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Postpartum Thyroid - Normal TSH

I was diagnosed with postpartum thyroid 2 months ago when I was 2 months postpartum. I developed swelling in my neck which prompted me to call the doctor. I was also having what I was told was hypothyroid symptoms, extreme fatigue, muscle weakness, sore joints, feeling cold all the time and very dry skin. My doctor drew labs TSH, T4, T3, TPO and the other antibody one. He also drew Cbc and checked everything even my vitamin d levels. Everything came back in range and normal except the antibody labs. The TPO was 997 and the other was 50. Both were high. He put me on 50mcg of levothyroxine which gave me crazy heart palpitations and profuse sweating so we cut it back to 25. I've been feeling really great until this last week where my skin started breaking out a ton and my joints are sore again and I'm having some anxiety and heart flutters. I'm just wondering if this is normal for postpartum thyroiditis or if I have something else going on like Hashimotos (which runs in the family) and if I should get a second opinion. Plus he drew labs on me this week but only checked my TSH, T4 and T3. They were normal again, but he didn't recheck the antibodies? I'm just very confused and want to feel better so I can enjoy my little baby.
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Avatar universal
Postpartum thyroiditis is considered a variant of Hashi's.  However, PPT is usually temporary, though it may come back to haunt you later in life.  PPT typically starts with a hyper period, a brief return to normal, and then a hypo phase.  

Please post both sets of labs with reference ranges so we can see where you are/were in the ranges.
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Avatar universal
12/17 - TSH - My Value 0.8  REF Range 0.35 - 5.50
FT4 - My Value 1.1 REF Range 0.8 - 1.8
FT3 - My Value 3.3 REF Range 2.3 - 4.2
ATG - MY Value 49.3 REF Range 0.0 - 39.9
ATPO - My Value 997.2 REF Range 0.0 - 39.9

2/4 TSH - My Value 2.79 REF Range 0.350 - 5.50
FT4 - My Value 1.2 REF Range 0.8 - 1.8

He didnt draw any additional labs on me the 2nd time only TSH and FT4.
In all honesty I feel like I was having hyper symptoms while I was still pregnant (diarrhea, heart palpitations, crazy anxiety, and insomnia) but all my doctors said "its just pregnancy", even when I was certain it wasn't.
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Avatar universal
Are you still taking 25 mcg of levo?

In December, your FT4 was a little on the low side.  It was 30% of range, and the rule of thumb for FT4 is 50%.  However, your FT3 was in the upper half of the range, which is right where it should be.  On paper, your thyroid looked in good shape.

By this month, your FT4 had actually gone up a little.  It's now at 40% of range.  It's interesting that your FT4 went up between these two labs, but your TSH also went up.  When FT4 goes up, TSH should go down and vice versa.  So, it's really unfortunate we don't have another FT3 to see if it explains why your TSH is going up.

Well, they call it POSTpartum thyroiditis for a reason, but it sounds almost like you had a hyper phase while still pregnant.  Of course, it is hard to separate the symptoms of pregnancy from thyroid symptoms.

If I were you, I'd get a second opinion.  Your current doctor didn't test FT3 this time around, and that's a red flag that he's not a great thyroid doctor.  In early stages, Hashi's can be characterized by swings from hyper to hypo.  You really need to find out what your FT3 is doing.  
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Avatar universal
I just got my lab results in the mail, turns out they did do a T3 they told me They didn't over the phone. The result was 3.0 with Ref range 2.3 - 4.2
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Avatar universal
So, your FT4 went up a little, and your FT3 went down a little.  FT3 is no longer in the top half of the range.  That could explain why your TSH has gone up quite a bit.

Are you still on 25 mcg?  Has your doctor mentioned an increase?
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Avatar universal
yes, I am still on the 25mcg. When he called with the results he said to stay on the 25mcg that I was "stable".  Thank you for all your help by the way!  I think I'm going to go for a second opinion just to make certain I'm on the right course of treatment.
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Avatar universal
I think that's a good idea.  

AACE recommended years ago that TSH range be changed to 0.3-3.0, which is much more reasonable than the range your lab uses.  As you can see, labs and doctors have been very slow to adopt the new range.  On the 0.3-3.0 range, you are very close to top of range.

I think you would feel better with a little increase.
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