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Primary Hypothyroidism: Case Report

Patient history:
A 26-year-old female is two months post-partum with her first pregnancy. Infant was carried to term without complications.
Chief complaints to her doctor include extreme fatigue, weight gain, episodes of depression, and feelings of inadequacy as a mother.
Tests ordered included a thyroid function profile.

Laboratory results:
  • TSH: 5.0 µIU/mL (ref range 0.4 - 4.12 µIU/mL) H
  • FT3: 1.8 pg/mL (ref range 2.5 - 3.9 pg/mL) L
  • FT4: 0.6 ng/dL (ref range 0.6 - 1.3 ng/dL)
  • TPOAb: 5.5 IU/mL(ref range <9.0 IU/mL)
  • TgAb: 2.5 IU/mL (ref range <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 found to be low, which serves to confirm that the hypothyroidism is PRIMARY. No evidence of a common autoimmune disorder was found.
This is a common case of post-partum hypothyroidism, which may be an underlying cause of post-partum 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 assure adequate amounts of thyroid hormone are available.