What is Postpartum Thyroiditis? Triggers and Treatment

Feeling foggy, anxious, and fatigued after having a baby?

It's understandable and 100% to be expected.

The change of routine, the hormone chaos, the physical recovery—it’s an understatement to say you’ve been through a lot.

But sometimes, there may be more to the story.

About 5% of women experience postpartum thyroiditis: A relatively rare autoimmune condition where your thyroid becomes inflamed post-pregnancy.

So aside from tiredness, brain fog, and anxiety, what exactly is this thyroid condition, and how can you tell if this is what you’re experiencing?

We've got you.

In this article 📝

What is the thyroid gland?

For starters, here’s a quick spin around what your thyroid is and how it works.

The thyroid is a small gland in the shape of a butterfly found at the front of the base of your neck that produces two main hormones:

Your thyroid produces six hormones in total: T1, T2, T3 (AKA triiodothyronine), T4 (AKA thyroxine), reverse T3, and calcitonin.

These hormones travel through your bloodstream to every tissue in your body and play an important role in how your major systems function.

They also have a bearing on how your body regulates your temperature and uses energy.

So when your thyroid isn’t functioning as it should, you can feel pretty out of sorts in several ways.

This can be challenging at the best of times, but particularly so when you have a newborn to care for.

What is postpartum thyroiditis?

Basically, postpartum thyroiditis is the inflammation of the thyroid in the first year after giving birth and is caused by antithyroid antibodies attacking the thyroid.

No one quite knows why these antibodies attack—especially since antibodies are produced by the immune system to protect you from invading pathogens.

In this sense, postpartum thyroiditis is an autoimmune disease very similar to Graves disease (linked to hyperthyroidism) and Hashimoto' thyroiditis (linked to hypothyroidism).

In fact, 25% of women who experience postpartum thyroiditis go through both forms of thyroid conditions, moving from hyperthyroidism in the first phase to hypothyroidism in the second.

What does postpartum thyroiditis feel like?

Because there are three distinct variations of postpartum thyroiditis, there’s no one blanket experience.

It's not uncommon for some women with the condition to have mild symptoms during the initial hyperthyroidism stage.

While other new mamas don't realize they have postpartum thyroiditis until they reach the hypothyroid state—anywhere from four to eight months after delivery.

Even then, you may only have isolated hyperthyroidism or isolated hypothyroidism, which only involves one of these phases.

The experience is entirely individual.

But to help give you a better picture, let's go through the two distinct phases:

1. Postpartum hyperthyroidism

Also known as thyrotoxicosis, this is when you have too much thyroid hormone circulating in your system.

This can result in anxiety, tiredness, hair loss, frequent bowel movements, and even heat intolerance.

There’s a chance that you may not feel anything during the thyrotoxic phase and that your thyroid will go back to normal functioning on its own.

There's even a chance these symptoms may overlap with your postpartum recovery.

But, in some cases, thyrotoxicosis can cause some damage to your thyroid, which will then lead to it slowing down.

The result is hypothyroidism.

Postpartum hypothyroidism

Also known as an underactive thyroid, this means your thyroid isn’t producing enough of its hormones for them to fulfill all the important jobs they have to do, leaving you feeling far less than your best.

Think weight gain, depression, and that all-too familiar tiredness you can't shake.

This phase is typically temporary, with thyroid function usually returning within 12 to 18 months

What are symptoms of postpartum thyroiditis?

As we mentioned above, postpartum hyperthyroidism and hypothyroidism have different effects on your body.

