Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about postpartum thyroiditis. And you can find written notes on this topic at

zero to finals.com slash postpartum thyroiditis or in the postnatal care section of the zero definals

obstetrics and gynecology book so let's get straight into it postpartum thyroiditis is a condition

where there are changes in the thyroid function within 12 months of delivery, affecting women without a

history of thyroid disease. This can involve thyrotoxicosis, which is hyperthyroidism,

or it can involve hypothyroidism, or it can involve both thyrotoxicosis and hypothyroidism.

Over time the thyroid function returns to normal and the patient will become asymptomatic again.

A small portion of women will remain hypothyroid and need long-term thyroid hormone replacement.

Let's talk about the pathophysiology. The cause of postpartum thyroiditis is not clear. The leading

theory is that pregnancy has an immunosuppressant effect on the mother's body that prevents her from rejecting the fetus.

Then once delivery has occurred, there can be an exaggerated rebound effect with increased immune system activity and expression of antibodies.

This may include antibodies that affect the thyroid gland, particularly thyroid peroxidase antibodies.

These antibodies cause inflammation of the thyroid gland, leading to over or underactivity.

Let's talk about the stages.

There is a typical pattern of postpartum thyroiditis, but not all women will follow this pattern. There are three stages. The first stage is

thyrotoxicosis or an overactive thyroid gland, and usually this is in the first three months after delivery.

The second stage is hypothyroid or an underactive thyroid gland, which is usually from three to six

months, and the third stage is when the thyroid function gradually returns to normal, which is usually within

one year.

Next let's talk about the signs and symptoms. The signs and symptoms of thyrotoxicosis or

hyperthyroidism and overactive thyroid gland include anxiety and irritability, sweating and heat intolerance,

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