Archived Article – The Thyroid Society (1998 – 2003)
The following is an article about post partum thyroiditis, written by Dr. John H. Lazarus, Senior Lecturer and Consultant Physician for the University of Wales College of Medicine.
What is Port Partum Thyroiditis?
Post partum (or silent) thyroiditis is a type of thyroiditis (inflammation of the thyroid gland) that occurs in 5-9% of women during the first 6 months after birth (postpartum). The thyroiditis is usually painless but there may be enlargement of the thyroid gland.
Which women get post partum thyroiditis?
The condition is usually (at least 80-90%) associated with the presence of thyroid antibodies in the blood. These are markers of thyroid disease and may be detected in early or mid-pregnancy. If present at this time about half the women will develop an overactive or underactive thyroid (or both) during the post partum period. The other half will have normal thyroid function during this time but continue to have thyroid antibodies.
What are the symptoms of post partum thyroiditis?
In the overactive stage you may feel hot and tired with a fast pulse together with increased sweating and nervousness. These symptoms are often mild and go unrecognized. The overactivity is always transient and only lasts a few weeks. The underactive symptoms include tiredness, feeling the cold, depression, dry skin and aches and pains. These symptoms are often more severe. Many of the symptoms are very general such that the doctor may not at first think of thyroid disorder. However post partum thyroid disease is now being diagnosed more frequently.
What will your doctor do?
Your doctor may:
- Listen carefully to your complaints.
- Examine you for signs of hyperthyroidism (overactive) or hypothyroidism (underactive).
- Check a blood test for thyroid hormones and thyroid antibodies.
- Perform a test called a radioiodine uptake to confirm the cause of the thyroid problem.
If you are hyperthyroid a beta-blocker such as Propanolol may be prescribed if there are severe symptoms. This can be stopped after a few weeks when the condition has subsided. If you are hypothyroid (underactive) thyroxine treatment may be given.
In about a fifth to a third of women the hypothyroidism becomes permanent and thyroxine therapy is necessary for life. Your doctor may wish to check whether you need thyroxine after a year or so by stopping it for 6 weeks and then rechecking your thyroid levels.
In some women with thyroid antibodies (about 30%) psychiatric symptoms of depression appear more commonly than in women who do not have these antibodies.
The depression is usually mild to moderate and occurs equally in those women who do and do not have abnormalities of thyroid function post partum.
You should recognize however that post partum thyroid disease is not the only cause of post partum depression
The long-term outlook
If you have had transient postpartum thyroid abnormalities there is a high chance that they will reoccur after a subsequent pregnancy. There is also a significant chance of developing thyroid failure during the next 10 years and you should have an annual thyroid hormone test.
If you require lifetime thyroxine therapy a blood test for thyroid hormones should be checked once per year. There is no bar to becoming pregnant again but the dose of thyroxine may require to be increased during the pregnancy.
If you have thyroid antibodies but did not develop post partum thyroid abnormalities you should have a thyroid test every year. There is a small chance of developing thyroid abnormalities after a subsequent pregnancy.
Occasionally, both men and women develop silent thyroiditis unrelated to pregnancy. The symptoms and signs in these patients are similar to post partum thyroiditis, as are the treatments and long-term outcomes.
Dr. John H. Lazarus,
Senior Lecturer and Consultant Physician,
University of Wales College of Medicine
Find more archived articles from The Thyroid Society (1998 – 2003) below: