The thyroid is a small, butterfly-shaped gland in the front of your neck. As part of your endocrine system, your thyroid produces hormones that control functions like your heart rate, metabolism, and body temperature. When your thyroid function is off it can cause significant issues and challenging symptoms. Common thyroid issues are hypothyroidism and hyperthyroidism. In hypothyroidism, your thyroid gland isn’t as active as it should be, and it’s not producing enough thyroid stimulating hormone (TSH). In hyperthyroidism, your thyroid has the opposite problem and is overactive, producing too much TSH.
Postpartum thyroiditis occurs in approximately 3 to 8 percent of women who have given birth.
While thyroid dysfunction can occur for a variety of reasons before or during pregnancy, it can also occur after delivery in women with no history of thyroid issues in a condition called postpartum thyroiditis. This condition is caused by inflammation in the thyroid, which affects its function and your hormone levels.
Postpartum thyroiditis occurs in approximately 3 to 8 percent of women who have given birth, and the condition can sometimes be challenging to diagnose because many of the symptoms are also associated with caring for a newborn and recovering from childbirth, as well as with some postpartum mood disorders. Scientists have not pinpointed the precise cause of postpartum thyroiditis, but based on their knowledge of the condition and its risk factors, it’s suspected that women who develop postpartum thyroiditis may have an underlying autoimmune thyroid condition.
What are the risk factors for postpartum thyroiditis?
· Type 1 diabetes or other autoimmune disorder
· Personal history of thyroid problems
· Family history of thyroid problems
· Previous postpartum thyroiditis
· Presence of anti-thyroid antibodies before pregnancy
Should I be screened?
According to the National Institutes of Health (NIH), the presence of anti-thyroid antibodies early in pregnancy indicates a 30-50 percent chance of developing postpartum thyroiditis. If the antibodies are still present in the third trimester, the chance increases to 80 percent. While universal screening for postpartum thyroiditis is not currently recommended, the NIH recommends screening high-risk women at three and six weeks postpartum, including those who have a positive test for antithyroid peroxidase antibody, history of postpartum thyroiditis, or type 1 diabetes.
What are some postpartum thyroiditis symptoms?
With hyperthyroidism, you might experience a rapid heart rate or heart palpitations (where it feels like your heart is fluttering, pounding, or skipping a beat), sensitivity to heat, unexplained weight loss, muscle weakness, irritability or anxiety, fatigue, tremor, or insomnia, among other signs and symptoms. With hypothyroidism, signs and symptoms can include dry skin, unexplained weight gain, fatigue, muscle cramps, constipation, depression, and sensitivity to cold.
Postpartum thyroiditis symptoms can look very different from person to person.
Postpartum thyroiditis symptoms can look very different from person to person. In some cases of postpartum thyroiditis, an individual will experience a period of hyperthyroidism that develops one to four months after delivery and lasts one to three months, followed by a longer period of hypothyroidism, which commonly develops four to six weeks after the hyperthyroid symptoms resolve and lasts six to 12 months. It’s also possible to experience only hypothyroidism or only hyperthyroidism.
How is postpartum thyroiditis diagnosed and treated?
If you develop postpartum thyroiditis symptoms, blood tests to determine your thyroid hormone levels are used to diagnose postpartum thyroiditis, and your provider will monitor your levels as you recover. According to the Mayo Clinic, most women who develop postpartum thyroiditis will see their condition resolve on its own and not need treatment, and the need for treatment is primarily based on the severity of the postpartum thyroiditis symptoms. Even if you have mild symptoms that do not require treatment, your provider will likely still monitor your hormone levels until they have returned to normal.
If you have significant symptoms, your provider will monitor your hormone levels and can prescribe medication to help. For hyperthyroidism, beta blockers (which slow your heart rate) and steroids (to help with inflammation) are often utilized. Beta blockers are not commonly prescribed for women who are breastfeeding. For hypothyroidism, a thyroid hormone replacement is frequently prescribed, and adequate thyroid hormone levels are actually necessary for normal milk production.
There is no way to prevent postpartum thyroiditis, and for most women it often resolves on its own 12–18 months after the start of symptoms. Approximately 80 percent of women will eventually be able to taper off medication as their thyroid function returns to normal, but around 20 percent of women with postpartum thyroiditis will develop permanent hypothyroidism. If left untreated, both hypothyroidism and hyperthyroidism can cause significant complications. According to the Mayo Clinic, untreated hypothyroidism can cause swelling of the thyroid gland (goiter), heart problems, mental health issues, nerve damage, infertility, birth defects, and a rare but life-threatening condition called myxedema. Untreated hyperthyroidism can cause heart issues, brittle bones, eye issues, and a condition called thyrotoxic crisis.
There is no way to prevent postpartum throiditis, and for most women it often resolves on its own 12-18 months after the start of symptoms.
If you have a personal or family history of thyroid issues or autoimmune disorders, be sure to discuss this with your providers during your pregnancy or before you get pregnant. Symptoms of postpartum thyroiditis can be easy to dismiss as a typical part of the postpartum experience, but it is best to discuss any symptoms or changes with your provider. It’s also crucial to note that symptoms of postpartum thyroiditis often develop after when you would typically have a postpartum check-up, so you may need to initiate contact if you start to develop any postpartum thyroiditis symptoms or signs of thyroid dysfunction after delivering your baby.