| What
causes postpartum thyroiditis?
Postpartum thyroiditis is caused by of anti-thyroid (anti-thyroid
peroxidase, anti-thyroglobulin) antibodies that attack the thyroid
and cause inflammation.
How common is postpartum thyroiditis?
In the United Status, postpartum thyroiditis occurs in approximately
5-10% of women. The incidence can be greater in certain high-risk
populations (see below). |
| Who is at risk for
developing postpartum thyroiditis?
Any woman with:
- Autoimmune disorders (such as Type 1, or juvenile onset, Diabetes
Mellitus)
- Positive anti-thyroid antibodies (risk correlates with antibody
levels, the higher the antibody the higher the risk)
- History of previous thyroid dysfunction
- History of previous postpartum thyroiditis (20% of women will
have recurrence of thyroiditis with subsequent pregnancies)
- Family history of thyroid dysfunction
What is the clinical course of
postpartum thyroiditis?
The classic description of postpartum thyroiditis includes thyrotoxicosis
followed by hypothyroidism. The thyrotoxic phase usually lasts for
1-3 months and is associated with symptoms including anxiety, insomnia,
palpitations (fast heart rate) fatigue, weight loss, and irritability.
The hypothyroid phase typically occurs 1-3 months after the thyrotoxic
phase and may last up to 9 –12 months. Typical symptoms include
fatigue, weight gain, constipation, dry skin, depression and poor
exercise tolerance. Most patients (~80%) will have return of their
thyroid function to normal within 12-18 months of the onset of symptoms.
|
| How
is postpartum thyroiditis treated?
The thyrotoxic phase may be treated with beta blockers to decrease
palpitations and reduce shakes and tremors. As symptoms improve,
the medication is tapered off since the thyrotoxic phase is transient.
Antithyroid medications (see Hyperthyroid
brochure) are not used for the thyrotoxic phase since the thyroid
is not overactive.
The hypothyroid phase is often treated with thyroid hormone replacement
(see Thyroid
Hormone Therapy brochure). It is important to try to discontinue
thyroid hormone after 6-9 months, since 80% of patients will regain
normal thyroid function and not require chronic therapy.
|
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