Postpartum thyroiditis — SCE Endocrinology MCQ

Correct answer: A — Levothyroxine then reassess recovery from postpartum thyroiditis

The best answer is “Levothyroxine then reassess recovery from postpartum thyroiditis”. Overt symptomatic hypothyroidism in the postpartum thyroiditis sequence is treated with levothyroxine, which is compatible with breastfeeding; some patients recover, so permanent need is reassessed later. “Administer radioiodine during ongoing breastfeeding” is less appropriate because radioiodine is inappropriate for hypothyroidism and incompatible with ongoing breastfeeding “Start carbimazole to reduce TSH” is less appropriate because carbimazole inhibits hormone synthesis and would worsen deficiency “Observe without treatment because every postpartum case resolves rapidly” is less appropriate because recovery is variable and significant symptomatic biochemical disease should not be left untreated “Use propylthiouracil for the hypothyroid phase” is less appropriate because propylthiouracil is another antithyroid drug and does not replace thyroid hormone

Reference: Endotext: Postpartum thyroiditis. https://www.ncbi.nlm.nih.gov/books/NBK278999/