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Postpartum Thyroiditis (PPT) Symptoms and Treatment

What is postpartum thyroiditis

Postpartum Thyroiditis (PPT) Symptoms and Treatment The term thyroiditis means the inflammation that occurs in the thyroid gland. That means the thyroiditis that happens after pregnancy is called postpartum thyroiditis. 5% of women worldwide get affected with postpartum thyroiditis within 12 months after child birth. Usually, postpartum thyroiditis goes thorough two stages- hyperthyroidism and hypothyroidism. Thyroid problems after pregnancy follow a most common course. At first, mild post partum hypothyroidism occurs within 2 to 6 months after the child birth. When the thyroid normalizes, the mild post partum hypothyroidism resolves. Next, common event is mild hyperthyroidism. This begins within 1 to four months after the delivery happens.

In some cases, at first, the mild hyperthyroidism comes within the first four months after child birth and stays for 2 to 8 weeks. Then comes a period of multiple weeks, in some cases, multiple months, causing mild hypothyroidism. And after that the thyroid gets back to its normal state.

In most of the cases the thyroid gets normalized. Some women get affected with permanent hypothyroidism and require lifelong treatment.

Causes for postpartum thyroiditis

The exact reasons for postpartum thyroiditis are still unclear to the experts. Some possible theories are being worked on. But, the disease can be detected under close observation and there are treatment options available.

Postpartum thyroiditis symptoms

Hyperthyroidism is the first phase of postpartum thyroiditis. This phase can happen at any time between 2 to 6 months of postpartum. During this phase physical changes due to the hormone disturbance don’t occur much. Also the symptoms are quite transient and the phase often passes undetected. They are usually the milder hyperthyroidism symptoms. Usual signs include the following:

  • Irritability;
  • Heat intolerance;
  • Fatigue;
  • Nervousness;
  • Palpitations;
  • Unexplained weight loss;
  • Diarrhea;
  • Anxiety;
  • Tremor;
  • Muscle weakness.
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The second phase is hypothyroidism. Hypothyroidism also comes with transient symptoms and can show up within 3 to12 months during the postpartum period. These symptoms are actually the milder version of hypothyroidism symptoms. In this phase women go through the following signs:

  • Low energy;
  • Impaired concentration;
  • Poor memory;
  • Dry skin;
  • General aches and other pains;
  • Cold intolerance;
  • Carelessness;
  • Constipation;
  • Low body temperature;
  • Weight gain.


Who are facing the risks

Any pregnant woman can face thyroid problems after pregnancy. Worldwide 5% of mothers experience postpartum thyroiditis. But women falling under conditions mentioned below are likely to face greater threats.

  • Mothers with type 1 diabetes are likely to face postpartum thyroiditis.
  • Women carrying anti-thyroid antibodies (anti-thyroglobulin, anti-thyroid peroxidase) and normal levels of thyroid hormone are also in risk.
  • For women with history of postpartum thyroiditis, it is a possibility that they might expwrience another episode.
  • Women with ‘elevated anti-peroxidase (anti-TPO) antibodies’ are at risk of developing postpartum thyroiditis.


Diagnosing Postpartum thyroiditis

Basically, postpartum thyroiditis is diagnosed with blood tests examining thyroid hormone levels. In the hyperthyroid part, usually blood tests show low level ‘Thyroid stimulating hormone (TSH)’ along with slightly elevated level of T4 and T3. In the hypothyroid part, the TSH level is quite high and T4 level is lowered. Also ‘Antithyroid peroxidase (anti-TPO) antibody’ level is expected to increase in the postpartum thyroiditis sufferers.

In some cases, doctors perform an ultrasound to examine the enlarged copy of the thyroid gland. Also, a disease named autoimmune Graves’ and postpartum thyroiditis are both responsible for causing hyperthyroidism after child birth. Both of them show similar symptoms and are very tough to distinguish. That’s why doctors also run tests to determine whether the patient is suffering from postpartum thyroiditis or the graves’ disease.

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Postpartum thyroiditis treatment options

Sometimes the most important part of the treatment process is to determine if the disease actually exists or not and if exists, to what extent? Women who go through hyperthyroidism during postpartum thyroiditis aren’t in need of the same treatment options as the women who are suffering from permanent hyperthyroidism require. If the women are having their heart rate elevated dangerously and shaking with tremor, beta-blockers may be of great use. This way, thyroid functions aren’t compromised and the patient will be relieved of the symptoms for the short time frame of the phase.

Treatment measures during the hypothyroid part depend on the severity of signs and the abnormal changes in hormone levels. Women usually take a pill of levothyroxine per day for almost 6 months. If the women are nursing, they can consume the levothyroxine pills without any hesitation, since only a minimal amount goes into the breast milk. There are a few factors which are proven predictors of whether a woman is experiencing the temporary or the permanent form of hypothyroidism. Women who have developed permanent hypothyroidism after suffering from postpartum thyroiditis should take levothyroxine medication once everyday for the rest of their lives.

Delores C. West is a compassionate healthcare professional with a focus on women's health and wellness. As a certified nurse-midwife, Delores is dedicated to providing comprehensive care to women throughout their reproductive journey. With a warm and nurturing approach, she empowers her patients to make informed decisions about their health and well-being. Delores's expertise in women's health makes her a trusted resource for individuals seeking personalized and compassionate care. Connect with her on LinkedIn to learn more about her commitment to women's health and wellness.