What is postpartum thyroiditis?

Postpartum thyroiditis is inflammation of the thyroid gland, the butterfly-shaped gland in the front of your neck that regulates your metabolism and other bodily functions. It is an autoimmune condition that occurs when antibodies produced by your immune system attack your thyroid.

The thyroid is like the body’s thermostat, helping to regulate your temperature. It also helps the body use energy and regulates the function of your heart, brain, muscles and other organs. Postpartum thyroiditis disrupts thyroid function and can cause either hypothyroidism (an underactive thyroid) or hyperthyroidism (an overactive thyroid).

How common is postpartum thyroiditis?

Postpartum thyroiditis develops within the first year after childbirth and affects about 5 to 10% of women in the US. In rare cases, it can also develop after a miscarriage.

Postpartum thyroiditis symptoms

When your thyroid becomes inflamed, it releases excess thyroid hormones into your bloodstream, leading to hyperthyroidism. You may experience no symptoms or any of the signs associated with an overactive thyroid.

After this initial phase, you might fully recover, or your thyroid could be damaged, potentially becoming underactive. This underactive state could be temporary or permanent, requiring lifelong hormone replacement. Symptoms may be different for each person and may include:

Overactive thyroid (hyperthyroidism)

For some women with postpartum thyroiditis, the first phase will be an overactive thyroid (hyperthyroidism) that will typically start within the first four months after childbirth and may last up to three months.

Not everyone in this phase has noticeable symptoms, but symptoms can include:

  • Feeling anxious or irritable
  • Feeling overheated
  • Heart racing or palpitations
  • Insomnia
  • Some weight loss

Many women may overlook the symptoms of hyperthyroidism, attributing them to the stress of adjusting to taking care of a new baby while trying to balance other life responsibilities.

When to see a doctor

See your OBGYN if you feel tired or experience mood changes. Women with postpartum thyroiditis may think they have the “baby blues” when their symptoms are actually caused by a thyroid condition. Symptoms of postpartum thyroiditis can also mimic those of Hashimoto’s thyroiditis and Graves’ disease, or other thyroid-related conditions.

Causes of postpartum thyroiditis

Postpartum thyroiditis occurs when anti-thyroid antibodies mistakenly attack your thyroid gland, causing inflammation. Normally, antibodies protect your body by fighting off germs, but in this case, they attack the thyroid. This process is similar to what happens in Hashimoto’s disease, the most common type of thyroiditis.

The exact cause of this antibody attack after pregnancy is still being researched. One theory suggests that an undiagnosed underlying autoimmune condition before pregnancy may increase your likelihood of developing postpartum thyroiditis.

Postpartum thyroiditis risk factors

You’re more likely to develop postpartum thyroiditis if you have:

  • Antithyroid antibodies before pregnancy
  • Type 1 diabetes
  • Personal history of thyroid problems
  • Family history of thyroid issues
  • Other autoimmune conditions, such as rheumatoid arthritis

How is postpartum thyroiditis diagnosed?

Generally, your OBGYN can diagnose postpartum thyroiditis with a blood test. They may first start with a physical exam to see if you have any signs and symptoms of thyroid disease. They may examine your thyroid by feeling your thyroid gland and having you swallow.

To diagnose the condition, you will likely have blood tests to check for any markers of thyroid disease, including TSH, free T4, T3 and thyroid antibodies.

cheerful young doctor listening to a patient in the office

Postpartum thyroiditis treatment

Most women experience mild symptoms and don’t need treatment unless their symptoms worsen. If your symptoms are severe, prescription medications may be necessary. If you’re breastfeeding, inform your provider so they can recommend safe medications for you and your baby.

Treatment varies based on whether you have hyperthyroidism or hypothyroidism:

  • Hyperthyroidism: Medications like corticosteroids (e.g., prednisone) reduce inflammation, while beta-blockers help manage the effects of excess thyroid hormones. Antithyroid medications are not used because the hyperthyroidism is due to inflammation, not hormone overproduction, found in conditions such as Graves’ disease.
  • Hypothyroidism: You’ll likely need thyroid hormone replacement therapy for six months to a year, with the possibility of tapering off as your thyroid normalizes.

Your healthcare provider will monitor your thyroid levels throughout treatment.

Find a specialized care for postpartum thyroiditis

We help you get care at a location that fits your needs. We offer several locations for your care, including specialized postpartum thyroiditis centers in North and Central Texas.

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