Occurs 0-6 months post-partum

Three stages

• 1. Thyrotoxicosis
• 2. Hypothyroidism
• 3. Normal thyroid function (but high recurrence rate in future pregnancies)
• Thyroid peroxidase antibodies are found in 90% of patients - useful to differentiate between this as graves disease
• Radio-iodine uptake scan is useful to differentiate this from graves disease (as long as the patient is not breastfeeding)

Diagnosis: The diagnosis of postpartum thyroiditis is based upon clinical manifestations and thyroid function tests alone

Management

• the thyrotoxic phase is not usually treated with anti-thyroid drugs as the thyroid is not overactive.
• Propranolol is typically used for symptom control (usually resolves within 1 yr without management
• the hypothyroid phase is usually treated with thyroxine

1/3 of patients with postpartum thyroiditis end up requiring thyroid hormone replacement therapy