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Postpartum Thyroiditis

Table of Contents

Postpartum Thyroiditis

Inflammation of the Thyroid After Giving Birth

Postpartum thyroiditis, or inflammation of the thyroid after giving birth, causes a brief period of hyperthyroidism, often followed by hypothyroidism that usually goes away within a year. It affects 10% of women. Learn more about causes, diagnosis, and treatment.

Postpartum Depression

Image by TheVisualMD

What Is Postpartum Thyroiditis?

What Is Postpartum Thyroiditis?

Postpartum thyroiditis is an inflammation of the thyroid that affects about 1 in 20 women during the first year after giving birth and is more common in women with type 1 diabetes. The inflammation causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage raises the hormone levels in your blood, leading to hyperthyroidism. The hyperthyroidism may last up to 3 months. After that, some damage to your thyroid may cause it to become underactive. Your hypothyroidism may last up to a year after your baby is born. However, in some women, hypothyroidism doesn’t go away.

Not all women who have postpartum thyroiditis go through both phases. Some only go through the hyperthyroid phase, and some only the hypothyroid phase.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

What Role Thyroid Hormones Play?

Brain Development of 29 Day Old Embryo

Brain Development of 33 Day Old Embryo

Brain Development of 52 Day Old Embryo

Brain Development of 59 Day Old Human Embryo

Brain Development of 70 Day Old Human Embryo

Brain Development of 20 Week Old Human Fetus

Brain Development of 6 Month Old Human Fetus

Brain Development of Adult

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3

4

5

6

7

8

Brain development from embryo to adult

Interactive by TheVisualMD

Brain Development of 29 Day Old Embryo

Brain Development of 33 Day Old Embryo

Brain Development of 52 Day Old Embryo

Brain Development of 59 Day Old Human Embryo

Brain Development of 70 Day Old Human Embryo

Brain Development of 20 Week Old Human Fetus

Brain Development of 6 Month Old Human Fetus

Brain Development of Adult

1

2

3

4

5

6

7

8

Brain development from embryo to adult

The cerebral cortex--the most prominent feature when we think of a human brain--derives from the forebrain. This region is responsible for reason, planning, emotion, and problem solving, and by the end of the second trimester it is the primary visible structure. If you examine the surface of the cerebral cortex, you'll see convoluted folds; the raised surfaces are known as gyri and the \"trenches\" are sulci. These irregular folds provide greater surface area for cell-to-cell communication and interaction, increasing the brain's complexity.

Interactive by TheVisualMD

What Role Do Thyroid Hormones Play in Pregnancy?

Thyroid hormones are crucial for normal development of your baby’s brain and nervous system. During the first trimester—the first 3 months of pregnancy—your baby depends on your supply of thyroid hormone, which comes through the placenta. At around 12 weeks, your baby’s thyroid starts to work on its own, but it doesn’t make enough thyroid hormone until 18 to 20 weeks of pregnancy.

Two pregnancy-related hormones—human chorionic gonadotropin (hCG) and estrogen—cause higher measured thyroid hormone levels in your blood. The thyroid enlarges slightly in healthy women during pregnancy, but usually not enough for a health care professional to feel during a physical exam.

Thyroid problems can be hard to diagnose in pregnancy due to higher levels of thyroid hormones and other symptoms that occur in both pregnancy and thyroid disorders. Some symptoms of hyperthyroidism or hypothyroidism are easier to spot and may prompt your doctor to test you for these thyroid diseases.

Another type of thyroid disease, postpartum thyroiditis, can occur after your baby is born.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (3)

Triiodothyronine, Total (T3)

Thyroid function tests (TFTs) is a collective term for blood tests used to check the function of the thyroid. A TFT panel typically includes thyroid hormones such as thyroid-stimulating hormone (TSH, thyrotropin) and thyroxine (T4), and triiodothyronine (T3) depending on local laboratory policy. TFTs may be requested if a patient is thought to suffer from hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid), or to monitor the effectiveness of either thyroid-suppression or hormone replacement therapy. It is also requested routinely in conditions linked to thyroid disease, such as atrial fibrillation and anxiety disorder.

Image by TheVisualMD

Does the Thyroid Affect Pregnancy?

Video by Mark Trolice/YouTube

Pregnancy and Thyroid Disease wtih Thyroidologist Dr. Kathleen Hands

Video by Best Docs Network/YouTube

Triiodothyronine, Total (T3)

TheVisualMD

2:38

Does the Thyroid Affect Pregnancy?

Mark Trolice/YouTube

2:21

Pregnancy and Thyroid Disease wtih Thyroidologist Dr. Kathleen Hands

Best Docs Network/YouTube

Who Is At Risk?

3D medical animation still of type 1 diabetes

Image by Scientific Animations, Inc.

3D medical animation still of type 1 diabetes

3D medical animation still of Type 1 Diabetes showing lower amount of insulin production in a diabetic patient.

Image by Scientific Animations, Inc.

Who Is at Risk for Postpartum Thyroiditis?

Your immune system may cause postpartum thyroiditis. If you have an autoimmune disease, like type 1 diabetes, your risk is higher.

Your risk is also higher if:

Have a personal history or family history of thyroid disorders
Had postpartum thyroiditis after a previous pregnancy
Have chronic viral hepatitis

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (2)

Thyroid Disease in Pregnancy - CRASH! Medical Review Series

Video by Paul Bolin, M.D./YouTube

Thyroid Disease in Women

Document by Office on Women's Health, U.S. Department of Health and Human Services

38:53

Thyroid Disease in Pregnancy - CRASH! Medical Review Series

Paul Bolin, M.D./YouTube

Thyroid Disease in Women

Office on Women's Health, U.S. Department of Health and Human Services

What Causes It?

