# Recurrent Episodes of Thyrotoxicosis in a Man following Pregnancies of his Spouse with Hashimoto's Thyroiditis

## TL;DR

A man experienced repeated thyroid issues coinciding with his wife's pregnancies and postpartum periods, suggesting a possible link to hormonal changes.

## Contribution

This is the first reported case of recurrent painless thyroiditis in a man linked to his spouse's pregnancies and Hashimoto's thyroiditis.

## Key findings

- The patient's thyrotoxicosis episodes coincided with his wife's pregnancies and postpartum periods.
- The condition followed the typical pattern of silent thyroiditis, including hyperthyroidism followed by resolution.
- The report suggests a possible link between male hormonal changes postpartum and thyroiditis.

## Abstract

Over an 8-year period, a male patient presented three times to an endocrinologist with strikingly similar presentations, including palpitations, anxiety, and tremors. Each of his presentations occurred following either the birth of one of his two children or his wife's late termination of pregnancy. This patient's illness followed the typical time course of silent thyroiditis: hyperthyroidism, followed by euthyroidism, a late hypothyroid phase, and then a complete resolution of symptoms and normalization of thyroid function tests over a period of several months. We discuss the curious clinical presentation, diagnostic evaluation, and a literature review of alternate explanations for this patient's condition, including a discussion of the impact of seasonal shift, spousal's autoimmune disease, stress, and evolutionary changes in males postpartum. Although the differential diagnosis is broad in this case and the thyrotoxicosis could have coincidentally followed pregnancies of the patient's wife, documented hormonal changes in men during postpartum period in conjunction with the timeline of the patient's condition are suggestive of recurrent “sympathetic” postpartum thyroiditis. To our knowledge, this is the first case report of recurrent painless thyroiditis in a man following pregnancies of his wife with Hashimoto's thyroiditis.