Postpartum Thyroiditis: Not Just a Worn Out Mom

Katherine Pereira; Ann J. Brown


Journal for Nurse Practitioners. 2008;4(3):175-182. 

In This Article

Plan of Care and Follow-Up

The above patient eventually had a return to a euthyroid state about 5 months after first developing symptoms. Her symptoms of thyrotoxicosis lasted approximately 2 months. During that time she was treated with propranolol 10 mg TID, which helped improve her symptoms of tremor, palpitations, shakiness, and difficulty concentrating.

She has voiced several times that she is worried that she will develop permanent thyroid problems. We agreed that we would check her TSH and free T4 again in 2 to 3 months, and she would call the office for symptoms of hypothyroidism. She was given a written list of symptoms of hypothyroidism at her clinic visit. She was reassured that if her future thyroid labs indicate hypothyroidism, we could treat this with levothyroxine and monitor for persistent hypothyroidism. We also clarified that, even if she developed permanent hypothyroidism, treatment with thyroid hormone replacement would be expected to normalize her symptoms. She was in agreement with our plan. If she does not develop persistent hypothyroidism, we can recommend that she have her TSH checked on an annual basis. She was advised that she was at higher than normal risk for developing hypothyroidism in the future. She was also informed that it was very likely that she would develop PPT following any future pregnancies.


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