What Causes Postpartum Thyroiditis?

Postpartum thyroiditis is an autoimmune condition similar to Hashimoto’s disease. If you have postpartum thyroiditis, you may have already had a mild form of autoimmune thyroiditis that flares up after you give birth.

Postpartum thyroiditis may last up to a year after your baby is born.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

What Are the Symptoms?

What Are the Symptoms of Postpartum Thyroiditis?

The hyperthyroid phase often has no symptoms—or only mild ones. Symptoms may include irritability, trouble dealing with heat, tiredness, trouble sleeping, and fast heartbeat.

Symptoms of the hypothyroid phase may be mistaken for the “baby blues”—the tiredness and moodiness that sometimes occur after the baby is born. Symptoms of hypothyroidism may also include trouble dealing with cold; dry skin; trouble concentrating; and tingling in your hands, arms, feet, or legs. If these symptoms occur in the first few months after your baby is born or you develop postpartum depression, talk with your doctor as soon as possible.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Hyperthyroidism

Thyroid Stimulating Hormone (TSH)

Image by TheVisualMD

Thyroid Stimulating Hormone (TSH)

The thyroid is a small, butterfly-shaped gland located at the base of the neck that produces hormones that help maintain body temperature, heart rate, moods, and metabolism. Hyperthyroidism (when too much hormone is produced) is often caused by an autoimmune disorder called Graves' disease, in which antibodies produced by the immune system over-stimulate the thyroid. The production of thyroid hormones is under the control of a hormone called TSH (thyroid-stimulating hormone) produced by the pituitary gland.

Image by TheVisualMD

What Are the Signs and Symptoms of Hyperthyroidism?

At first, you might not notice the signs or symptoms of hyperthyroidism. Symptoms usually begin slowly. But, over time, a faster metabolism can cause symptoms such as:

Weight loss, even if you eat the same or more food (most but not all people lose weight)
Eating more than usual
Rapid or irregular heartbeat or pounding of your heart
Feeling nervous or anxious
Feeling irritable
Trouble sleeping
Trembling in your hands and fingers
Increased sweating
Feeling hot when other people do not
Muscle weakness
Diarrhea or more bowel movements than normal
Fewer and lighter menstrual periods than normal
Changes in your eyes that can include bulging of the eyes, redness, or irritation

Hyperthyroidism raises your risk for osteoporosis, a condition that causes weak bones that break easily. In fact, hyperthyroidism might affect your bones before you have any of the other symptoms of the condition. This is especially true of women who have gone through menopause or who are already at high risk of osteoporosis.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

Understanding Hyperthyroidism and Graves Disease

Video by Zero To Finals/YouTube

11:06

Understanding Hyperthyroidism and Graves Disease

Zero To Finals/YouTube

Hypothyroidism

Depression is a real illness

Image by TheVisualMD

Depression is a real illness

Mental stress, along with depression (which affects twice as many women as men), have a more debilitating effect on women's hearts than on men's.

Image by TheVisualMD

What Are the Signs and Symptoms of Hypothyroidism?

Symptoms of hypothyroidism develop slowly, often over several years. At first, you may feel tired and sluggish. Later, you may develop other signs and symptoms of a slowed-down metabolism, including:

Feeling cold when other people do not
Constipation
Muscle weakness
Weight gain, even though you are not eating more food
Joint or muscle pain
Feeling sad or depressed
Feeling very tired
Pale, dry skin
Dry, thinning hair
Slow heart rate
Less sweating than usual
A puffy face
A hoarse voice
More than usual menstrual bleeding

You also may have high LDL or "bad" cholesterol, which can raise your risk for heart disease.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (1)

Hypothyroidism: Mayo Clinic Radio

Video by Mayo Clinic/YouTube

9:22

Hypothyroidism: Mayo Clinic Radio

Mayo Clinic/YouTube

How Is It Diagnosed?

How Do Doctors Diagnose Postpartum Thyroiditis?

If you have symptoms of postpartum thyroiditis, your doctor will order blood tests to check your thyroid hormone levels.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

TSH (Thyroid-Stimulating Hormone) Test

TSH (Thyroid-Stimulating Hormone) Test

Also called: TSH, Thyroid-Stimulating Hormone, Thyrotropin

The test measures the amount of thyroid-stimulating hormone (TSH) in a sample of your blood. TSH is made in the pituitary gland and stimulates the release of thyroid hormone. If your TSH levels are too high or too low, it can indicate a thyroid disorder.

TSH (Thyroid-Stimulating Hormone) Test

Also called: TSH, Thyroid-Stimulating Hormone, Thyrotropin

The test measures the amount of thyroid-stimulating hormone (TSH) in a sample of your blood. TSH is made in the pituitary gland and stimulates the release of thyroid hormone. If your TSH levels are too high or too low, it can indicate a thyroid disorder.

