Postpartum Thyroiditis: Symptoms, Causes And Treatment Options

During pregnancy, a woman’s body goes through a number of changes.

Hormones fluctuation, physical changes and, of course, another set of changes just before giving birth.

After birth, changes occur once again, and the woman may continue to experience fluctuations in her hormones for some time.

While the delivery of a baby is supposed to be a magical moment in a woman’s life, some women are unfortunate and experience adverse effects post birth.

Most publications that talk about problems that may develop postpartum describe depression-related symptoms, which is quite common amongst women who have given birth.

Today, we want to focus on a condition that is less common than postpartum depression, but still a particular condition that women should be aware of. There are numerous cases where a woman may be misdiagnosed.

The condition is known as postpartum Thyroiditis.

In many cases, a doctor may consider postpartum depression the condition causing symptoms in a particular patient, when, in fact, the woman is really affected by postpartum Thyroiditis.

Overview of Postpartum Thyroiditis

The Thyroid gland is responsible for the production of numerous vital hormones in the human body.

These hormones assist with the regulation of metabolism functions that occur within every cell in the body. In some women, however, problems with the Thyroid gland may develop after she has given birth.

Postpartum Thyroiditis is not as common as some of the other conditions that may affect a woman post delivery of a baby, but still an important health issue that women need to be aware of – especially since the symptoms associated with postpartum Thyroiditis is also associated with some of the other conditions that are known to commonly affect women after they have given birth.

In this post, we’ll go over the symptoms that may be caused by postpartum Thyroiditis, consider the possible causes for the condition, look at how the condition can be diagnosed and consider some of the treatment options currently available to patients diagnosed with postpartum Thyroiditis.

Additionally, we will also consider some lifestyle changes that can assist with improving the symptoms experienced by the patient.

Symptoms Of Postpartum Thyroiditis

Postpartum Thyroiditis is a relatively complex condition. It is often difficult to accurately diagnose the condition amongst women after they have given birth.

Not only do healthcare professionals find it sometimes difficult to diagnose this condition because it causes symptoms similar to other postpartum conditions, but also because this condition causes symptoms associated with two different Thyroid disorders – including Hyperthyroidism and Hypothyroidism1.

Women typically start to experience symptoms associated with Hyperthyroidism soon after pregnancy, should they be affected by postpartum Thyroiditis. These symptoms typically last for up to three months. They tend to develop within the first four months following the birth of a child.

Once the symptoms of Hyperthyroidism subsides, patients usually enters a phase where symptoms associated with Hypothyroidism starts to develop.

The symptoms of Hypothyroidism is usually mild in most cases, and may last for up to one year after the woman has started to experience these symptoms.

Even though many women who do suffer from postpartum Thyroiditis tend to experience the symptoms of both Hyperthyroidism and Hypothyroidism, there are cases where a woman would only experience the symptoms associated one particular type of Thyroid disorder.

Hyperthyroidism

Hyperthyroidism is a condition where the Thyroid gland produces too many hormones, which can cause a significant increase in the rate of metabolism functions throughout the body2.

Heart rate can be increased considerably.

Additional symptoms may also include sweating and weight loss, sleeping problems, and hyperactivity. Irregular heartbeats are also not uncommon amongst patients who experience Hyperthyroidism.

Hypothyroidism

While Hyperthyroidism is a speed up in metabolism caused by an excess level of Thyroid hormones, Hypothyroidism is the opposite – an insufficient level of Thyroid hormones are present in the body, which causes a slow down on metabolism3.

This can cause an array of symptoms to develop, including fatigue and weakness, reduced perspiration, weight gain, constipation, a hoarse voice, hair loss, dry skin, mental performance issues, lethargy and signs that are associated with depression.

Causes of Postpartum Thyroiditis

Even though a lot of information has been identified regarding postpartum Thyroiditis, scientists and medical experts are still not sure exactly what causes some women to experience this condition after they have given birth.

It is known that postpartum Thyroiditis is a condition that occurs when antithyroid antibodies are produced in the woman’s body and then starts to attack her Thyroid gland – why this occurs is not yet fully understood, and still requires further investigation.

One theory is that women who do develop postpartum Thyroiditis has an autoimmune disease affecting their Thyroid, which remains silent after the fluctuations in their immune function occurs during pregnancy4.

Following childbirth, the disease is triggered, causing the Thyroid gland to become a target of the immune system. In turn, this causes inflammation to occur.

Women who have a high level of antithyroid antibodies present in their body during the early months of pregnancy, as well as following childbirth, is known to be at a higher risk of developing postpartum Thyroiditis.

If a woman has been previously diagnosed with any type of autoimmune disorder, including type 1 diabetes, for example, then she is also at a higher risk of developing this condition following childbirth.

Additional risk factors include a personal or family history of postpartum thyroiditis, as well as a personal or family history of Thyroid problems, including Hyperthyroidism and Hypothyroidism.

Diagnosis of Postpartum Thyroiditis

A diagnosis of postpartum Thyroiditis is required before a patient can be treated for the condition. Patients who develop symptoms associated with this condition will need to be examined by a healthcare professional, who will request more details on the particular symptoms experienced by the patient. The primary aim of the healthcare professional would be to determine the patient’s risk of postpartum Thyroiditis by looking at their medical history.

