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December 1, 2000


Question from Baltimore, Maryland, USA:

I am 24 years old and found out that I had an enlarged thyroid right after my 18 month old daughter was born. My blood test was normal. I have been experiencing severe forgetfulness, occasional dizziness, and irritability. Do you think that it is a hormonal problem? This whole situation is really bothering me! What do you recommend for me to do, or who to see?


It is very common to have an enlarged thyroid gland associated with pregnancy. There are certain stressors that cause the thyroid to have to work harder. In women with normal thyroid function, a slight increase in size compensates for the increased demands and it returns to normal size after pregnancy. However, in women who have autoimmune forms of thyroid disease, underlying damage to the thyroid may not allow the thyroid to fully compensate, causing elevated TSH levels, and an enlargement in the thyroid out of proportion to that seen in normal women. The key here is know that your thyroid levels are normal and stay normal. The use of symptoms as the only indicator of thyroid dysfunction is fraught with problems.

I would recommend that you review your thyroid function studies with your physician to more fully understand your particular situation.

Additional comments from Dr. Tessa Lebinger:

In addition to the situations described by Dr. Lane, many woman (with or without diabetes) can develop an overactive thyroid [hyperthyroidism] with some of the symptoms you describe. In this case TSH levels would be very low and the other thyroid hormones high. The situation described by Dr. Lane with an elevated TSH and low thyroid hormones is indicative of an underactive thyroid [hypothyroidism]. In any case, the recommendations remain the same. You should monitor your thyroid tests about once a month for a few months to ascertain whether your thyroid gland is functioning in the normal range, the low range, or the high range. Sometimes after birth, woman my develop an overactive thyroid condition that may only last a few weeks and then evolve into an underactive thyroid. This is why you need more than one check of thyroid function if there is any question.


[Editor’s comment: Dr. Lane’s comments apply for both for women with diabetes and women who do not have diabetes.