{"label":"TSH reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":0.45},"text":"A low TSH level usually indicates that the thyroid is producing too much thyroid hormone (hyperthyroidism). Occasionally, a low TSH may result from an abnormality in the pituitary gland, which prevents it from making enough TSH to stimulate the thyroid (central hypothyroidism).","conditions":["Hyperthyroidism","Chronic thyroiditis","Hashimoto's Disease","Graves' disease","Toxic nodular goiter","Multinodular goiter","Damage to the pituitary gland","Insufficient anti-thyroid medication","Too much iodine in the body"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0.45,"max":4.5},"text":"The pituitary gland releases TSH into the blood to stimulate the thyroid to make more thyroid hormone. The amount of TSH that the pituitary sends into the bloodstream depends on the amount of thyroid hormone in the body. In most healthy individuals, a normal TSH value means that the thyroid is functioning properly.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":4.5,"max":10},"text":"A high TSH level indicates that the thyroid gland is not making enough thyroid hormone (hypothyroidism).","conditions":["Hypothyroidism","Grave's Disease","Pituitary gland tumor",""]}],"units":[{"printSymbol":"(mi.U.)\/mL","code":"m[IU]\/mL","name":"milli international unit per milliliter"}],"value":2.5,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
(mi.U.)/mL
0.45
4.5
Your result is Normal.
The pituitary gland releases TSH into the blood to stimulate the thyroid to make more thyroid hormone. The amount of TSH that the pituitary sends into the bloodstream depends on the amount of thyroid hormone in the body. In most healthy individuals, a normal TSH value means that the thyroid is functioning properly.
Related conditions
You may need a TSH test if you have symptoms of too much or too little thyroid hormone in your blood.
Hyperthyroidism (too much thyroid hormone) is also called overactive thyroid. Having more thyroid hormones than you need speeds up your body functions and causes symptoms that include:
- Weight loss, even though you may be eating more than usual
- Rapid or irregular heartbeat
- Feeling nervous or irritable
- Trouble sleeping, fatigue
- Shaky hands, muscle weakness
- Sweating or being very sensitive to heat
- Frequent bowel movements (pooping a lot)
- Goiter (enlarged thyroid)
Hypothyroidism (too little thyroid hormone) is also called underactive thyroid. Not having enough thyroid hormone slows down your body functions and causes symptoms that include:
- Fatigue
- Weight gain
- Being very sensitive to cold
- Joint and muscle pain
- Dry skin
- Dry, thinning hair
- Heavy or irregular menstrual periods
- Depression
- Constipation
You may also have a TSH test, along with other tests, to help diagnose unusual bumps or lumps on your thyroid that may be thyroid cancer or thyroid nodules (growths on your thyroid that aren't cancer).
Your TSH test results can tell you if your thyroid is making too much or too little thyroid. But the test can't explain why your TSH levels may be too high or too low.
If your test results aren't normal, your provider will probably order other thyroid blood tests to find out what's causing your thyroid problem. These blood tests may include:
- T4 thyroid hormone test
- T3 thyroid hormone test
- Thyroid antibodies test to help diagnose an autoimmune thyroid disorder, such as:
  Graves' disease, the most common cause of hyperthyroidism
  Hashimoto's disease, that the most common cause of hypothyroidism
In certain cases, an abnormal TSH result may be a sign of a pituitary gland problem, but this doesn't happen often.
1. 004259: Thyroid-stimulating Hormone (TSH) | LabCorp [accessed on Oct 04, 2018]
2. TSH test: MedlinePlus Medical Encyclopedia [accessed on Oct 04, 2018]
3. TSH [accessed on Oct 04, 2018]
4. 004593: Thyroid-stimulating Hormone (TSH) in Pregnancy | LabCorp [accessed on Oct 04, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (28)

Thyroid Gland

The thyroid is a small, butterfly-shaped gland located at the base of the neck, just below the Adam's apple. The thyroid gland produces two main hormones, thyroxine (T4) and triiodothyronine (T3), which play key roles in regulating many aspects of metabolism, the rate at which the cells use energy and carry out chemical processes. The thyroid and the hormones it produces are under the control of a hormone called TSH (thyroid-stimulating hormone) produced by the pituitary gland.

Image by TheVisualMD

Importance of Thyroid Gland

The thyroid and the hormones it produces, for example, are under control of a hormone called TSH (thyroid-stimulating hormone), which is produced by the pituitary gland. The pituitary gland is often referred to as the "master gland" because it regulates the activities of other endocrine glands. The pituitary gland, however, takes its orders from the hypothalamus, which decides which particular hormones the pituitary should release and when.

Image by TheVisualMD

Thyroid Gland

Image by CFCF

Follicular Cell of Thyroid Gland

The thyroid is a small, butterfly-shaped gland located at the base of the neck, just below the Adam's apple. The thyroid gland produces two main hormones, thyroxine (T4) and triiodothyronine (T3). The hormones help maintain body temperature, heart rate, moods, energy levels, bowel function and rates of fat, protein and carbohydrate metabolism. The thyroid contains spherical follicles that absorb iodine ions from the blood for use in the production of T4 and T3. Iodine deficiency, rare in the U.S., affects two billion people worldwide and is the leading preventable cause of mental retardation.

Image by TheVisualMD

Woman with visible Brain revealing Pituitary Gland

The pituitary gland is a pea-sized endocrine gland located at the base of the skull, between the optic nerves. It is often referred to as the endocrine system's \"master gland\" because it regulates the activities of other glands. The pituitary, however, takes its orders from the hypothalamus, which decides which particular hormones the pituitary should release and when. The pituitary governs testosterone and estrogen production, as well as ovulation and breast milk production; it also helps regulate growth, blood pressure, maintain proper fluid balance, and other aspects of metabolism.

Image by TheVisualMD

Follicle-stimulating hormone

Follicle-stimulating hormone

Image by MartaFF

Follicle-stimulating hormone

The time scale starts with the (LMP), given as day number. Day number 1 corresponds to 0 to 0.99 days from LMP, and Day number 2 corresponds to 1.00 to 1.99 days from LMP and so forth. The time scale ends at whatever is the actual next menstruation, which marks the beginning of the next cycle, which is equivalent to starting all over again from the beginning of the time scale.

Image by Mikael Haggstrom

hCG testing for pregnancy

Diagram of typical immunoassay home pregnancy test which detects human chorionic gonadotropin (hCG). (A) A urine sample is applied to the stick. If pregnant, this should contain hCG. (B) As the sample is absorbed into the stick it goes through free dye-labeled antibodies that recognize and stick to hCG. (C) An anchored set of antibodies stick to and capture hCG molecules (and the attached dye-labeled antibodies), creating the first line. In the "not pregnant" sample no hCG is attached to the dye-labeled antibodies, so they wash past this point and no line appears. (D) A second anchored set of antibodies captures the dye-labeled antibodies, providing a positive control to indicate that the test is working properly.

