Thyroid Dysfunction Postpartum
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Flowchart 5. Approach to Abnormal TSH Levels in Postpartum
Abnormal TSH in the
first year postpartum
Subclinical
hyperthyroidism
No treatment needed
Repeat thyroid function
tests in 4–8 weeks
If overt hyperthyroidism
persists for >2–3 months,
consider other causes
Stigmata of
Graves' disease
Treat for Graves'
disease and verify with
TRAb and/or TSI
Treat for
Graves' disease
Check TRAb
and/or TSI
Overt
hyperthyroidism
Postpartum thyroiditis
Symptom control with
β-blocker and monitor clinically
Low TSH
Normal FT4 and (F)T3
Present
Positive
Positive
High FT4 and/or (F)T3
Not present
