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July 12, 2023 10 min read

So, you've just welcomed your bundle of joy into the world, and now you find yourself dealing with symptoms like fatigue, weight gain or loss, mood swings, and hair loss. These frustrating symptoms may indicate that your thyroid gland is not functioning correctly after childbirth, a condition called postpartum thyroiditis. Yes, other than affecting pregnant women, thyroid problems may also occur after pregnancy. But don't worry - there are steps you can take to address this issue and alleviate your symptoms. Keep reading to find out everything about this thyroid disease!

What is postpartum thyroiditis?

Firstly, congratulations on your newborn! Along with the joy and challenges of motherhood, women sometimes encounter changes in their body's functioning, one being a condition called postpartum thyroiditis, a thyroid problem after pregnancy. This term might initially seem daunting, but understanding it can help you navigate postpartum life more confidently.

Postpartum thyroiditis occurs when the thyroid gland—that small, butterfly-shaped endocrine structure in the front of your neck—becomes inflamed following childbirth. The thyroid's key role involves producing certain hormones crucial for your body's energy usage and organ operations.

In the case of postpartum thyroiditis, inflammation of the thyroid results in the release of pre-formed thyroid hormones into your bloodstream, causing a temporary state known as hyperthyroidism—where your thyroid gland is overactive and produces excessive hormones. This situation might cause your body to operate at a faster-than-normal pace.

Over time, however, this condition can swing to the other end of the spectrum leading to hypothyroidism, whereby the gland becomes underactive and doesn't produce enough hormones. Consequently, certain areas of your body may work slower than usual. In some cases, it might also lead to the development of goiter (enlarged thyroid gland).

This switch from hyperthyroidism to hypothyroidism usually occurs within the first year after delivery. According to the American Thyroid Association, it affects roughly 5-10% of women. Moreover, this condition is typically temporary and resolves itself within 12-18 months post-childbirth.

Postpartum thyroiditis may exhibit similarities with an autoimmune disease known as Hashimoto's thyroiditis due to certain antithyroid antibodies typically present in both conditions. However, postpartum thyroiditis and Hashimoto's thyroiditis are distinct conditions despite their overlapping features.

What are the different types of postpartum thyroiditis?

The term' postpartum thyroiditis' is essentially an umbrella for different variations of the condition, each with distinct timelines and symptom profiles. Therefore, it's crucial to be aware of these differences in order to make sense of your unique medical situation.

Classic

A common form is 'Classic' postpartum thyroiditis, affecting roughly 22% of diagnosed patients. In this variant, women typically endure a period of temporary thyrotoxicosis—characterized by an overflow of thyroid hormones in the body. This hyperactive state is followed by a subsequent phase of hypothyroidism, whereby the thyroid gland does not generate sufficient hormones. The rollercoaster of hormone fluctuations generally stabilizes by the end of the first postnatal year, returning to healthy thyroid activity.

Isolated thyrotoxicosis

Another type is 'Isolated Thyrotoxicosis,' experienced by approximately 30% of women with postpartum thyroiditis. Individuals with this type go through a phase of thyrotoxicosis, mirroring the initial stage of Classic postpartum thyroiditis. Distinctly, in this form, hypothyroidism does not follow the thyrotoxic state. Instead, the excessive production of thyroid hormones resolves independently over time. This typically begins between two to six months after childbirth.

Isolated hypothyroidism

The third type, known as 'Isolated Hypothyroidism,' tends to affect nearly half of the diagnosed patients. Women with this form of postpartum thyroiditis exclusively develop hypothyroidism, which usually emerges anywhere between three to 12 months post-childbirth. Although this low-activity thyroid state resolves in most cases, it's pivotal to be aware that 20% to 40% of these instances can potentially progress to permanent hypothyroidism.

These diverse forms underline the importance of close monitoring and understanding of individual symptoms, followed by tailored treatment options in managing postpartum thyroiditis successfully. As always, consult with your healthcare provider for the best postpartum care for you and your beautiful newborn.

