The classic description of postpartum thyroiditis includes thyrotoxicosis followed by hypothyroidism. Not all women demonstrate evidence of going through both phases; approximately 1/3 of patients will manifest both phases, while 1/3 of patients will have only a thyrotoxic or hypothyroid phase. The thyrotoxic phase occurs 1-4 months after delivery of a child, lasts for 1-3 months and is associated with symptoms including anxiety, insomnia, palpitations (fast heart rate), fatigue, weight loss, and irritability. Since these symptoms are often attributed to being postpartum and the stress of having a new baby, the thyrotoxic phase of post-partum thyroiditis is often missed. It is much more common for women to present in the hypothyroid phase, which typically occurs 4-8 months after delivery and may last up to 9 –12 months. Typical symptoms include fatigue, weight gain, constipation, dry skin, depression and poor exercise tolerance. Most women will have return of their thyroid function to normal within 12-18 months of the onset of symptoms. However, approximately 20% of those that go into a hypothyroid phase will remain hypothyroid.
Some neck discomfort at the site of the biopsy is expected following the procedure. Tylenol® and ice compresses can be used to relieve discomfort.