Hyperthyroidism postpartum

The manifestations of hyperthyroidism depend on the severity of the disease, the age of the patient, the presence or absence of extrathyroidal manifestations, and the specific disorder producing the thyrotoxicosis. Of the various types of hyperthyroidism, only two are common Graves disease and toxic multinodular goiter. Less common causes include toxic adenoma and postpartum thyroiditis, among others. 

The 24-hour RAIU wiU be suppressed to less than 2% during the thyrotoxic phase of painless thyroiditis. Antithyroglobuhn and antimicrosomal antibody levels are elevated in more than 50% of patients. Painless thyroiditis frequently occurs during the immediate postpartum period, and individual patients may experience recurrence of the disease with subsequent pregnancies. Patients with mild hyperthyroidism and painless thyroiditis should be reassured that they have a self-hmited disease. Adrenergic symptoms may be ameliorated with propranolol. Antithyroid drugs are not indicated because they do not decrease the release of preformed thyroid hormone. 

Indications Liver/kidney yin deficiency, liver yang ascendancy, qi and blood counterflow and chaos. Wind stroke, convulsions, epilepsy, cerebrovascular accident, aphasia, apraxia, renal hypertension, essential hypertension, hypertensive encephalopathy, cerebral arteriosclerosis, arteriosclerotic heart disease, hyperthyroidism, premenstrual tension, postpartum fever with spasms and convulsions, and glaucoma... 

In general, the incidence of autoimmune thyroid disease is not strikingly different among the various areas in Japan. Similarly, postpartum thyroiditis, which can be considered as a good index to compare the incidence of autoimmune thyroid.disorder in a population, is present with the same frequency in different Japanese areas. Finally, concerning hyperthyroidism in relation to high iodine intake, I must say that I have never seen a single case of Jod-Basedow in Japan. 

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