What causes postpartum thyroiditis?

Thyroid issue after pregnancy: How can you treat postpartum thyroiditis?

While the exact cause of postpartum thyroiditis remains unknown, several findings suggest links to the autoimmune thyroid disease or autoimmune thyroiditis, known as Hashimoto's thyroiditis, which primarily affects the thyroid gland. These conditions might be challenging to differentiate from one another, adding another layer of complexity to the equation.

Interestingly, the thyroid antibodies associated with autoimmune responses have been discovered to play a potentially significant role in postpartum thyroiditis. An important substance in the thyroid gland, thyroid peroxidase autoantibodies (TPO), greatly assists in hormone production. When thyroid antibodies incorrectly target TPO, it can raise the risk of postpartum thyroiditis. Specifically, studies show that women testing positive for TPO antibodies early in pregnancy have a 30-52% risk of developing postpartum thyroiditis. This risk jumps to 80% if these antibodies persist into the third trimester.

The presence of these antibodies can lead to inflammation of the thyroid gland, triggering an acceleration of thyroid hormone production. This excessive output, known as hyperthyroidism, can cause the body to operate at a faster pace than normal. However, an overactive thyroid could also face potential depletion, resulting in hypothyroidism or an underactive thyroid state that slows down bodily functions.

Why these antibodies initiate an attack on the thyroid still remains a mystery. Some believe that women who develop postpartum thyroiditis might have an underlying, asymptomatic autoimmune thyroid disorder already. Although there's still plenty to discover about the origins of postpartum thyroiditis, ongoing research continues to enhance our understanding and provide crucial insights into managing this condition effectively.

What are the symptoms of postpartum thyroiditis?

Postpartum thyroiditis symptoms typically unfold in two phases, beginning with an overactive thyroid or hyperthyroidism and possibly transitioning to an underactive thyroid, also known as hypothyroidism. The transition between these phases and the experience of their related symptoms can vary widely among women. Most women experience mild symptoms, but others can also experience severe symptoms.

The initial phase, hyperthyroidism, starts 1 to 4 months after childbirth when the inflamed thyroid gland releases excessive hormones into the bloodstream. Some women might not even recognize the symptoms of this phase, as they can be subtle or non-existent. However, for those who do experience this phase, common symptoms can include:

  • An increase in body temperature beyond the usual

  • Heightened feelings of nervousness and anxiety

  • A faster-than-normal heart rate

  • Muscle weakness

  • Difficulty focusing on tasks

  • Unexpected weight loss

  • Insomnia

  • Increased irritability

These symptoms tend to last for 1 to 3 months.

The second phase, hypothyroidism, could be the sequel if the thyroid gland's damage in the hyperthyroidism phase impairs its ability to produce an adequate quantity of hormones. Thus, you'll have low thyroid hormone levels. This phase typically occurs between 4 to 8 months post-childbirth, and symptoms can last anywhere between 9 to 12 months. Hypothyroid symptoms include:

  • Fatigue

  • Sensitivity to cold temperatures

  • Muscular cramps

  • General weakness

  • Unexpected weight gain

  • Memory loss

  • Constipation

  • Dry skin

  • Decreased tolerance to exercise

  • Mood changes, including depression

Some women might experience symptoms from both phases, while others might relate to one or the other.

Who is at risk for postpartum thyroiditis?

Postpartum thyroiditis, though not widespread, does have certain risk factors that increase a woman's likelihood of developing the condition after childbirth. Understanding these risk factors for this thyroid dysfunction can help in early detection and management.

One of the significant risk factors is the presence of pre-existing autoimmune disorders. Specifically, women who have conditions such as type 1 diabetes or lupus are at an elevated risk of developing postpartum thyroiditis. The immune system changes that occur during pregnancy may make thyroiditis symptoms more severe in these cases.

