Postpartum thyroiditis is an inflammation of the thyroid gland that occurs after pregnancy. 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 two to four months. Too much thyroid hormone in your blood causes your metabolism to speed up.
The inflammation can damage the thyroid, making it less able to produce thyroid hormone. This can lead to the second phase, hypothyroidism, too little thyroid hormone in the blood. 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:
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 have had postpartum thyroiditis before.
For some women who develop hyperthyroidism after giving birth, the thyroid levels return to normal within a few months without going through the second phase (hypothyroidism). However, most women 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 most commonly used thyroid hormone medication. 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.
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