female_health

Postpartum Thyroiditis

5-10% of postpartum women develop transient thyroiditis. Classic course: hyperthyroid (1-4 m) → hypothyroid (4-8 m) → recovery in ~80%. 20% develop permanent hypothyroidism.

Nutrition

Pattern

Anti-inflammatory + adequate iodine + selenium

Foods to emphasise

Brazil nuts (selenium 2-3/day)
Sea vegetables in moderation (iodine)
Anti-inflammatory: fatty fish, berries, olive oil, leafy greens
Adequate iron + protein

Foods to limit

Excessive iodine (kelp supplements)
Ultra-processed foods
Soy in large quantities (interferes with thyroid med absorption)

Exercise

Aerobic

Modulate to symptoms — gentle in hyperthyroid phase (avoid overheating), graded in hypothyroid phase.

Strength

Maintain 2-3×/wk.

Flexibility

Daily.

Weekly target

150 minutes

Supplements

Selenium

200 mcg/day

RCT

May reduce TPO antibody titre; do not exceed 400 mcg/day long-term.

Vitamin D3

1000-2000 IU/day if 25(OH)D < 30

observational

Low D associated with autoimmune thyroid.

Iron

65-130 mg if ferritin < 50

guideline

Low ferritin worsens fatigue + hair loss.

Monitor + cadence

What to track

TSH + free T4 at 6 weeks, 3, 6, 12 months postpartum
TPO antibodies once at diagnosis
Symptoms diary
Hgb + ferritin if fatigue dominant

Red flags — seek care

TSH < 0.1 with severe symptoms → urgent endo
TSH > 10 → start levothyroxine
Goiter or rapid neck swelling → urgent imaging

Sources

ATA 2017 Postpartum Thyroid Guidelines
Endocrine Society Postpartum Thyroid 2020

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