Similarly, positive antithyroid antibodies - substances that mistakenly target the body's own thyroid tissues - can also increase the likelihood of postpartum thyroiditis. This risk corresponds directly with the amount of antithyroid antibodies present before pregnancy; the higher their levels, the higher the risk.

A personal history of thyroid conditions or postpartum thyroiditis can also significantly increase the chance of experiencing postpartum thyroiditis. In fact, about 20% of women who had postpartum thyroiditis in one pregnancy can expect recurrent thyroiditis in subsequent pregnancies.

Lastly, a family history of thyroid disease plays a noteworthy role. Women who have relatives—parents or siblings—with thyroid conditions are more likely to experience postpartum thyroiditis themselves.

In summary, while there is no fail-proof means to predict who will develop postpartum thyroiditis, being aware of these risk factors can open the doors for early diagnosis, proactive management, and, ultimately, a smoother postpartum journey.

How do doctors diagnose postpartum thyroiditis?

Diagnosing postpartum thyroiditis largely relies on blood tests, with doctors examining different elements in the blood related to thyroid functioning. The main tests to check your postpartum thyroid status are as follows:

Thyroid-stimulating hormone (TSH) test

One of the primary substances analyzed is thyroid-stimulating hormone (TSH), which is produced by the pituitary gland. TSH helps manage the thyroid gland's hormone production, an essential aspect of how various body systems function. Any inconsistencies in a patient's TSH levels could serve as a herald of potential thyroid issues.

In the initial hyperthyroidism phase, blood tests typically reveal low levels of TSH, while the levels of thyroxine (T4) and triiodothyronine (T3) - the hormones responsible for metabolism regulation - are often high-normal or elevated. This spike in T4 and T3 reflects the thyroid gland's overactivity at this stage.

As postpartum thyroiditis advances to the subsequent hypothyroidism phase, doctors would likely observe the inverse scenario. The TSH levels often rise, reflecting the pituitary gland's effort to encourage more thyroid hormone production. However, the response typically lags, resulting in low or low-normal T4 and T3 levels, indicative of an underactive thyroid.

TPO antibodies test

Another crucial aspect doctors may check is the presence and levels of thyroid peroxidase (TPO) antibodies in the blood. These antibodies, which usually attack the body's own thyroid tissues in error, will likely be elevated in most women experiencing postpartum thyroiditis, highlighting the occurrence of an autoimmune response. The elevation of TPO antibodies is particularly prominent in the hypothyroid phase.

Other tests

In certain cases, doctors may also opt for an ultrasound, which can reveal the potential enlargement of the thyroid gland, a possible manifestation of postpartum thyroiditis. This combination of tests, each delving into a unique aspect of thyroid function, assists doctors in providing a comprehensive and accurate postpartum thyroiditis diagnosis.

How is postpartum thyroiditis treated?

Thyroid issue after pregnancy: How can you treat postpartum thyroiditis?

As with any health condition, the successful management of postpartum thyroiditis hinges on timely diagnosis and tailored treatment plans. Generally, postpartum thyroiditis is treated based on the phase presenting the most significant discomfort and deviation from normal health. The primary aim is to ease symptoms and regain balance in the body's hormonal levels to enable a smooth transition through this post-birth period.

Treatment for thyrotoxic

When it comes to treating the thyrotoxic phase of postpartum thyroiditis, the approach is quite different from that of typical hyperthyroidism, given the unique nature of this postpartum condition.

While antithyroid drugs are a common solution for hyperthyroidism, they are generally not recommended for the thyrotoxic period of postpartum thyroiditis. Rather, the preferred approach is to address the uncomfortable symptoms that might be experienced during this phase, allowing the condition to naturally resolve as the immune system restores equilibrium.

In instances where symptoms prove to be particularly troublesome—causing heart palpitations or insomnia, for example—healthcare providers may prescribe a category of drugs called beta-blockers. Medications like propranolol or metoprolol, taken at the lowest viable dose for a few weeks, can mitigate such symptoms. Propranolol is often favored, especially in breastfeeding mothers, as it is less likely to be transferred to breast milk and can help decrease the activation of thyroid hormone.

