questions to ask include:
Don't hesitate to ask any other relevant questions you have.
Your doctor is likely to ask you a number of questions, including: