Initially diagnosed with post partum thyroiditis

[Cathiebrink5]

Hi my daughter is 27 and just had her first child in December of 2016. In May she had a nagging cough that would not go away. She also was so tired that she could not get out of bed to go to work or care for her baby. One afternoon we noticed a huge lump on her neck. We took her to the emergency room and they said that her blood work indicated hyperthyroidism. They diagnosed her with post partum thyroiditis. They explained that it should slowly get better over time and that she may swing between hypo and hyper thyroid symptoms. She just saw an endocrinologist for the second time and they said that on an ultrasound that she had done it looks as though her swallowing and her breathing may be affected. She says that she doesn't feel like it is as far as she can tell.  Her blood work came back showing TSH was less than .01 and her T4 was 1.33 . She is now scheduled to have an i123 uptake scan. We were wondering if anyone else has experienced this or what any of this may be indicative of. Thank you so much for your time !

[Barb135]

Hi... What's the reference range for the T4?  Ranges vary from lab to lab and have to come from her own report for proper comparison.  

I just completed an I-123 uptake scan today... there's not much to it.  Some imaging centers have you go in and have an injection of the radioactive iodine, wait about 20 minutes, then have a scan.  Others have you take a radioactive iodine pill, wait 6 hrs, then go back for the scan.  I took the pill.

The scan includes a camera that's placed very close to the thyroid/face.  It's done in 3 parts (40-45 minutes, total).  You lie on your back and the first part has the camera directly above you taking pictures from the top.. this takes approximately 15 minutes.  Then the camera is placed at an angle toward the right side of your head and that portion takes 10-12 minutes.  The camera is them placed to the left side of your head for another 10-12 minutes.  The next morning, you go back for another scan that takes 10 minutes.

All the patient does is lie very still during the entire process. The facility where I had mine done even offered me a blanket to keep warm because I have hypothyroidism and stay cold all the time.  If the technicians are good, they will do everything they can to make the experience as comfortable as they can for your daughter.

Results of the scan should be ready in a couple of days, but that might depend on your doctor.  I get mine via a patient portal, so I get them pretty quickly.  

The results will show how much of the iodine your thyroid took up.  If the uptake was high, your daughter will likely be diagnosed with hyperthyroidism and, possibly, Graves Disease.  If the uptake is low/minimal, she will be diagnosed with hypothyroidism.  Of course, this is only valid for what happens during this time and things can change the next day...

The scan shows photos of the thyroid, which will include characteristics of the thyroid, including any nodules that might be present and will show whether or not those are taking up the iodine as well, which means they're producing hormones independently of the thyroid.  If they aren't taking up the iodine, they aren't producing hormones.  There are other things that may be determined from the scan as well.

[Barb135]

I forgot to mention that your daughter will receive a list of instructions to follow for a few weeks (mine was 3 weeks) prior to the uptake scan.  Part of these instructions will be to follow a low iodine diet, which will include not eating any fish or taking vitamins that may include iodine, such as some daily multi's.  If she's nursing, she will need to stop for a while after she's had the iodine to avoid passing it to her infant.  Be sure to ask all these questions when she's scheduled for the scan.