SHM Converge Scientific Abstract ePoster Gallery-Consider Thyroid Dysfunction for Abnormal Weight Loss in Postpartum

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A 37-year-old woman, five months postpartum, presented with palpitations and unintentional 20-lb weight loss. Examination was normal, but thyroid studies showed marked thyrotoxicosis with very low TSH (0.005 mIU/mL) and elevated free T4 (3.33 ng/dL). Thyroid ultrasound was normal. The differential diagnosis included Graves’ disease, Hashimoto thyroiditis, and postpartum thyroiditis. She was discharged on propranolol for symptom control.<br /><br />The case highlights postpartum thyroiditis, a painless autoimmune thyroid condition that occurs within one year after delivery. It typically follows a triphasic course: an initial hyperthyroid phase, then a hypothyroid phase, and finally recovery. Because it can mimic Graves’ disease or Hashimoto thyroiditis, thyroid function testing is important in postpartum patients with symptoms such as weight loss, palpitations, or fatigue.<br /><br />Management is mainly supportive. Antithyroid medications are generally not effective in postpartum thyroiditis. Beta-blockers such as propranolol can help relieve adrenergic symptoms during the hyperthyroid phase. Levothyroxine is reserved for patients who develop a symptomatic hypothyroid phase.<br /><br />The case emphasizes the need to consider thyroid dysfunction in postpartum women with abnormal weight loss and palpitations.

Asset Subtitle

Prakash Adhikari

Meta Tag

Author List Prakash Adhikari

Category Clinical Vignettes

Concept Postpartum Thyroiditis

Concept Thyrotoxic Phase

Concept Hypothyroid Phase

Concept Graves Disease

Concept Hashimoto Thyroiditis

Distinguished Non-Finalist

Presenter Organization Tower Health-Reading Hospital

Presenting Author Prakash Adhikari

Track Adult

Keywords

postpartum thyroiditis

thyrotoxicosis

palpitations

weight loss

low TSH

elevated free T4

Graves disease

Hashimoto thyroiditis

propranolol

postpartum women

Postpartum Thyroiditis

Thyrotoxic Phase

Hypothyroid Phase

Graves Disease

Hashimoto Thyroiditis