Is it normal to have fluctuating thyroid level after delivery?

Question

Hi doctor,

I had postpartum thyroiditis with my first child and it presented again with second child at 7 months postpartum. I am dealing with anxiety, higher than normal heart rate, fatigue and trouble sleeping. During previous PPT, I could not tolerate medicines and it resolved when my child was 13 months old. Is it normal to cycle back and forth between hyper and hypo cycles, numerous times with postpartum thyroiditis? Is it fine to not treat it since it is cycling back and forth? If it should be treated what would be the proper treatment since the levels fluctuate so rapidly? My three months consecutive TSH levels are 2.85, 7.00 and 4.4 respectively. Also, TPoAb 96 (high) and TSI 53, within normal limits. My current medications include prenatal vitamin - still nursing, probiotic, vitamin D and Moducare.

Answer 1

Hi,

Welcome to icliniq.com.

The duration of the cycle that is normal is 23 to 35 days. So, anything in between these days is actually normal. After delivery, cycles tend to be irregular for a year or so and hence, no medicines are required during this period. Your thyroid-stimulating hormone is normal currently. Are you taking any medicine for thyroid? Anti-TPO antibody (anti-thyroid peroxidase) being positive is a point towards autoimmunity. Do not worry about it. Kindly do recheck for TSH and free T4 after three months.

Answer 2

Hi,

Welcome back to icliniq.com.

Symptoms usually subside after delivery over a period of time. Since that you are already experienced similar symptoms and since they have resolved, currently I would not suggest any medicine. Also, your latest TSH is 4.2. So, I would say that the symptoms are not due to thyroid. As of now no medicine required. Do repeat TSH and free T4 after three months. Try some breathing exercises or yoga for anxiety. They should abate over time. And if they do not, then we can try a small course of beta blockers.