Patient history:
A 26-year-old is two months postpartum with their first pregnancy. The infant was carried to term without complications. Chief complaints to the physician include extreme fatigue, weight gain, episodes of depression, and feelings of inadequacy as a parent.
Tests ordered included a thyroid function profile.
Laboratory results:
| Test | Patient Result | Reference Range |
| TSH | 5.0 µIU/mL | 0.4 - 4.12 µIU/mL |
| FT3 | 1.8 pg/mL | 2.5 - 3.9 pg/mL |
| FT4 | 0.6 ng/dL | 0.6 - 1.3 ng/dL |
| TPOAb | 5.5 IU/mL | <9.0 IU/mL |
| TgAb | 2.5 IU/mL | <4.0 IU/mL |
Note that the TSH concentration is elevated to a slight degree, indicating that thyroid hormone production may be deficient. In this case, the FT3 level was low, confirming that the hypothyroidism is PRIMARY. No evidence of a common autoimmune disorder was found.
This is a typical case of postpartum hypothyroidism, which may be an underlying cause of postpartum depression. Such cases are treated with prescription synthetic thyroid hormones to supplement the under-production of the thyroid. The laboratory provides ongoing service in such cases by monitoring the TSH levels to ensure adequate amounts of thyroid hormone are available.
