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10th April 2024
Postpartum thyroid dysfunction
Postpartum thyroiditis (PPT) is a transient autoimmune lymphocytic thyroiditis which can result in thyrotoxicosis, hypothyroidism or thyrotoxicosis followed by hypothyroidism (Table 4). It usually resolves within a year but there is an increased risk of developing permanent hypothyroidism. Anti-thyroid peroxidase antibodies can be found in 90% of people with postpartum thyroiditis.
| Postpartum thyrotoxicosis | Postpartum hypothyroid |
| Differentiating from Grave’s: PPT has a high T4:T3 ratio, negative thyroid receptor antibody test and no clinical signs of Grave’s disease.
TFTs to be checked 4-8 weeks after resolution of thyrotoxic phase to screen for hypothyroid phase Referral to endocrinology particularly if suspicion of Grave’s disease. Treatment is usually not required, beta-blockers can be considered for symptomatic management. |
Most symptoms resolve within 1 year postpartum. Treatment is recommended if TSH levels are >10 mlU/L, bothersome symptoms or considering further pregnancy.
Levels should be reassessed at 4-8 weeks in untreated cases. |
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