How Sheehan’s syndrome affects the thyroid

If a person loses a lot of blood while giving birth, the pituitary gland can get harmed — this is known as Sheehan’s syndrome (postpartum pituitary necrosis). Damage to the pituitary gland can prevent it from producing hormones, including TSH and prolactin (1).

Signs and symptoms of Sheehan’s syndrome can be mild, and potentially not present for weeks or months after birth. They include (2, 3):

  • Absence of lactation (agalactorrhea)
  • Hot flashes
  • Fatigue
  • Irregular heartbeat
  • Weight gain
  • Constipation

How is Sheehan’s syndrome diagnosed?

Sheehan’s syndrome is diagnosed through testing blood markers, including (1):

  • TSH, fT3, and fT4
  • Follicle stimulating hormone (FSH), Luteinizing hormone (LH), and estrogen
  • Prolactin (PRL) and complete blood count (CBC)
  • Cortisol

Sometimes an MRI (magnetic resonance imaging) is needed to confirm a diagnosis.

How is Sheehan’s syndrome treated?

It’s recommended to visit an endocrinology specialist with working knowledge of hypopituitarism and growth hormone. Treatment of Sheehan’s syndrome is lifelong and includes (1):

1. Either synthetic T4, T4+T3, or a natural thyroid preparation (for an underactive thyroid)

2. Prednisone or hydrocortisone (for cortisone deficiency)

3. Estrogen, or both estrogen and progesterone (for gonadotropin deficiency)

4: Growth hormone (for growth hormone deficiency)

Sheehan’s syndrome can exacerbate Hashimoto’s

Changes in pituitary gland hormone production has a major effect on the immune system. It can trigger Hashimoto’s in undiagnosed people, or worsen Hashimoto’s symptoms in diagnosed people (4).

You may track symptoms and blood tests to stay on top of Sheehan’s syndrome and hypothyroidism:

  • Fatigue
  • Heart palpitations
  • Weight changes
  • Digestion
  • TSH, fT3, and fT4
  • FSH (follicle stimulating hormone), LH (luteinizing hormone), and estrogen
  • PRL (prolactin), and complete blood count (CBC)
  • Cortisol

How we write: our information is based on the results of peer reviewed studies using the National Library of Medicine platform. It is written by scientists and reviewed by external experts. If you believe we might have overseen crucial scientific information, please contact us at

Disclaimer: This information is not intended to mitigate, prevent, treat, cure or diagnose any disease or condition. If you want to change your treatment, lifestyle, your diet, include supplements in your diet or have concerns about your health, please consult your doctor before trying new approaches.


  1. Schury MP, et al. Sheehan Syndrome, 2020
  2. Karaca Z, et al. Neuroendocrine changes after aneurysmal subarachnoid haemorrhage, 2019
  3. Thompson CJ, et al. Management of hypothalamic disease in patients with craniopharyngioma, 2019
  4. Takasu N, et al. A Patient with Postpartum Hypopituitarism (Sheehan’s Syndrome) Developed Postpartum Autoimmune Thyroiditis (Transient Thyrotoxicosis and Hypothyroidism): A Case Report and Review of the Literature, 2011

Photo: Unsplash; Design: VLM Health



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