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Postpartum thyroiditis is believed to result from the modifications to the immune system necessary in pregnancy, and histologically is a subacute lymphocytic thyroiditis. The process is normally self-limiting, but when conventional antibodies are found there is a high chance of this proceeding to permanent hypothyroidism.
Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% and 0.3-0.5% for subclinical and overt hypothyroidism respectively. [8] Endemic iodine deficiency accounts for most hypothyroidism in pregnant women worldwide while chronic autoimmune thyroiditis is the most common cause of hypothyroidism in iodine sufficient parts of the world.
Subacute lymphocytic thyroiditis, also called painless or silent thyroiditis, occurs in individuals with underlying autoimmune disease or after pregnancy. [2] [4] [5] It is considered to be a variant of Hashimoto's thyroiditis. When subacute lymphocytic thyroiditis occurs up to 12 months postpartum, it is called postpartum thyroiditis.
Postpartum thyroiditis can occur in women with Hashimoto's. [5] In healthy women, Postpartum thyroiditis can occur up to 1 year after delivery and should be differentiated from Hashimoto's thyroiditis as it is treated differently. [136] After giving birth, Tregs rapidly decrease and immune responses are re-established.
A postpartum disorder or puerperal disorder is a disease or condition which presents primarily during the days and weeks after childbirth called the postpartum period.The postpartum period can be divided into three distinct stages: the initial or acute phase, 6–12 hours after childbirth; subacute postpartum period, which lasts two to six weeks, and the delayed postpartum period, which can ...
[20] [21] Still, there is a substantial variability in clinical course between patients and even for different pregnancies in the same patient. [20] Also, the other way around, Behçet's disease confers an increased risk of pregnancy complications , miscarriage and Cesarean section .
De Quervain thyroiditis is diagnosed through clinical and test results, with laboratory features including elevated C-reactive protein and erythrocyte sedimentation rate. Thyroid function testing often shows decreased thyroid stimulating hormone and increased serum levels of triiodothyronine and thyroxine during the acute phase.
After long-term heavy strain, levels of thyroid hormones decrease. [2] This is exacerbated by other stressors such as undernutrition and lack of sleep, such as in a military training setting. During endurance exercise, before exhaustion, elevated thyroid hormone levels may happen due to increased expected energy demand (type 2 allostatic load). [2]
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