About postpartum thryoiditis:
postpartum thyroiditis (PPT) is inflammation of the thyroid gland within the first year after giving birth, miscarriage, or medical abortion in individuals who did not have clinical thyroid disease before pregnancy.
5-10% of women will develop thyroid dysfunction during the first year after delivery of a baby
Per the American Thyroid Association (ATA), this is typically caused from underlying autoimmune issues. About 20% to 50% of women with postpartum thyroiditis go on to develop permanent hypothyroidism (Hashimoto's), while a smaller percentage (typically under 11%) can progress into hyperthyroidism (Graves' disease)
How postpartum thyroiditis is diagnosed:
Physical examination
Specific blood tests
Thyroid function tests: Free T3, Free T4 and TSH
Thyroid antibody tests: TPO antibodies - confirms autoimmune activity & likelihood of postpartum thyroiditis
Additional tests: TSI - highly specific for Graves' disease & TRAb tests for a broader range of antibodies to catch any other problems with the thyroid outside of postpartum thyroiditis, Graves' and Hashimoto's.
Graves' Disease: an autoimmune disorder where the immune system produces antibodies that attack the thyroid gland and stimulate it to overproduce thyroid hormones.
Hashimoto's disease: An autoimmune disorder where the immune system produces antibodies [thyroid peroxidase (TPO) and/or thyroglobulin (Tg)] that attack and damage your thyroid gland. As the thyroid is damaged, it loses the ability to produce enough thyroid hormone, resulting in an underactive thyroid.
Hyperthyroid phase (overactive):
COMMON: anxiety, irritability, insomnia, unexplained weight loss, and rapid heartbeat (palpitations).
UNCOMMON/LESS PROMINENT: muscle weakness, heat intolerance (feeling too warm), difficulty focusing, and a painless, swollen lump at the base of the neck.
Hypothyroid phase (underactive):
COMMON: extreme fatigue, weight gain, constipation, dry skin and depressive mood.
UNCOMMON/LESS PROMINENT: intolerance to cold temperatures (feeling abnormally cold), muscle cramps, generalized weakness or poor exercise tolerance.
What are the common phases of postpartum thyroiditis?
Phase 1 - Hyperthyroidism; typically 1-4 months after delivery and lasts 1-3 months.
Phase 2 - Hypothyroidism; typically 4-8 months after delivery and can last up to a year.
What is the typical timeline for postpartum thyroiditis?
About 80% of women achieve full, spontaneous resolution within 12 to 18 months postpartum without long-term damage - though, some patients report lingering sypmtoms beyond that timeline. Discuss persisten symptoms with your healthcare provider.
20-40% of women go on to have long-term thyroid issues, most commonly - hashimoto's.
Why is postpartum thyroiditis often missed?
PPT sypmptoms frequently overlap with common, expected physical changes after childbirth, making eaasy to miss.
What are some commonly reported symptoms?
PPD & Mood changes
Poor breastmilk production
Extreme brain fog & memory loss
Poor exercise tolerance
Possible low iron (this is one that is linked more to blood loss from delivery, but it's very commonly overlooked as it can mimic hypothyroid symptoms).
What does this mean for future pregnancies?
Women who have had PPT face a 70% chance of recurrence in future pregnancies and an elevated risk of thyroid failure years down the road.
Our goal is to make healthcare information easier to understand-not replace professional medical advice. While we prioritize established medical evidence, we may also discuss emerging research and patient-reported experiences when relevant. Additional resources are provided below for those who wish to explore the topic in greater depth.