Once the thyrotoxic phase starts to subside, the American Thyroid Association suggests another examination of your TSH level within four to six weeks. This is to screen for the potential onset of the hypothyroid phase, which occurs in approximately 75% of postpartum thyroiditis cases.

Treatment for hypothyroidism often involves thyroid hormone replacement medications. However, the necessity for this will depend on the severity of the symptoms. In instances where symptoms are minimal or non-existent, this phase might resolve naturally, without the need for treatment.

Treatment for hypothyroidism

Understanding the treatment pathways for hypothyroidism, especially when it surfaces in the form of postpartum thyroiditis, can make a vast difference in managing this complex condition. Here are two of the most effective treatments currently being employed:

Levothyroxine

Firstly, we have levothyroxine, an often-prescribed treatment that replenishes low thyroid hormone levels. This synthetic thyroid hormone replacement medication is aimed at restoring the body's hormonal equilibrium, thus facilitating normal function. If you're prescribed this medication, you're likely to start with a low dose, which will be gradually increased based on your body's response and tolerance to the medicine.

Natural Desiccated Thyroid (NDT)

Not to be overlooked, Natural Desiccated Thyroid (NDT) has been increasingly favored in treating hypothyroidism. Originally derived from the dried thyroid glands of pigs, NDT contains both T4 and T3 hormones, and as such, it presents a more holistic treatment approach.

NDT is optically viewed as a more 'natural' solution compared to synthetic hormones, and some patients prefer it for this reason. From a medical standpoint, it could be particularly beneficial in cases where individuals might struggle with T4 to T3 conversion—an issue that could undermine the efficacy of levothyroxine alone.

In the United States, the most widely used Natural Desiccated Thyroid (NDT) medications are Armour Thyroid and NP Thyroid. However, you can also buy desiccated thyroid online without a prescription, typically in the form of a supplement such as VitaliThy. This supplement offers a comprehensive approach to thyroid support, providing not only T4 and T3 thyroid hormones but also additional ingredients beneficial to thyroid health, including spica prunellae siccus, ashwagandha extract, and selenium yeast. These components collectively work towards enhancing your overall thyroid function and health.

The importance of monitoring

Regardless of the treatment selected, close monitoring of thyroid levels is essential for successful hypothyroidism management. Considering the delicate nature of the body's hormonal balance, even slight shifts can significantly impact your overall well-being. Consequently, regular check-ups and thyroid hormone level tests are strongly advised to ensure the effectiveness of the treatment and to tweak the approach as necessary in line with changing body needs so you can have your normal thyroid function back.

What comes next after postpartum thyroiditis?

Thyroid issue after pregnancy: How can you treat postpartum thyroiditis?

Don't worry too much. Postpartum thyroiditis might be temporarily unsettling but can usually take care of itself with time, especially when properly diagnosed and managed. Early detection makes all the difference and can help avoid undue discomfort and confusion. Awareness and understanding of your body's changes after childbirth are key stepping stones to tackling this condition head-on!

For those transitioning into hypothyroidism, treatment options abound. While levothyroxine, a synthetic hormone replacement, is certainly an effective solution, consider exploring the benefits of Natural Desiccated Thyroid (NDT)—a more 'natural' alternative that has effectively helped many regain their hormonal balance.

NDT, such as VitaliThy, derived originally from the dried thyroid glands of pigs, delivers a holistic treatment package by offering both T4 and T3 hormones critical to normal bodily function. Furthermore, VitaliThy, a natural desiccated thyroid you can buy online, includes beneficial components like ashwagandha extract, selenium yeast, and spica prunellae siccus for enhanced thyroid health. It's a comprehensive approach to thyroid support, focusing not just on treating the symptoms but restoring the healthy function of your thyroid gland.

Wojciech Majda
Wojciech Majda


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