Image by Madprime

The classic finding of exophthalmos and lid retraction in Graves' disease

Proptosis and Lid Retraction from Graves Disease : Photograph showing a classic finding of Graves' Disease, proptosis and lid retraction.

Image by Jonathan Trobe, M.D. - University of Michigan Kellogg Eye Center

What are the symptoms of Graves' disease?

Graves' disease symptoms

Image by Original uploader was Madhero88 at en.wikipedia

What is Graves' ophthalmopathy?

Magnetic Resonance Imaging of the orbits, showing congestion of the retro-orbital space and enlargement of the extraocular muscles (arrows), consistent with the diagnosis of Graves' Ophthalmopathy.

Image by Huy A Tran and Glenn EM Reeves

Thyroid Gland

The thyroid is a small, butterfly-shaped gland located at the base of the neck, just below the Adam`s apple. Hormones produced by the thyroid gland have an enormous impact on many aspects of metabolism.

Image by TheVisualMD

Thyroid Stimulating Hormone

A Classic Negative Feedback Loop

Image by OpenStax College

Woman's neck region with visible thyroid

The thyroid is a small, butterfly-shaped gland located at the base of the neck. The gland produces two main hormones, thyroxine and triiodothyronine. The hormones help maintain body temperature, heart rate, moods, energy levels, bowel function and rates of fat, protein and carbohydrate metabolism. The thyroid is under the control of a hormone called thyroid-stimulating hormone produced by the pituitary gland; the pituitary gland, in turn, takes its orders from the hypothalamus. Thyroid problems usually fall into one of two categories: hypothroidism, when the gland produces too little hormone; or hyperthroidism, when the gland produces too much.

Image by TheVisualMD

Woman with Visible Thyroid

The thyroid is a small, butterfly-shaped gland located at the base of the neck, just below the Adam's apple. The thyroid gland produces two main hormones, thyroxine (T4) and triiodothyronine (T3). The hormones help maintain body temperature, heart rate, moods, energy levels, bowel function and rates of fat, protein and carbohydrate metabolism. The thyroid and the hormones it produces are under the control of a hormone called TSH (thyroid-stimulating hormone) produced by the pituitary gland, which is often referred to as the \"master gland\" because it regulates the activities of other endocrine glands.

Image by TheVisualMD

Thyroid Stimulating Hormone (TSH)

The thyroid is a small, butterfly-shaped gland located at the base of the neck that produces hormones that help maintain body temperature, heart rate, moods, and metabolism. Hyperthyroidism (when too much hormone is produced) is often caused by an autoimmune disorder called Graves' disease, in which antibodies produced by the immune system over-stimulate the thyroid. The production of thyroid hormones is under the control of a hormone called TSH (thyroid-stimulating hormone) produced by the pituitary gland.

Image by TheVisualMD

Woman With Goiter Due to Hypothyroidism

The thyroid is a small, butterfly-shaped gland located at the base of the neck that produces two hormones, thyroxine (T4) and triiodothyronine (T3), that help maintain body temperature, heart rate, moods, and metabolism. A goiter is any visible enlargement of the thyroid gland. In the past, goiters were often due to a lack of iodine in the diet (iodized salt has greatly reduced such goiters). Goiters can be present in cases of either hormone overproduction (hyperthyroidism) or underproduction (hypothyroidism).

Image by TheVisualMD

Hormonal Control of the Menstrual Cycle, Animation.

Video by Alila Medical Media/YouTube

What Is High FSH?

Video by fertilityauthority/YouTube

What is FSH?

Video by fertilityauthority/YouTube

Human Physiology - Hormonal Regulation of Male Reproduction

Video by Janux/YouTube

What is Graves Disease?

Video by TriHealth Cincinnati/YouTube

Graves' Disease Education

Video by Jennifer Riccobono/YouTube

Reproductive System, Part 1 - Female Reproductive System: Crash Course A&P #40

Video by CrashCourse/YouTube

Male Sex Hormones

Video by Academic Algonquin/YouTube

Thyroid gland - What's the function of the thyroid?

Video by Healthchanneltv / cherishyourhealthtv/YouTube

Normal Thyroid cell

A normal thyroid cell (Nthy.ori 3-1) adhered to gold surface. Picture taken by a Scanning electron microscope (SEM), University of Crete, Heraklion, Greece.

Image by ChronakiDimitra

Thyroid scintigraphy

5 different scintigramms taken from thyroids with different syndroms: A) normal thyroid, B) Graves disease, diffuse increased uptake in both thyroid lobes, C) Plummers disease (TMNG, toxic multinodular goitre), D) Toxic adenoma, E) Thyroiditis. Marker 99Tc

Image by Petros Perros

Thyroid Gland

TheVisualMD

Importance of Thyroid Gland

TheVisualMD

Thyroid Gland

CFCF

Follicular Cell of Thyroid Gland

TheVisualMD

Woman with visible Brain revealing Pituitary Gland

TheVisualMD

Follicle-stimulating hormone

MartaFF

Follicle-stimulating hormone

Mikael Haggstrom

hCG testing for pregnancy

Madprime

The classic finding of exophthalmos and lid retraction in Graves' disease

Jonathan Trobe, M.D. - University of Michigan Kellogg Eye Center

What are the symptoms of Graves' disease?

Original uploader was Madhero88 at en.wikipedia

What is Graves' ophthalmopathy?