But there are three overarching postpartum thyroiditis symptoms:

• Fatigue: Yep, it’s a biggie. And coupled with the challenges of new mamahood, it can feel pretty debilitating.
• Postpartum thyroiditis hair loss: Many new mamas experience some postpartum hair loss as a result of dropping estrogen levels. If your hair loss feels excessive, it’s worth talking to your doctor about.
• Mood fluctuation: This may lead to feelings of depression and anxiety. (And while we’re here, there are so many reasons your emotions might feel all over the place at this point. Postpartum depression is one of them—and it requires treatment. Reach out to your healthcare provider. Know that help is available, and there’s also a whole community on Peanut ready to support you through this.)
  Then there's more specific symptoms you may experience, depending on whether you have thyrotoxicosis or hypothyroidism.

Postpartum hyperthyroidism symptoms

Like those you might experience if you have an overactive thyroid or Graves disease, these include:

• Heart palpitations
• Anxiety
• Feeling nervous
• Feeling warm
• Diarrhea
• Weight loss
• Muscle weakness
• Difficulty focussing

Postpartum hypothyroidism symptoms

These are similar to symptoms of Hashimoto's thyroiditis and include:

• Lethargy
• Constipation
• Feeling cold
• Feeling “puffy” in your face and hands
• Dry skin
• Muscle cramps
• Weight gain (or struggles losing weight)
• Brain fog

Postpartum thyroiditis and breastfeeding

Postpartum thyroiditis can make breastfeeding a challenge in various ways.

With hypothyroidism, it may get in the way of your milk flow.

If this is the case for you, working with your doctor (and possibly a lactation specialist) can help you navigate your unique journey through this.

On the other end of the spectrum, an overactive thyroid may cause you to produce more milk than you need.

If you find that you have excess, pumping after each feed can help you relieve the pain and discomfort of engorgement.

How long does postpartum thyroiditis last?

Isolated hyperthyroidism usually starts somewhere between one and six months after you give birth.

Isolated hypothyroidism occurs anywhere from four to eight months post-pregnancy.

And as many as 48% of patients skip thyrotoxicosis and go straight to hypothyroidism.

Most times, your thyroid should return to normal within about a year to 18 months, but some patients may not recover at all from hypothyroidism after pregnancy and instead will need to manage the condition long-term.

What is the best investigation for postpartum thyroiditis?

You’re far more vulnerable if you’ve had thyroid issues before or if they run in your family.

And if you have it once, there’s a 70% chance it will occur again in future pregnancies.

Other risk factors for developing postpartum thyroiditis include type 1 diabetes, lupus, or chronic hepatitis.

And research shows that in up to 50% of cases, women who are thyroid antibody-positive in the first trimester go on to develop postpartum thyroiditis.

So, if you do have a history of thyroid dysfunction, it's recommended to get screened early.

Here, your doctor will go through your symptoms and history with you before taking a blood test to check your thyroid hormone levels.

They will then discuss the best thyroid management options for you while monitoring you throughout your pregnancy and into postpartum.

When to check thyroid levels after pregnancy?

If you recognize any signs of thyroid issues after pregnancy (or were flagged as high risk during), it's recommended to have your levels checked every eight weeks during the first nine months postpartum.

And because there is a risk of developing chronic hypothyroidism after pregnancy, it's recommended to have your levels checked every year following your recovery.

Postpartum thyroiditis treatment

Your healthcare provider will work with you to figure out the best course of treatment for your specific situation.

If you’re experiencing major symptoms related to an underactive thyroid, your doctor may prescribe thyroid hormone replacement treatment.

You might need to take this medication for about 12 months, with frequent thyroid tests in between.

For an overactive thyroid, you may need some medication to bring down your heart rate and help you with some of the other symptoms you’re experiencing.

Common medications for this are beta-blockers and prednisone.

Equally, one of the most common issues for women with hypothyroidism is iodine deficiency, so introducing more foods rich in iodine can be a useful preventative measure for thyroid disorders.

The bottom line? If you’re not feeling yourself, honor it and check in with your healthcare provider.

You don’t have to write it off as just one of the challenges of early mamahood.

You are important.

Your health is important.

And getting the treatment you need is the bare minimum you deserve, Mama.

You've got this.

And support is never far away on Peanut.