Thyroid UK
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PPT vs Hashimotos


This may be (very) wishful thinking but: I gave birth 18 months ago and was diagnosed with Hashi's one year ago.

I have felt AWFUL for the last 3 weeks ish. I am on B&R (2 x 20mg Carb + 25/50mcg Levo alternate days).

I don't even know what I've been feeling - a whole host of mixed up and horrible symptoms, panic attack included.

I've been doing some reading and see that PPT can almost be indistinguishable from Hashi's, I also read that the same autoantibodies are tested.

Is there any possibility that I could be feeling so awful because I have PPT and it is now nearing the end of the latter phase yet I am still medicating? Or am I thyroid-crazy?

20 Replies

Hi, I was diagnosed with PPT after the birth of my first child 23 years ago. I don't remember if autoantibodies were measured all I know is that I was under active with a TSH of 70 6 months PP and 8 months later I was over active.

I was not treated, just monitored for 2 years. I was told it was unlikely I'd ever have a thyroid problem again. How I wish that had been the case but after my second child I had the same problem and 18 years later I am still trying to sort my health out. Sorry to be negative!

I understand that if you have auto antibodies you have Hashi. Have you been given the results of your blood tests that you can post here?

I feel for you and hope others can give you better answers. I hope you are getting a lot of support at home because I know how tough it is to have a baby to care for when you feel rotten.

I hope you feel better soon.

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Oh, BlueMundo, thank you so much for your kindness. I just read elsewhere that they also test TPO etc. (The same as in Hashi's) for PPT. Then I'm not sure how you do differentiate the two!

I had my daughter in May, felt hyper symptoms around the August/Sep and was diagnosed toxic in the November. Then saw Endo and was not specifically told I had Hashi's but had tested positive and high for TPO antibodies and heard him say Hashimoto's into his dictaphone.

I'm so sorry you have been through so much - pregnancy and child rearing really is taxing enough, however wonderful! I do get support at home yes, but as time goes on and you're medicated it becomes understandably 'invisible' to your partner. I often have to remind him and it's not pleasant to recount all of the details. He's busy too though. I have quit my career and work a small amount of hours + raise my daughter because I couldn't handle the stress causing me to feel terrible.

It's rather grim sometimes but I am really trying to focus on positives. I hope you are able too, too.


Chloececilia, post-partum thyroiditis just means thyroiditis was triggered by pregnancy. Thyroiditis is used to describe autoimmune thyroid disease which is Graves, Hashimoto's or both.

I think your thyroid levels need checking as the Carbimazole and Levothyroxine doses may need adjusting.


I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.


Oh dear, Clutter, I feel like a broken record! Sorry!

It was this that I read:

And it got me thinking. Technically, if I did have Thyroiditis triggered by pregnancy then, unless I am one of the sufferers who will always be hypo, it would be starting to stabilise itself about now.

I am taking that from the understanding that PPT resolves itself within 12-18 months OR am I totally confused and what they are saying is:

PPT is triggered by pregnancy, Hashi's or graves etc. and 'resolving itself' is another term for going into remission after a 12-18 month treatment course? I am really confused haha.


Chloececilia, PPT and the hyperthyroid phase you've been in can resolve after 9-18 months. This is why your thyroid levels need checking every few weeks so that Carbimazole dose can be adjusted. Your dose is likely to be titrated and when thyroid levels have been stable for a while on low dose Carbimazole you'll probably be weaned off to try for remission. Remission has less than 50% chance of being permanent when Graves antibodies are present but if you don't have Graves, remission may be successful, although Hashimoto's will be lurking and may make you hypothyroid in a few years.


I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.


Thank you Clutter, I'm so glad you're here to put me right! No Graves thankfully. I am on a positive thinking binge, ask believe receive, I 'believe' is the saying!

I have TFT on Wed. I have had about 2 'normal' TFT's and the rest have elevated TSH, dosage then adjusted. I feel terribly hyper at the moment with some odd little hypo symptoms, sometimes I don't know where to start with deciphering myself.

I am aiming to go gluten free, and have all my vits and mins tested if I can bear the blood collection.

Thanks again.


Chloececilia, gluten-free can be very helpful in managing Hashimoto's and reducing antibodies which will delay progression to hypothyroidism.

If your TSH was high your dose of Carbimazole was too high or Levothyroxine too low. If you're feeling hyper after the adjustment dose probably needs adjusting again.

Post your new results and ranges in a new question and members will advise.


I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

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I'm confused - you say you don't have Graves yet I always thought that block and replace was the treatment used for people with Graves disease (I'm in remission from Graves) I always took 40mcg carbimazole and gradually worked up to 75/100 mcg Levo - then my bloods were where my endo wanted them and I stopped everything at once, so I can't understand why your hashis which I always thought was under active thyroid with antibodies is being treated with block and replace which I always thought was the treatment for Graves' disease which is an overactive thyroid with antibodies.

I know when I needed my Levo increased I got symptoms of being hyper - I wasn't I just used to feel that way. Hopefully your blood tests on Wednesday will help clear things up for you, it's no fun feeling as awful as you are especially with a little one to look after.


Oh, I'm confused again! I tested negative for Graves antibodies at the beginning. When my levels weren't settling he suggested B&R. Not sure of anything else!

That's fab you're in remission!