Huy A Tran and Glenn EM Reeves

Thyroid Gland

TheVisualMD

Thyroid Stimulating Hormone

OpenStax College

Woman's neck region with visible thyroid

TheVisualMD

Woman with Visible Thyroid

TheVisualMD

Thyroid Stimulating Hormone (TSH)

TheVisualMD

Woman With Goiter Due to Hypothyroidism

TheVisualMD

3:15

Hormonal Control of the Menstrual Cycle, Animation.

Alila Medical Media/YouTube

1:16

What Is High FSH?

fertilityauthority/YouTube

2:46

What is FSH?

fertilityauthority/YouTube

3:38

Human Physiology - Hormonal Regulation of Male Reproduction

Janux/YouTube

2:25

What is Graves Disease?

TriHealth Cincinnati/YouTube

9:07

Graves' Disease Education

Jennifer Riccobono/YouTube

10:15

Reproductive System, Part 1 - Female Reproductive System: Crash Course A&P #40

CrashCourse/YouTube

2:30

Male Sex Hormones

Academic Algonquin/YouTube

1:55

Thyroid gland - What's the function of the thyroid?

Healthchanneltv / cherishyourhealthtv/YouTube

Normal Thyroid cell

ChronakiDimitra

Thyroid scintigraphy

Petros Perros

Triiodothyronine (T3) Tests

Triiodothyronine (T3) Tests

Also called: T3 Test, T3 Free and Total

This test measures triiodothyronine (T3) in your blood. Your thyroid gland makes T3. T3 plays an important role in the body's control of metabolism (the many processes that control the rate of activity in cells and tissues). The test is mainly used to diagnose hyperthyroidism.

Triiodothyronine (T3) Tests

Also called: T3 Test, T3 Free and Total

This test measures triiodothyronine (T3) in your blood. Your thyroid gland makes T3. T3 plays an important role in the body's control of metabolism (the many processes that control the rate of activity in cells and tissues). The test is mainly used to diagnose hyperthyroidism.

{"label":"T3, total reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":80},"text":"A lower-than-normal level of T3 may be a sign of a thyroid disorder.","conditions":["Hypothyroidism","Hashimoto disease","Severe illness","Malnutrition","Thyroiditis"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":80,"max":220},"text":"The total T3 test measures the T3 that is both attached to proteins and floating free in the blood. A normal result indicates normal thyroid function called euthyroid.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":220,"max":300},"text":"A higher-than-normal level of T3 may be a sign of a thyroid disorder. A high level of T3 may occur in pregnancy (especially with morning sickness at the end of the first trimester) or with the use of birth control pills or estrogen.","conditions":["Hyperthyroidism","Graves disease","T3 thyrotoxicosis","Toxic nodular goiter","Thyroid medicines or certain supplements","Liver disease"]}],"units":[{"printSymbol":"ng\/dL","code":"ng\/dL","name":"nanogram per deciliter"}],"value":150,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
ng/dL
80
220
Your result is Normal.
The total T3 test measures the T3 that is both attached to proteins and floating free in the blood. A normal result indicates normal thyroid function called euthyroid.
Related conditions
{"label":"T3, free reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":2},"text":"A lower-than-normal level of T3 may be a sign of a thyroid disorder.","conditions":["Hypothyroidism","Hashimoto disease","Severe illness","Malnutrition","Thyroiditis"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":2,"max":4.4},"text":"The free T3 test measures the T3 that is floating free in the blood. The tests for free T3 are generally less accurate than for total T3.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":4.4,"max":10},"text":"A higher-than-normal level of T3 may be a sign of a thyroid disorder. A high level of T3 may occur in pregnancy (especially with morning sickness at the end of the first trimester) or with the use of birth control pills or estrogen.","conditions":["Hyperthyroidism","Graves disease","T3 thyrotoxicosis","Toxic nodular goiter","Thyroid medicines or certain supplements","Liver disease"]}],"units":[{"printSymbol":"pg\/mL","code":"pg\/mL","name":"picogram per milliliter"}],"value":3.2,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
pg/mL
2
4.4
Your result is Normal.
The free T3 test measures the T3 that is floating free in the blood. The tests for free T3 are generally less accurate than for total T3.
Related conditions
A triiodothyronine (T3) test measures the level of T3 in a sample of your blood. It's used to help diagnose thyroid disease.
Your thyroid is a small, butterfly-shaped gland at the base of your throat. It makes two hormones, T3 and T4 (thyroxine). Hormones are chemical messengers in your bloodstream that control the actions of certain cells or organs.
Thyroid hormones work together to control the way your body uses energy. They affect your weight, heart, body temperature, muscle strength, and even your mood. In children, thyroid hormones affect growth, too.
There are two forms of T3 in your blood:
- Free T3 is the active form that enters your tissues where it's needed.
- Bound T3 is attached to certain proteins which prevent it from entering your tissues. Most of your T3 is bound.
There are different tests for measuring T3:
- A total T3 test measures both bound and free T3 together. Medical experts think that this test is the more accurate way to measure T3.
- A free T3 test only measures free T3.
Other names: thyroid function test; total triiodothyronine, free triiodothyronine, FT3, TT3, radioimmunoassay FT3
A T3 test is used to help:
- Diagnose hyperthyroidism, a condition in which your thyroid gland makes too much thyroid hormone. The test can also help find out what's causing the condition.
- Diagnose pituitary disorders. The pituitary is a pea-sized gland at the base of your brain. It makes a hormone called TSH (thyroid stimulating hormone). TSH tells the thyroid how much T3 and T4 to make. So, abnormal T3 levels may be a sign of a pituitary problem.
- Monitor treatment for thyroid disease, including hyperthyroidism and hypothyroidism, which is when the thyroid gland makes to little thyroid hormone.
T3 tests are usually ordered with blood tests that measure T4 and TSH (thyroid stimulating hormone) tests.
You may need a T3 test if you have symptoms of hyperthyroidism (too much thyroid hormone). Symptoms may include:
- Anxiety, nervousness, irritability
- Weight loss, even though your appetite may increase
- Shaky hands, muscle weakness
- Sweating or being very sensitive to heat
- Irregular heartbeat (arrhythmia)
- Frequent bowel movements (poops)
- Goiter (an enlarged thyroid gland)
- Trouble sleeping and fatigue
You may also need a T3 test if:
- You take thyroid hormone medicine to treat a thyroid problem. A T3 test can check whether you're taking the right dose to keep your thyroid hormone levels in a healthy range.
- You had abnormal results on a TSH and/or T4 test. Providers usually order these tests first to look into a possible thyroid disorder. If your test results are abnormal or unclear, your provider may use a T3 test to confirm or rule out hyperthyroidism.
T3 testing isn't commonly used to help check for hypothyroidism (too little thyroid hormone). That's because other thyroid tests can diagnose hypothyroidism earlier than a T3 test.
To understand the results of your T3 test, your provider will usually compare them with the results of your TSH and T4 tests. Like T3, T4 tests may measure either free or total T4, but providers usually measure free T4.
Your provider will look for different combinations of high, low, and normal results. Each combination suggests a different thyroid condition. Ask your provider to explain what your test results say about your health.
In general:
- Normal T3 levels (free or total) alone do not rule out thyroid disease. But if your TSH and free T4 levels are also normal, you probably don't have a thyroid condition.
- High T3 levels (free or total) may mean you have hyperthyroidism (too much thyroid hormone).
  
