Postpartum Thyroiditis

What is postpartum thyroiditis?

Postpartum (post-PAHR-tum) thyroiditis (thi-roi-DI-tis) is a condition where there is inflammation (swelling) of the thyroid gland in women after giving birth. The thyroid gland is a butterfly-shaped organ that makes hormones, and is located in the front part of your neck. Hormones are special chemicals that act as messengers to help control how your body works. The thyroid gland makes the thyroid hormone that help control your body's functions, including body temperature, heart rate, and growth. Postpartum thyroiditis usually occurs right after or within a year after giving birth to the baby. It may also happen after an abortion or miscarriage. Postpartum thyroiditis usually starts with having hyperthyroidism (increased levels of thyroid hormone in the blood) for the first few weeks. It is then followed by hypothyroidism where there is a decreased level of the thyroid hormone.

What causes postpartum thyroiditis?

Postpartum thyroiditis is an autoimmune disease. The immune system is your body's defense system against infections and diseases. An autoimmune disease happens when immune cells produce antibodies that attack your own body's cells. Your body's immune cells attack the thyroid gland and affect its ability to work properly. During pregnancy, the immune system slows down its activity to prevent antibodies from forming. These antibodies could harm the baby. After delivery of the baby, the immune system may start working normally. It is during this time that the immune system makes antibodies that may attack and damage the thyroid gland.

What are the signs and symptoms of postpartum thyroiditis?

Early signs and symptoms of postpartum thyroiditis may include:

Feeling hot even when it is cold, and sweating more than usual.

Feeling nervous, tense, tired, restless, and being unable to sleep or stay still for long periods.

Having a fast heartbeat even when you are resting.

Having an increase in the size of the thyroid gland.

Having hypertension (high blood pressure).

Having tremors.

Losing weight and always feel hungry, even if you are eating most of the time.

Late signs and symptoms of postpartum thyroiditis may include:

Feeling weak and having muscle pain.

Gaining weight without trying to, and having high blood sugar levels.

Having a very slow heartbeat, and feeling cold most of the time.

Having constipation (dry, hard bowel movements), dry or flaky skin, and thin and brittle fingernails or hair.

Having mood swings, such as being irritable, depressed, or anxious.

Swelling around the eyes.

Thinking more slowly and a change in your voice or speech.

How is postpartum thyroiditis diagnosed?

Postpartum thyroiditis is diagnosed by any of the following:

Blood tests:

You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It may tell your caregiver how low or how high your thyroid hormone levels are in your blood. This information may also be used to see how well treatments are working. You may need to have blood drawn more than once.

Thyroid scan:

This test shows caregivers how well your thyroid is working. Radioactive dye is put into your IV or is given to you to drink. The working part of the thyroid gland absorbs (soaks up) the dye. Two to 48 hours later, caregivers put a machine called a scintillator over your neck. The machine takes pictures showing the areas of your thyroid that absorbed the dye.

How is postpartum thyroiditis treated?

Postpartum thyroiditis usually goes away on its own. Caregivers may watch you for changes over time. You may need short-term treatment with one or more of the following:

Medicines:

Antithyroid medicines:

These medicines act on the thyroid and stop it from making too much thyroid hormone. They may also decrease and prevent the signs and symptoms of hyperthyroidism.

Hormone replacement therapy:

This medicine is given if you have very little thyroid hormone in the blood.

Others:

Medicines to treat a very fast heartbeat, nervousness, too much sweating, and trembling may also be given.

Radioactive iodine:

Iodine is an important mineral used by the thyroid gland to work correctly. The thyroid gland is the only organ in the body that can absorb iodine. A radioactive form of iodine is given to damage or kill some thyroid gland cells. This may decrease the amount of thyroid hormone made by the thyroid gland. This treatment is not given to mothers who are breast feeding.

Who are at risk to have postpartum thyroiditis?

Women who just had a pregnancy or have just given birth with one or more of the following are at risk:

Diagnosed with thyroid problems during past pregnancies.

Having family members who have thyroid disease.

High levels of thyroid antibodies during the first months of pregnancy.

Insulin dependent diabetes mellitus (high levels of sugar in the blood).

Where can I find more information?

Having postpartum thyroiditis is hard. You and those close to you may feel scared, angry, or sad. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. Contact the following for more information:

American Thyroid Association
6066 Leesburg Pike, Suite 550
Falls Church, VA 22041
703-998-8890
800-849-7643
www.thyroid.org