Yes, remission is really good :) I stopped my B&R two years ago on 3/11

Was it your endocrinologist who suggested B&R? I've never heard of it being used for an under active thyroid but I suppose it could be - when you think of it all it what it does is to stop any / all natural thyroid production and replace it with synthetic thyroid.

I've never heard of block and replace being used to treat an under active thyroid - until now - but then I'm not a doctor and have no medical background - only my own experience.

I went totally gluten free three months ago - I was diagnosed with inflammatory arthritis - yet another autoimmune condition so I decided I had to try something to dampen down my antibodies - I know Graves and RA antibodies aren't the same but I thought every little would help. I'm fading it ok - harder to eat out and I've found that I don't snack any more which is a good thing really. If you join Coeliac UK you get an amazing food shopping directory filled with every single GF product you can think of so its worth thinking about.

Hopefully your blood test will help them get you sorted out. It's so hard keeping up with every day life when you are feeling awful.


Yes, my endo. A lot of the time I was going back to him complaining of hyper symptoms and now I am wondering if what I have been experiencing are actually hypo. Sometimes it's impossible to tell by the time you get your bloods done, you sometimes feel better!

3 weeks ago my other half almost blinded himself at work, at the same time I fell ill with a virus, so did my Grandmother (who has to be careful with any illness) and my daughter who had soaring temps. Within all of this I was at a bit of a loss for help due to my other half being out of action.

Hence stress levels soared, I became fatigued, agony all over, anxious and problems sleeping. The pain relieved after some yoga etc, but the anxiety and palps are still going.

I'm wondering if I had a flare, becoming hyper at the other end which my alternate double dose has interfered with. I'm not sure, I'm really still in the dark! I would be devastated if I had Graves and Hashi's and no one had explained it to me.

Thanks so much for the GF web recommendation! Sounds great. What I'm most worried about is being a pain at family dinners!


Gosh, what a lot to have to deal with! I hope your other half is ok now - well I hope everyone is ok now. The thyroid is all a bit of a minefield isn't it.

There are lots of things you can eat more or less normally on a gf diet. Good plain cooking but watch what you thicken gravies with and you're ok. I've got gravy mix made by Orgran and it's pretty like Bisto. You can thicken with cornflour as well. I often cook for a group of people and one or two of them are gf so I just make everything gf and that works. Once you get into the swing of it, it's not too bad.

Just a case of training my other half to read the ingredients carefully. Even though wheat is written in bold black letters there are times when we have *both* manages to miss it.

It's surprising the places wheat can pop up - it can be put in foods you would never imagine it to be in - but we've already bought gf stuffing for the turkey. I think what I miss most is puff pastry and real French stick, gf bread is expensive and not always all that great to eat - crumbly and sort of sweet taste (well it is to me) and I find the pastry a bit weird to deal with - I really like Schar bread though, it tastes almost normal but it comes in a tiny packet and isn't cheap :)

We eat out more than we ever used to - and it's proving to be easier than I expected. I've got a friend who is coeliac and he says it is thanks to us non coeliac gf people that he has such a good choice of places to eat out now.

HU also have a forum called GlutenFreeGuerillas which would be worth taking a look at.

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Just for reference my TPO was:

483.8 (<6)

Thyroid receptor: 3/L (0-15)


Goodness me - your TPO is a bit over the range isn't it! 😉 Hopefully y will get answers soon.


I had postpartum thyroiditis, but it was never uncovered. I thought I had postnatal depression and had some days, to be honest, when I thought I couldn't carry on. It was awful. Like you, I am also confused as to whether or not I now have hashimotos. I can't offer much advice, but as someone who has never been treated (and still is on no medication now) I can give you an outline as to what happened so that you can compare. I was hyper at first (1-5 months after giving birth to my 2nd child), and was anxious, panicky, palpitations, and weight loss, then I was severely hypo (couldn't get out of bed, no interest in anything, listless, forgetful, depressed) for a year. Then suddenly one day I was better, although still exhausted, I could get up and interact with my family again. Four years on, I am still fatigued, although not as badly as I was when I was hypo, and I do suffer from hypo symptoms. Now, my PPT should have resolved itself and my TSH is technically acceptable to doctors (It is always over 4), TPO is 237, but I still feel bad. So, my theory is that the PPT has triggered hashimotos or at least brought it to the surface, and now my thyroid is slowly degenerating. Perhaps you have also technically 'recovered' from PPT, but you now have hashis? I don't know. You sound like you are hyperthyroid. I am just as confused as you, but you're not alone. I want to be the mum who is full of energy, but sometimes feel that I am struggling to get through each day.


Thank you for your thoughtful post, ada11. I'm sorry you are still feeling symptoms, it really is a minefield that I am guessing takes an awful lot of self-research!

How often do you get your bloods done now? I would love to be a bouncing ball of energy for my little one, but instead I am kind of struggling through every day, sometimes going weeks feeling fine and weeks feeling awful. I'm sick to death of it.

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Hi Chloececilia,

I get my bloods done every six months, but as i'm still 'in the reference range', my doctor has not yet put me on any medication. It is a hard road, especially with little ones depending on you. Good luck to you, and know that you aren't alone.


That's so very frustrating ada11. I sincerely hope you get some answers soon. Thank you for your kind words, you too are not alone!


if you have hashi's antibodies, then i would think you have hashi's.


Does anyone know the minimum amount of blood that can be drawn for a TFT?


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