  High T3 levels with:
  Low TSH and high free T4 levels may mean that a problem with your thyroid gland is causing too much thyroid hormone.
  Normal or high TSH and high free T4 levels may mean that a pituitary gland condition is causing too much thyroid hormone.
- Low T3 levels (free or total) may mean hypothyroidism (too little thyroid hormone).
  
  Low or normal T3 levels with:
  High TSH levels and low free T4 levels may mean that a problem with your thyroid gland is causing too little thyroid hormone.
  Low TSH and low free T4 levels may mean that a pituitary gland condition is causing too little thyroid hormone.
If you have questions about your results, talk with your provider.
1. Triiodothyronine (T3) Tests: MedlinePlus Medical Test [accessed on Jan 16, 2024]
2. T3 test: MedlinePlus Medical Encyclopedia [accessed on Jan 16, 2024]
3. T3 Test - Testing.com. Nov 29, 2022 [accessed on Jan 16, 2024]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (9)

Thyroid Gland

The thyroid is a small, butterfly-shaped gland located at the base of the neck, just below the Adam's apple. The thyroid gland produces two main hormones, thyroxine (T4) and triiodothyronine (T3), which play key roles in regulating many aspects of metabolism, the rate at which the cells use energy and carry out chemical processes. The thyroid and the hormones it produces are under the control of a hormone called TSH (thyroid-stimulating hormone) produced by the pituitary gland.

Image by TheVisualMD

Woman's neck region with visible thyroid

The thyroid is a small, butterfly-shaped gland located at the base of the neck. The gland produces two main hormones, thyroxine and triiodothyronine. The hormones help maintain body temperature, heart rate, moods, energy levels, bowel function and rates of fat, protein and carbohydrate metabolism. The thyroid is under the control of a hormone called thyroid-stimulating hormone produced by the pituitary gland; the pituitary gland, in turn, takes its orders from the hypothalamus. Thyroid problems usually fall into one of two categories: hypothroidism, when the gland produces too little hormone; or hyperthroidism, when the gland produces too much.

Image by TheVisualMD

Thyroid problems - most common thyroid problems, symptoms and treatment

Video by Healthchanneltv / cherishyourhealthtv/YouTube

Thyroid gland - What's the function of the thyroid?

Video by Healthchanneltv / cherishyourhealthtv/YouTube

How does the thyroid manage your metabolism? - Emma Bryce

Video by TED-Ed/YouTube

T3 And T4, What Do They Do?

Video by EmpowHER/YouTube

Understanding Thyroid Function Tests

Video by AdonaiDEC/YouTube

Thyroid Blood Tests

Video by Tom Wade MD/YouTube

Understanding Blood Test Video 2: Comprehensive Metabolic Panel

Video by Health in a Nutshell/YouTube

Thyroid Gland

TheVisualMD

Woman's neck region with visible thyroid

TheVisualMD

4:11

Thyroid problems - most common thyroid problems, symptoms and treatment

Healthchanneltv / cherishyourhealthtv/YouTube

1:55

Thyroid gland - What's the function of the thyroid?

Healthchanneltv / cherishyourhealthtv/YouTube

3:37

How does the thyroid manage your metabolism? - Emma Bryce

TED-Ed/YouTube

1:56

T3 And T4, What Do They Do?

EmpowHER/YouTube

6:07

Understanding Thyroid Function Tests

AdonaiDEC/YouTube

6:57

Thyroid Blood Tests

Tom Wade MD/YouTube

5:17

Understanding Blood Test Video 2: Comprehensive Metabolic Panel

Health in a Nutshell/YouTube

Thyroxine Test

Thyroxine Test

Also called: Thyroxine Screen, Tetraiodothyronine

This test measures the level of thyroxine (T4) in the blood. T4 is the main hormone secreted into the bloodstream by the thyroid gland. Too much or too little T4 can indicate thyroid disease.

Thyroxine Test

Also called: Thyroxine Screen, Tetraiodothyronine

This test measures the level of thyroxine (T4) in the blood. T4 is the main hormone secreted into the bloodstream by the thyroid gland. Too much or too little T4 can indicate thyroid disease.