The healthcare provider also needs to determine in what phase of postpartum Thyroiditis the patient may be, should this condition be suspected.

The symptoms experienced by the patient will help the healthcare provider determine whether the patient may still be in the early stages of postpartum Thyroiditis; thus causing an overactive Thyroid, also called Hyperthyroidism, or rather in the later stages, which causes an underactive Thyroid in most women, also known as Hypothyroidism.

Further tests will often also be needed in order to make an official diagnosis. Blood tests are usually ordered in order to determine the level of Thyroid hormones, including both T3 and T4 hormones, as well as Thyroid-Stimulating Hormones, also called TSH, present in the patient’s body5.

This will offer the healthcare provider with more accurate data regarding whether the patient may have an overactive or underactive Thyroid, and will also help them provide the patient with a more appropriate treatment plan.

Treatment for Postpartum Thyroiditis

Before we look at the treatment options for postpartum Thyroiditis, we want to note that the condition is, in most cases, temporary. The majority of women who do develop this condition after giving birth tend to recover from the condition within 12 to 18 months after the symptoms started to appear. Treatment, however, should still be administered to the patient as this will help to reduce the negative effects that the symptoms are causing in their life.

The symptoms can be very unpleasant for the patient, causing them to experience fluctuations in weight, as well as fatigue and other problems. The treatment options will help to restore normal Thyroid hormones levels and assist with alleviating the symptoms they are suffering from.

The treatment options administered to a patient who had been diagnosed with postpartum Thyroiditis usually defers from one patient to another.

The particular treatments provided to a patient will depend on the phase of the condition they are currently in – meaning whether the condition is currently causing them to experience Hyperthyroidism, due to an overactive Thyroid, or rather Hypothyroidism, due to an underactive Thyroid.

Hyperthyroidism

Hyperthyroidism is usually the first condition experience when a patient suffers from postpartum Thyroiditis. It is important for a healthcare provider to first determine how much excess Thyroid hormones are present in the patient’s body before administering a treatment to the patient. Additionally, the severity of the symptoms the patient is experiencing should also be taken into account.

In most cases, antithyroid medication is not considered an appropriate treatment option since postpartum Thyroiditis is a complex condition that transitions from Hyperthyroidism to Hypothyroidism in most patients – when antithyroid medication is given to a patient, it may become a problem when the patient enters the second phase of the condition, where the Thyroid’s function becomes impaired.

Beta-blockers are sometimes provided to patients in the Hyperthyroidism phase of postpartum Thyroiditis to assist with reducing heart palpitations, as well as to assist with nervousness and irritability6.

Hypothyroidism

After the symptoms of Hyperthyroidism starts to clear up in a patient who suffers from postpartum Thyroiditis, then symptoms of Hypothyroidism may start to develop.

Once again, blood tests need to be obtained to determine how much the patient’s Thyroid gland functionality has been impaired through Hypothyroidism. A healthcare provider also needs to discuss the symptoms the patient is experiencing with them, and also consider the severity of the patient’s symptoms.

This data will help the healthcare provider, together with their patient, determine the best route to take in treating the condition. Hypothyroidism medication, which usually includes synthetic Thyroid hormones, are commonly provided to patients who enter the Hypothyroidism phase of postpartum Thyroiditis, in order to help elevate levels of Thyroid hormones in their body, and restore normal functioning of their metabolism – including cellular metabolism.

This may assist with alleviating the particular symptoms that the patient is experiencing and, ultimately, may also assist with improving their quality-of-life.

In addition to these particular treatment options, it should be noted that patients are often also advised to include healthier lifestyle choices – this would include a diet that is rich in vegetables, nuts and other sources of vital nutrients. Thyroid supplements often contain these valuable vitamins, minerals, herbs, and amino acids.

A fitness plan that focuses on improving their overall bodyweight would also be beneficial, as Thyroid-related problems are more common amongst individuals who are obese.

Conclusion

Postpartum Thyroiditis is a relatively uncommon condition that may affect a woman after she has given birth.

The condition may set in within the first year following the delivery of the baby, and may cause symptoms that are similar to that associated with other postpartum conditions, such as postpartum depression.

Realizing the symptoms associated with postpartum Thyroiditis can assist with a more accurate diagnosis of the condition causing the symptoms a patient is suffering from. The condition can be diagnosed through certain blood tests, and treatment can be provided to assist with improving the symptoms a patient is experiencing.

References:

1 Postpartum thyroiditis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/postpartum-thyroiditis/symptoms-causes/syc-20376675

2 Overactive thyroid: Overview. PubMed Health. 9 October 2014. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072664/

3 Underactive thyroid: Overview. PubMed Health. 10 August 2017. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072785/

4 Postpartum Thyroiditis. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15294-postpartum-thyroiditis

5 Postpartum Thyroiditis. Stanford Children’s Health. http://www.stanfordchildrens.org/en/topic/default?id=postpartum-thyroiditis-85-P00425

6 Alex Stagnaro-Green. Postpartum Thyroiditis. The Journal of Clinical Endocrinology & Metabolism. 1 September 2002. https://academic.oup.com/jcem/article/87/9/4042/2846380

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