Postpartum Thyroiditis

What is postpartum thyroiditis?

Postpartum thyroiditis happens when a woman’s thyroid gland becomes inflamed after having a baby. This condition affects a small percentage of pregnant women, or about 3 in 100 to 2 in 25.

The thyroid is a tiny gland in the front of your neck. Its job is to make thyroid hormones. These hormones travel through your bloodstream to all parts of your body. Thyroid hormones control how your body uses energy. They affect almost every organ in your body. When your thyroid doesn’t make the right amount of hormones, you don’t feel well.

Postpartum thyroiditis may first make your thyroid overactive (hyperthyroidism). This means it sends too many thyroid hormones out into the bloodstream. This can make parts of your body work too fast. But over time the condition leads to an underactive thyroid (hypothyroidism). This means it doesn’t make enough thyroid hormones. Then parts of your body slow down.

What causes postpartum thyroiditis?

Experts don’t know what causes this condition. But it is a lot like the autoimmune disease Hashimoto thyroiditis. It is hard to tell the two conditions apart.

Who is at risk for postpartum thyroiditis?

You may be more likely to get this condition if you have any of these:

  • Antithyroid antibodies before pregnancy

  • Type 1 diabetes

  • A history of thyroid problems

  • Family history of thyroid problems

What are the symptoms of postpartum thyroiditis?

When the thyroid becomes inflamed, it first sends a lot of thyroid hormone into your blood. That causes hyperthyroidism. During this time, you may not have any symptoms. Or any symptoms you do have may be mild and not last long.

After this first phase, you may fully recover. Or your thyroid may be damaged. A damaged thyroid can become underactive. This condition may also go away. Or you may have an underactive thyroid for the rest of your life. In this case you may need hormone replacement.

Each person’s symptoms may vary. Symptoms may include:

Overactive thyroid (hyperthyroidism)              

  • Feeling warm

  • Muscle weakness

  • Nervousness

  • Anxiety

  • Fast heartbeat

  • Loss of focus

  • Weight loss

Underactive thyroid (hypothyroidism)

  • Tiredness and lack of energy (fatigue)

  • Constipation

  • Memory loss

  • Can’t handle cold weather

  • Muscle cramps

  • Weakness

  • Weight gain

These symptoms may not appear until a few months after childbirth. They are often mistaken for normal signs of recovery from childbirth. Always see your healthcare provider for a diagnosis.

How is postpartum thyroiditis diagnosed?

Tests used to diagnose postpartum thyroiditis depend on the phase of the disease. A blood test can often tell if you have an overactive or underactive thyroid.

How is postpartum thyroiditis treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment depends on the phase of the disease and your symptoms:

  • Overactive thyroid. If you have major symptoms of hyperthyroidism, your provider will often prescribe beta blockers, prednisone, or both. These medicines slow down your heart rate and ease symptoms of inflammation.

  • Underactive thyroid. If you have major symptoms of hypothyroidism, your provider will prescribe thyroid hormone replacement.

You should have regular thyroid tests. Your thyroid may be working normally within 12 to 18 months after the symptoms start. If so, you may be able to stop treatment. Thyroid function will return to normal in 4 in 5 women.

Key points about postpartum thyroiditis

  • Postpartum thyroiditis happens when a woman’s thyroid becomes inflamed after having a baby. It may first cause the thyroid to be overactive. But in time it can lead to an underactive thyroid.

  • Experts don’t know what causes this condition.

  • You are more likely to get it if you had antithyroid antibodies before pregnancy. Other risk factors include having type 1 diabetes or a history of thyroid problems.

  • A blood test can often tell if you have an overactive or underactive thyroid.

  • Treatment is based on how severe your symptoms are.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your provider if you have questions.