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Use the slider below to see how your results affect your health.
μg/dL
4.5
12
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
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Use the slider below to see how your results affect your health.
ng/dL
0.82
1.77
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
A thyroxine test is a blood test that helps diagnose thyroid conditions. The thyroid is a small, butterfly-shaped gland at the base of your throat. Your thyroid makes hormones that control the way your body uses energy. These hormones affect your weight, heart, body temperature, muscle strength, and even your mood. In children, thyroid hormones affect growth, too.
Thyroxine, also known as T4, is a type of thyroid hormone. A T4 test measures the level of T4 in your blood. Too much or too little T4 can be a sign of thyroid disease.
There are two forms of T4 in your blood:
- Free T4 is the active form of thyroxine hormone that enters your tissues where it's needed.
- Bound T4 is thyroxine that attaches or binds to certain proteins which prevent it from entering your tissues.
T4 levels can be measured with either a free T4 test or a total T4 test:
- A free T4 test directly measures the amount of free T4 in your blood. Medical experts believe this test provides more accurate information than a total T4 test, so it's used more often.
- A total T4 test measures free and bound T4 together. A calculation may be done to figure out how much T4 is free. This is a less accurate way to check how well your thyroid is working.
Other names: free thyroxine, free T4, total T4 concentration, T4 index, thyroxine screen, free T4 concentration, thyroxine test by equilibrium dialysis
A T4 test is used to check how well your thyroid is working. It's also used to help diagnose and monitor thyroid disease and conditions that may affect your thyroid, including:
- Hypothyroidism, or underactive thyroid, which is when your thyroid gland doesn't make enough thyroid hormone to meet your body's needs
- Hyperthyroidism, or overactive thyroid, which is when your thyroid gland makes more thyroid hormone than your body needs
- Disorders of the pituitary gland, which is a gland at the base of your brain that makes TSH (thyroid stimulating hormone). TSH controls how much T4 your thyroid gland makes. If the results from a TSH test aren't normal, a T4 test can help diagnose whether the problem is with your thyroid or your pituitary gland.
In certain cases, a T4 test may be done as part of a group of tests called a thyroid panel. A thyroid panel includes a test for TSH as well as other thyroid tests.
You may need a T4 test if your provider thinks you may have a thyroid problem. Usually, a TSH test is done first. If your TSH results aren't normal, a T4 test may be done to learn more.
Thyroid problems tend to run in families, so your provider may order a T4 test if a member of your family has had thyroid disease. You may also need a T4 test if you have symptoms of having too much or too little thyroid hormone.
Symptoms of hypothyroidism (too little thyroid hormone), may include:
- Weight gain
- Fatigue
- Dry skin
- Dry, thinning hair
- Being very sensitive to cold temperatures
- Heavy or irregular menstrual periods or fertility problems
- Slow heart rate
- Depression
Symptoms of hyperthyroidism (too much thyroid hormone) may include:
- Anxiety, nervousness, irritability
- Weight loss, even though your appetite may increase
- Shaky hands, muscle weakness
- Sweating or being very sensitive to heat
- Arrhythmia (a problem with the rate or rhythm of your heartbeat)
- Frequent bowel movements (poops)
- Goiter (an enlarged thyroid gland)
- Trouble sleeping and fatigue
If you had a free T4 test, your test results may be reported as "free T4." If you had a total T4 test, your results may be reported as "free T4 index (FTI)." To fully understand your results, your provider will often need to compare them with the results of other thyroid tests.
In general, T4 results that are lower than normal may be a sign of:
- Hypothyroidism, which may be caused by Hashimoto disease or another medical condition that causes your thyroid to make too little T4
- Thyroiditis (thyroid inflammation)
- Side effects from certain drugs
- Congenital hypothyroidism (a condition that affects babies from birth)
In general, T4 results that are higher than normal may be a sign of:
- Hyperthyroidism, which may be caused by Graves disease or another medical condition that causes your thyroid to make too much T4
- Thyroiditis (thyroid inflammation)
- Toxic goiter (an enlarged thyroid with areas that make extra thyroid hormone)
- Toxic thyroid nodule (a single lump on the thyroid that makes extra thyroid hormone)
- Too much iodine in your diet
- A noncancerous (not cancer) tumor in your pituitary gland
Talk with your provider about what your results mean.
1. Thyroxine (T4) Test: MedlinePlus Lab Test Information [accessed on Oct 03, 2018]
2. 000620: Thyroid Profile With TSH | LabCorp [accessed on Oct 03, 2018]
3. T4 - Clinical: T4 (Thyroxine), Total Only, Serum [accessed on Oct 03, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (15)

Thyroxine, Total (T4): Thyroid Gland

The thyroid is a 2-inch, butterfly-shaped gland located at the base of the neck, just below the Adam's apple. The gland consists of two lobes, which lie on either side of the windpipe. The thyroid produces the hormones thyroxine (T4) and triiodothyronine (T3), which help maintain body temperature, heart rate, and metabolism rates.

Image by TheVisualMD

Importance of Thyroid Gland

The thyroid and the hormones it produces, for example, are under control of a hormone called TSH (thyroid-stimulating hormone), which is produced by the pituitary gland. The pituitary gland is often referred to as the "master gland" because it regulates the activities of other endocrine glands. The pituitary gland, however, takes its orders from the hypothalamus, which decides which particular hormones the pituitary should release and when.

Image by TheVisualMD

Thyroxine, Total (T4): Pituitary Gland

The pituitary is a pea-size gland attached to the base of the brain. It is often referred to as the \"master gland\" because it regulates the activities of other endocrine glands. The pituitary, however, takes its orders from the hypothalamus, an area of the brain that sits above the pituitary and is connected to it by neurons. The hypothalamus decides which particular hormones the pituitary should release and when.

