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CPE-001 · synthetic case FX-010
Postpartum overt hypothyroid pattern with iron deficiency context
Eight months postpartum, TSH 12.4, low FT4, mild anemia.
Purpose: Detect overt pattern while routing postpartum context.
Inputs the engine received
Patient
- Age and sex
- 32, female
Context
- Postpartum within12 months
- Yes
- Breastfeeding
- Yes
Symptoms
- Fatigue
- Present
- Cold intolerance
- Present
- Hair loss
- Present
Laboratory
- TSH
- 12.4 mIU/L (ref 0.4–4.5)
- FT4
- 0.7 ng/dL (ref 0.8–1.8)
- ANTI-TPO
- 320 IU/mL (ref 0–35)
- HEMOGLOBIN
- 11 g/dL (ref 12–16)
What the engine reports
Special Population Pathway
Postpartum context identified. Consider postpartum thyroiditis and overlapping contributors such as anemia, mood symptoms and lactation-related clinical factors.
Detected clinical pattern
Biochemical Pattern Compatible with Overt Primary Hypothyroidism
Elevated TSH with FT4 below the laboratory reference range supports this pattern.
- Etiology / context: Autoimmune Thyroiditis Supported
- Etiology / context: Postpartum Thyroiditis Context Present
Why this pattern was identified
- Elevated TSH with low FT4. TSH 12.4 mIU/L (ref 0.4–4.5) and FT4 0.7 ng/dL (ref 0.8–1.8).
- Autoimmune etiology supported. ANTI-TPO 320 IU/mL (ref 0–35). Etiology is separate from the functional state.
Context modules routed
CTX-HT-POSTPARTUM Postpartum Thyroiditis Context
Consider postpartum thyroiditis when thyrotoxicosis or hypothyroidism occurs within one year postpartum; separate thyroid symptoms from overlapping mood, fatigue, anemia and lactation contexts; consider lactation status before any radioactive iodine uptake.
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Confirm clinical context, etiology modifiers and medication/exposure history.
- 2Consider lipid panel, CBC and CK if clinically indicated.
- 3Physician to determine levothyroxine initiation and dose using age and cardiovascular context.
Evidence and rule trace · 2 rules
PR-HT-01Overt Primary Hypothyroidism Biochemical Pattern
Inputs: TSH 12.4 mIU/L (ref 0.4–4.5) · FT4 0.7 ng/dL (ref 0.8–1.8)
TSH above and FT4 below the laboratory reference range.
CTX-HT-POSTPARTUMPostpartum Thyroiditis Context
Context module routed.
Evidence
- EV-AACE-ATA-2012 · Garber JR et al. Clinical Practice Guidelines for Hypothyroidism in Adults. Endocr Pract. 2012;18(6):988-1028.
- EV-ATA-HYPO-2014 · Jonklaas J et al. Guidelines for the Treatment of Hypothyroidism. Thyroid. 2014;24(12):1670-1751.
- EV-ATA-THYROIDITIS · American Thyroid Association. Thyroiditis.
Physician adjudication required. For clinician review only. This output identifies clinical patterns and safety considerations from the documented inputs. It does not establish an autonomous diagnosis or treatment plan. Physician confirmation is required.
Change the values
The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.
Thyroid-function testsMove the sliders or type values
- below range
- within range
- above range
- below range
- within range
- above range
Zones are drawn from your reference intervals. The engine, not the map, decides the pattern.
Laboratory values and reference rangesUse your lab's own interval
µIU/mL and mIU/L are numerically identical.
Interpreted against the reporting assay's upper limit.
Only used in the thyrotoxicosis pathway.
Patient context
Medications and exposures
Symptoms and physical findingsSupportive only: never classify on their own
Symptoms
Signs and decompensation red flags
More thyroid cases
FX-001
Overt primary hypothyroidism with autoimmune support
A 54-year-old with fatigue, cold intolerance and a TSH of 18.4.
FX-002
Antibody positive with euthyroid function
Strongly positive antibodies, but TSH and FT4 are both normal.
FX-003
Mild subclinical pattern with positive Anti-TPO
Mildly high TSH, normal FT4, positive Anti-TPO.
FX-004
TSH at or above 10 with normal FT4
TSH of 12 with a normal FT4 in a woman of 57.
FX-005
Pregnancy context with mild TSH elevation and Anti-TPO positivity
Pregnant, TSH 3.1 against a pregnancy range, Anti-TPO positive.
FX-006
Preconception infertility context
Trying to conceive, TSH 4.8, Anti-TPO positive.
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