Postpartum Thyroiditis

Postpartum thyroiditis is an uncommon condition in which a previously normal-functioning thyroid gland — a butterfly-shaped gland located at the base of your neck just below your Adam's apple — becomes inflamed within the first year after childbirth.

This condition can be difficult to recognize because its symptoms are often mistakenly attributed to the stress of having a newborn and postpartum mood disorders.

Lasting for about several weeks to several months as most women who develop postpartum thyroiditis, thyroid function returns to normal within 12 to 18 months of the start of symptoms.

However, some women who experience postpartum thyroiditis develop permanent complications.

Signs and symptoms of postpartum thyroiditis vary depending on its phase.

There are two phases experienced during postpartum thyroiditis.

First phase, mild signs and symptoms similar to those of an overactive thyroid (hyperthyroidism) is caused by the inflammation and release of thyroid hormones.

Signs and symptoms include:

• irritability,
• anxiety,
• palpitations or rapid heartbeat,
• increased sensitivity to heat,
• unexplained weight loss,
• tremor,
• insomnia
• and fatigue.

The signs and symptoms that occur during the first phase last from one to four months after delivery and last one to three months.

As the condition progress, as thyroid cells become impaired, you might experience:

• lack of energy,
• increased sensitivity to cold,
• constipation,
• dry skin,
• difficulty concentrating,
• aches and pains.

These are the mild signs and symptoms of underactive thyroid (hypothyroidism), which typically occur four to eight months after delivery and can last from nine to 12 months.

Keep in mind, however, that not all women who have postpartum thyroiditis develop symptoms of only hyperthyroidism or only hypothyroidism, but not both, as condition still vary.

It is still unclear on the actual cause of postpartum thyroiditis.

It is believed that women who develop postpartum thyroiditis likely have an underlying autoimmune thyroid condition that is triggered after delivery due to fluctuations in immune function, this is so as women with postpartum thyroiditis often have high concentrations of anti-thyroid antibodies in early pregnancy and after giving birth.

This underlying condition, in which your immune system attacks your thyroid gland, appears to be very similar to Hashimoto's disease.

Seeking medical consultation from your family doctor or a health care provider is the beginning of postpartum thyroiditis diagnosis.

Most likely an endocrinologist, which is a doctor who specializes in the body's hormone-secreting glands, is the best to consult.

Make sure to come prepared with information which will help optimize your medical appointment as well as what you can expect for your health care provider.

Also know the pre-appointment restrictions by asking your doctor beforehand, such as anything that needs to be done in advance.

List down all the symptoms that you are experiencing and make sure to relay it to your doctor.

Include not just the physical symptoms but even changes in emotions or mood as well as causes of stress or recent life changes. Do not forget to include the list of medications that you have been taking.

It is also important that you are accompanied by a family member or a friend which can offer comfort as you are probably fearing for your condition and is anxious of what you are feeling.

Having someone with you during the appointment may help remember things that you forgot and unable to notice which can prove important in understanding your condition.

Here are some common questions to ask your health care provider in understanding postpartum thyroiditis

• What is causing my symptoms or condition?
• What tests do I need?
• Are there other possible causes for my symptoms or condition?
• What are the alternatives to the primary approach you're suggesting?
• How can I best manage them together?
• Are there restrictions I need to follow?
• Is my condition likely temporary or chronic?
• What is the best course of action?
• Should I see a specialist?
• Is there a generic alternative to the medicine you're prescribing?
• Are there brochures or other printed material I can take with me? What websites do you recommend?

Expect to receive questions from your doctor to help assess your condition

Here are some basic questions to expect:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Do you have a prior history or family history of thyroid disease?

Other diagnostic tests to check your thyroid function that will be ordered by your doctor to diagnose postpartum thyroiditis include: blood tests that measure the level of thyroid-stimulating hormone (TSH) and the level of the thyroid hormone thyroxine.

If you have risk factors for postpartum thyroiditis, your doctor will likely test the functioning of your thyroid three and six months after delivery. If your thyroid test results are abnormal, your doctor will likely recommend further testing within one to two weeks.

In addition, once you have been diagnosed to having postpartum thyroiditis, an annual thyroid test will need to be perform to monitor if you have developed hypothyroidism.

Treatment is most likely not needed for women who develop postpartum thyroiditis when on hyperthyroid or hypothyroid phases of their condition.

But this does not mean that further monitoring and management is not going to be perform, actually your doctor will monitor your thyroid function through regular blood tests such as every four to eight eeks.

Doing so will allow the doctor to monitor and track changes in the hormone level or the development of hypothyroidism.

Once severe signs and symptoms of hyperthyroidism occurs, your doctor will prescribe a drug that blocks the effects of thyroid hormone on the body (beta blocker). Beta blockers typically aren't recommended for women who are breast-feeding.

However, another beta blocker which is propranolol might be given to mothers as it is not as concentrated in breast milks.

If severe signs and symptoms of hypothyroidism happen, a thyroid hormone therapy for six to 12 months is needed.

This involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Synthroid, others) but once this treatment is stopped regular blood testing is needed to monitor development of hypothyroidism.

You might need blood tests after two months, three months, six months and then, if your test results remains normal, annually.

There are no specific prevention against postpartum thyroiditis, however steps can be taken to properly take care of yourself after delivery.

You must not discount the unusual signs and symptoms you might be experiencing after childbirth, do not right away assume that all stress and negative emotions are related to the new role of having to take care of a newborn.

It is best to work with your health care provider to monitor your health once it has been determined that you are at a risk of postpartum thyroiditis.

A few alternative remedies exist for managing postpartum thyroiditis.

Proper diet and nutrition will help you in the management of postpartum thyroiditis.

Dietary adjustments would have to be made based on the symptoms experieneced.

Also, Exercise is necessary to maintain general body health and support the struggling immune system.

Lifestyle modifications are necessary in order to cope with postpartum thyroiditis.

Always work hand in hand with your health care provider to come up with the best plan to manage your condition once you have been diagnosed with postpartum thyroiditis.

You will still be able to function normally and fulfill your new role as a mother as long as you stick with your treatment regime as advised by your doctor.

The following pre-existing conditions puts you at increased risk of developing postpartum thyroiditis:

• An Autoimmune disorder, such as type 1 diabetes,
• A history of postpartum thyroiditis,
• High concentrations if anti-thyroid antibodies,
• A history of previous thyroid problems,
• A family history of thyroid problems.

Postpartum thyroiditis and postpartum depression have also been link based on some studies. Hence, once you have been diagnosed with postpartum depression, a thyroid function test would most likely be performed by your doctor.

Typically within 12 to 18 months of the start of symptoms, most women who develop postpartum thyroiditis, thyroid function eventually returns to normal unless hypothyroid phase is experience which some women do not recover from.

This results to the development of hypothyroidism, a condition in which your thyroid gland doesn't produce enough of certain important hormones.