Image by TheVisualMD

Woman With Goiter Due to Hypothyroidism

The thyroid is a small, butterfly-shaped gland located at the base of the neck that produces two hormones, thyroxine (T4) and triiodothyronine (T3), that help maintain body temperature, heart rate, moods, and metabolism. A goiter is any visible enlargement of the thyroid gland. In the past, goiters were often due to a lack of iodine in the diet (iodized salt has greatly reduced such goiters). Goiters can be present in cases of either hormone overproduction (hyperthyroidism) or underproduction (hypothyroidism).

Image by TheVisualMD

Thyroxine 3D Molecule

The major hormone derived from the thyroid gland. Thyroxine is synthesized via the iodination of tyrosines (MONOIODOTYROSINE) and the coupling of iodotyrosines (DIIODOTYROSINE) in the THYROGLOBULIN. Thyroxine is released from thyroglobulin by proteolysis and secreted into the blood. Thyroxine is peripherally deiodinated to form TRIIODOTHYRONINE which exerts a broad spectrum of stimulatory effects on cell metabolism. (MESH/NLM/NIH)

Thyroid problems - most common thyroid problems, symptoms and treatment

Video by Healthchanneltv / cherishyourhealthtv/YouTube

Thyroid gland - What's the function of the thyroid?

Video by Healthchanneltv / cherishyourhealthtv/YouTube

Thyroid Animation

Video by Columbia University Department of Surgery/YouTube

Thyroid Gland, Hormones and Thyroid Problems, Animation

Video by Alila Medical Media/YouTube

Thyroid Gland - Thyroid Hormones

Video by Armando Hasudungan/YouTube

How does the thyroid manage your metabolism? - Emma Bryce

Video by TED-Ed/YouTube

Understanding Thyroid Function Tests

Video by AdonaiDEC/YouTube

T3 And T4, What Do They Do?

Video by EmpowHER/YouTube

Woman's neck region with visible thyroid

The thyroid is a small, butterfly-shaped gland located at the base of the neck. The gland produces two main hormones, thyroxine and triiodothyronine. The hormones help maintain body temperature, heart rate, moods, energy levels, bowel function and rates of fat, protein and carbohydrate metabolism. The thyroid is under the control of a hormone called thyroid-stimulating hormone produced by the pituitary gland; the pituitary gland, in turn, takes its orders from the hypothalamus. Thyroid problems usually fall into one of two categories: hypothroidism, when the gland produces too little hormone; or hyperthroidism, when the gland produces too much.

Image by TheVisualMD

Thyroxine

The structural formula (left) and a space-filling model (right) of (S)-triiodothyronine (T3, also called liothyronine in the pharmaceutical industry)

Image by Benjah-bmm27

Thyroxine, Total (T4): Thyroid Gland

TheVisualMD

Importance of Thyroid Gland

TheVisualMD

Thyroxine, Total (T4): Pituitary Gland

TheVisualMD

Woman With Goiter Due to Hypothyroidism

TheVisualMD

Thyroxine 3D Molecule

4:11

Thyroid problems - most common thyroid problems, symptoms and treatment

Healthchanneltv / cherishyourhealthtv/YouTube

1:55

Thyroid gland - What's the function of the thyroid?

Healthchanneltv / cherishyourhealthtv/YouTube

1:48

Thyroid Animation

Columbia University Department of Surgery/YouTube

4:03

Thyroid Gland, Hormones and Thyroid Problems, Animation

Alila Medical Media/YouTube

12:47

Thyroid Gland - Thyroid Hormones

Armando Hasudungan/YouTube

3:37

How does the thyroid manage your metabolism? - Emma Bryce

TED-Ed/YouTube

6:07

Understanding Thyroid Function Tests

AdonaiDEC/YouTube

1:56

T3 And T4, What Do They Do?

EmpowHER/YouTube

Woman's neck region with visible thyroid

TheVisualMD

Thyroxine

Benjah-bmm27

How Is It Treated?

How Do Doctors Treat Postpartum Thyroiditis?

The hyperthyroid stage of postpartum thyroiditis rarely needs treatment. If your symptoms are bothering you, your doctor may prescribe a beta-blocker, a medicine that slows your heart rate. Antithyroid medicines are not useful in postpartum thyroiditis, but if you have Grave’s disease, it may worsen after your baby is born and you may need antithyroid medicines.

You’re more likely to have symptoms during the hypothyroid stage. Your doctor may prescribe thyroid hormone medicine to help with your symptoms. If your hypothyroidism doesn’t go away, you will need to take thyroid hormone medicine for the rest of your life.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Is It Safe to Breastfeed?

Breastfeeding and Beta-blocker

Image by TheVisualMD/JaGa

Breastfeeding and Beta-blocker

Breastfeeding and Beta-blocker

Image by TheVisualMD/JaGa

Is It Safe to Breastfeed While I’m Taking Beta-Blockers, Thyroid Hormone, or Antithyroid Medicines?

Certain beta-blockers are safe to use while you’re breastfeeding because only a small amount shows up in breast milk. The lowest possible dose to relieve your symptoms is best. Only a small amount of thyroid hormone medicine reaches your baby through breast milk, so it’s safe to take while you’re breastfeeding. However, in the case of antithyroid drugs, your doctor will most likely limit your dose to no more than 20 milligrams (mg) of methimazole or, less commonly, 400 mg of PTU.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (2)

Mechanism of action for beta blockers

Beta-blockers cause a competitive inhibition of the β-receptor, which counters the effects of catecholamines

Image by Mogsan1

Diovan

Diovan (valsartan) tablet 160 mg

Image by George Shuklin

Mechanism of action for beta blockers

Mogsan1

Diovan

George Shuklin

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