Editing Hashimoto's thyroiditis (section)

=== Postpartum ===
Thyroid peroxidase antibodies testing is recommended for women who have ever been pregnant regardless of pregnancy outcome. "[P]revious pregnancy plays a major role in development of autoimmune overt hypothyroidism in [[premenopausal]] women, and the number of previous pregnancies should be taken into account when evaluating the risk of hypothyroidism in a young women [''sic'']."<ref name="Carlé-2014" />

[[Postpartum thyroiditis]] can occur in women with Hashimoto's.<ref name="Ramos-Levi2023" /> In healthy women, Postpartum thyroiditis can occur up to 1 year after [[Childbirth|delivery]] and should be differentiated from Hashimoto's thyroiditis as it is treated differently.<ref>{{cite journal | vauthors = Lee SY, Pearce EN | title = Assessment and treatment of thyroid disorders in pregnancy and the postpartum period | journal = Nature Reviews. Endocrinology | volume = 18 | issue = 3 | pages = 158–171 | date = March 2022 | pmid = 34983968 | pmc = 9020832 | doi = 10.1038/s41574-021-00604-z }}</ref>

After giving birth, [[Regulatory T cell|Tregs]] rapidly decrease and immune responses are re-established. It may lead to the occurrence or aggravation of autoimmune thyroid disease.<ref name="Weetman-2010">{{cite journal | vauthors = Weetman AP | title = Immunity, thyroid function and pregnancy: molecular mechanisms | journal = Nature Reviews. Endocrinology | volume = 6 | issue = 6 | pages = 311–318 | date = June 2010 | pmid = 20421883 | doi = 10.1038/nrendo.2010.46 | s2cid = 9900120 }}</ref> In up to 50% of females with thyroid peroxidase antibodies in the early pregnancy, thyroid autoimmunity in the postpartum period exacerbates in the form of postpartum thyroiditis.<ref>{{cite journal | vauthors = Lazarus JH | title = The continuing saga of postpartum thyroiditis | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 96 | issue = 3 | pages = 614–616 | date = March 2011 | pmid = 21378224 | doi = 10.1210/jc.2011-0091 | doi-access = free }}</ref> Higher secretion of [[Interferon gamma|IFN-γ]] and [[Interleukin 4|IL-4]], and lower plasma [[cortisol]] concentration during pregnancy has been reported in females with postpartum thyroiditis than in healthy females. It indicates that weaker immunosuppression during pregnancy could contribute to the postpartum thyroid dysfunction.<ref>{{cite journal | vauthors = Kokandi AA, Parkes AB, Premawardhana LD, John R, Lazarus JH | title = Association of postpartum thyroid dysfunction with antepartum hormonal and immunological changes | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 88 | issue = 3 | pages = 1126–1132 | date = March 2003 | pmid = 12629095 | doi = 10.1210/jc.2002-021219 | doi-access = free }}</ref>