Post partum thyroiditis

This is a functional thyroid condition that affects 5% of pregnancies   

  • Occurs in 5 - 10 % of women in the US
  • Occurs in 25 % of women with type 1 diabetes
  • Manifests after delivery or pregnancy loss (miscarriage, abortion, ectopic) as well as after normal delivery. 
Post-partum thyroiditis is a subset of general thyroiditis. There are technically two forms of this condition both of which occur within the 1 year after delivery of a patient's child. Classic postpartum thyroiditis is characterized by transient hyperthyroidism, or transient hyperthyroidism followed by transient or rarely permanent hypothyroidism.  Postpartum-exacerbation-of-Hashimoto's may cause temporary or permanent hypothyroidism, and may be associated with transient or permanent increase in goiter. The hyperthyroid phase may be treated with beta blockers if needed. The transient hypothyroidism may be treated with levothyoxine if needed. Unfortunately the hypothyroidism can be permanent in 30-50% of patients.  Women with any type of postpartum thyroiditis are likely to have recurrent thyroiditis with future pregnancies. The vitamin selenium may decrease inflammatory activity in patients with autoimmune thyroiditis and may reduce the risk of subsequent postpartum thyroiditis in women who are known to have thyroid peroxidase (TPO) antibodies. One hundred fifty one TPO-positive women were randomly assigned get selenium (200 mcg daily) or placebo beginning at about the 12th week of gestation. Postpartum thyroiditis occurred in 22 of 77 women (29 %) in the selenium group, compared to 36 of 74 (49 %) in the placebo group. Further study is needed (1)  The endocrinologists at Houston Thyroid Specialists can help you fully understand how to treat and prevent post partum thyroiditis. 

Symptoms of postpartum thyroiditis

Decreased breast milk volume
Tremor or anxiety or moodiness
Fast or pounding heart beats
Fatigue
Enlargement of the thyroid (goiter)

The symptoms depend on which phase of thyroiditis a patient is within. There is a hyperthyroid phase and hypothyroid phase. 

References:
1) Negro, R, Greco, G, Mangieri, T, et al. The influence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies. J Clin Endocrinol Metab 2007; 92:1263.

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