Given that postpartum thyroiditis is three times more common in women with type 1 diabetes, this group of women should have thyroid evaluation at both 3 and 6 months postpartum.
Women who have a history of postpartum thyroiditis are at a substantially increased risk of developing hypothyroidism in the 5 to 10 years after their postpartum thyroiditis episode. These women should have annual thyroid evaluation.
Women with postpartum thyroiditis who have no symptoms and a subclinical TSH level -- a TSH above the reference range but less than 10 µU/ml -- do not necessarily require intervention unless they are planning a subsequent pregnancy. These women should, however, be re-evaluated and tested again in four to eight weeks.
Women with postpartum thyroiditis who do have symptoms, and an elevated TSH level and who potentially are attempting pregnancy should be treated.
The research is not definitive as to a relationship between postpartum depression and postpartum thyroid problems or thyroid autoimmunity. Because, however, hypothyroidism is a potentially reversible cause of depression, women with postpartum depression should be tested for hypothyroidism and treated when appropriate.
