Overview

Postpartum thyroiditis is an uncommon condition in which a previously normal-functioning thyroid gland — a butterfly-shaped gland located at the base of your neck just below your Adam's apple — becomes inflamed within the first year after childbirth.

Postpartum thyroiditis often lasts several weeks to several months. However, postpartum thyroiditis can be difficult to recognize because its symptoms are often mistakenly attributed to the stress of having a newborn and postpartum mood disorders.

For most women who develop postpartum thyroiditis, thyroid function returns to normal within 12 to 18 months of the start of symptoms. However, some women who experience postpartum thyroiditis develop permanent complications.

Symptoms

During postpartum thyroiditis, you might experience two phases. The inflammation and release of thyroid hormone might first cause mild signs and symptoms similar to those of an overactive thyroid (hyperthyroidism), including:

  • Anxiety
  • Irritability
  • Rapid heartbeat or palpitations
  • Unexplained weight loss
  • Increased sensitivity to heat
  • Fatigue
  • Tremor
  • Insomnia

These signs and symptoms typically occur one to four months after delivery and last one to three months.

Later, as thyroid cells become impaired, mild signs and symptoms of underactive thyroid (hypothyroidism) might develop, including:

  • Lack of energy
  • Increased sensitivity to cold
  • Constipation
  • Dry skin
  • Difficulty concentrating
  • Aches and pains

These signs and symptoms typically occur four to eight months after delivery and can last from nine to 12 months.

Keep in mind, however, that some women who have postpartum thyroiditis develop symptoms of only hyperthyroidism or only hypothyroidism, but not both.

Causes

The exact cause of postpartum thyroiditis isn't clear. However, women who develop postpartum thyroiditis often have high concentrations of anti-thyroid antibodies in early pregnancy and after childbirth. As a result, it's believed that women who develop postpartum thyroiditis likely have an underlying autoimmune thyroid condition that flares after childbirth due to fluctuations in immune function. This underlying condition appears to be very similar to Hashimoto's disease, in which your immune system attacks your thyroid gland.

Risk factors

You might be at increased risk of postpartum thyroiditis if you have:

  • An autoimmune disorder, such as type 1 diabetes
  • A history of postpartum thyroiditis
  • High concentrations of anti-thyroid antibodies
  • A history of previous thyroid problems
  • A family history of thyroid problems

While further research is needed, some studies have also shown a link between postpartum thyroiditis and postpartum depression. As a result, if you have postpartum depression your doctor will likely check to see how your thyroid is functioning.

Complications

For most women who develop postpartum thyroiditis, thyroid function eventually returns to normal — typically within 12 to 18 months of the start of symptoms. However, some women who experience postpartum thyroiditis don't recover from the hypothyroid phase. As a result, they develop hypothyroidism, a condition in which your thyroid gland doesn't produce enough of certain important hormones.

Prevention

While you might not be able to prevent postpartum thyroiditis, you can take steps to care for yourself in the months after childbirth. If have any unusual signs or symptoms after childbirth, don't assume they're related to the stress of caring for a newborn. If you're at increased risk of postpartum thyroiditis, talk to your health care provider about how to monitor your health.

Aug. 20, 2013
References
  1. Burman KD. Postpartum thyroiditis. http://www.uptodate.com/home. Accessed May 29, 2013.
  2. Cunningham FG, et al. Williams Obstetrics. 23rd ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=46. Accessed May 29, 2013.
  3. Todd CH. Management of thyroid disorders in primary care: Challenges and controversies. Postgraduate Medical Journal. 2009;85:655.
  4. De Groot L, et al. Management of thyroid dysfunction during pregnancy and postpartum: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism. 2012;97:2543.
  5. Stagnaro-Green A, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011;21:1081.
  6. Stagnaro-Green A. Approach to the patient with postpartum thyroiditis. Journal of Clinical Endocrinology and Metabolism. 2012;97:334.
  7. Hale TW. Medications and Mother's Milk 2012: A Manual of Lactational Pharmacology. 15th ed. Amarillo, Texas: Hale Publishing L.P.; 2012:673.
  8. Halter JB, et al. Hazzard's Geriatric Medicine and Gerontology. 6th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=5133014&searchStr=hyperthyroidism. Accessed June 4, 2013.
  9. Postpartum thyroiditis. The American Thyroid Association. http://www.thyroid.org/postpartum-thyroiditis/. Accessed June 4, 2013.
  10. Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. June 5, 2013.