Postpartum thyroiditis is an inflammation of the thyroid gland. It usually occurs within a year after a woman gives birth. It affects five to ten out of every 100 women after they deliver a baby. There are usually two phases of the disease – hyperthyroidism (too much thyroid hormone) and hypothyroidism (too little thyroid hormone).
In the usual first phase—hyperthyroidism—the inflamed thyroid gland leaks stored thyroid hormone (which consists of T3 and T4) into the blood. This phase usually lasts 2 to 4 months. Too much thyroid hormone in your blood causes your metabolism to speed up. Symptoms can include
Inflammation can damage the thyroid, making it less able to produce thyroid hormone. This can lead to the second phase—hypothyroidism. This phase may last up to a year. Too little thyroid hormone in your blood slows your metabolism. Many women with hypothyroidism have a goiter—an enlarged thyroid gland that causes swelling in the front part of the neck. Other symptoms of hypothyroidism can include
The thyroid gland, located in the front of your neck, releases a hormone that controls your metabolism—how your body uses and stores energy from food.
You are at greater risk of developing postpartum thyroiditis if you have an immune system disorder such as type 1 diabetes, a personal or family history of thyroid disease, or had postpartum thyroiditis before.
Some women who develop hyperthyroidism after giving birth return to normal within a few months without going through the second phase (hypothyroidism). Most women, however, do experience the second phase. Of these women, about one out of five develops permanent hypothyroidism. They require life-long treatment with thyroid hormone. If left untreated, hypothyroidism can cause serious problems such as heart disease.
Diagnosis depends on the phase of the disease and is based on your symptoms and laboratory test results. These tests help determine if you are in the hyper- or hypothyroid phase:
In the first phase (hyperthyroidism), you usually don’t need treatment because symptoms are mild and brief. If your symptoms are extreme, however, your doctor might give you a beta blocker drug to slow your heart rate and lessen nervousness.
In the second phase (hypothyroidism), you will receive thyroid hormone therapy if you develop symptoms. Levothyroxine is the product of choice. It is a synthetic (laboratory-made) form of T4 that is the same as the T4 the thyroid gland naturally makes. After 6 to 12 months, the medication is stopped to see whether your thyroid will function normally on its own. In most cases the thyroid returns to normal, but some women develop long-term hypothyroidism and need lifelong thyroid hormone replacement therapy.