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Postpartum Thyroiditis

Signs, Symptoms and Treatment of PPT

By Shannon McKelden

McShane's symptom complex was pretty typical of postpartum thyroiditis. "[With] early postpartum thyroiditis, you may initially experience signs and symptoms of overactive thyroid (hyperthyroidism), which may include rapid heartbeat, sudden and unexplained weight loss, nervousness, fatigue and increased sensitivity to heat," says Dr. Annette Perez-Delboy, assistant clinical professor of Obstetrics and Gynecology, Columbia University Medical Center Eastside. "Later, you may develop signs and symptoms of underactive thyroid (hypothyroidism), which may include unexplained weight gain, hoarse voice, constipation, puffy face, fatigue and increased sensitivity to cold."

There can be some difficulty in correctly diagnosing PPT in that so many of the symptoms can be explained by having recently given birth. "I was tired all the time but ... didn't think much of it as I was keeping up with a newborn that was up numerous times a night," says Megan Venner, a resident of Nova Scotia.

Two months after the birth of her son, Venner visited her family. "I [was] still complaining about being tired, and it was my sister who first noticed my goiter (a swelling around the base of my neck)," she says. "She has some medical knowledge and suspected my thyroid might be the problem." Venner's physician sent her to a specialist, who confirmed her diagnosis with a blood test, which revealed hypothyroidism.

Dr. Powrie states that, like Venner, most women with postpartum thyroiditis have a small, non-tender enlargement of the thyroid gland, followed by the symptoms noted above. A formal diagnosis is made on the basis of blood tests, including the level of thyroid hormone (T4 and T3) and thyroid stimulating hormone (TSH). "The results that are seen will vary depending on whether the patient is in the hyper- or hypo-thyroid phase of the condition," Dr. Powrie says. "Sometimes a thyroid scan or other additional blood tests may be needed to help distinguish this condition from other causes of thyroid disease."

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• Mom's Postpartum Health: Why New Moms Need Doctor Visits Too
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