April 15, 2006
Question from New Orleans, Louisiana, USA:
I have had type 1 diabetes for 20 years. I am now 23. I had my daughter 15 months ago. Shortly after she was born, I was diagnosed with postpartum thyroiditis. After about two months, my symptoms disappeared and my TSH levels returned to normal. I am starting to have symptoms again, except now they are more extreme. My TSH level was normal, but I know there is something wrong. I feel the way I did before. Is it still possible to have hyperthyroidism even though my TSH levels are “normal?” Is hyperthyroidism common in type 1 diabetes?
Congratulations on the arrival of your daughter. Postpartum thyroiditis is very common in patients with type 1 diabetes. Both are considered to be autoimmune diseases that can cluster together in the same patient. Thyroiditis is associated with a transient period of hyperthyroidism, followed by a variable period of hypothyroidism. Your symptoms may be related to going from hyperthyroidism to hypothyroidism. If you catch it just right, the TSH may not show you the change. I would suggest you also have the free T4 followed, in addition to the TSH. Some of the symptoms you are having now could be from low thyroid. The good news is that the thyroid status eventually normalizes in most patients who experience postpartum thyroiditis.