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Postpartum thyroiditis is a common disorder involving anti-microsomal anti-thyroid antibodies (a destructive thyroiditis) that is underreported and underdetected. The actual incidence is believed to be about 5-10%, occurs about 3-6 months after delivery (pregnancy) transiently for about 6 months, usually starts with hyperthyroidism that is followed by hypothyroidism,
and is often mistaken for depression or anxiety. The disorder tends to recur in subsequent pregnancies and usually the woman will eventually develop hypothyroidism secondary to the destructive thyroiditis. Antithyroid medication does not treat the hyperthyroid stage because the outpouring of thyroid hormone is due to destruction of the microsomal compartments of the thyroid cells (thyroiditis is not affected by the antithyroid medicines). Thyroid replacement medication is effective for the hypothyroid state but since there usually is a spontaneous remission treatment is usually not initiated. If treatment is initiated, the patient is generally weaned off treatment (slowly) after about 1 year and reassessed.
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