After childbirth women typically experience a postpartum period that promotes a wide range of symptoms. During this time, it is common for mothers to experience mood swings, fatigue, and even signs of depression. A primary dictator of postpartum symptoms is thyroid function. Women who experience an exceptionally long or difficult postpartum period may be suffering from postpartum thyroiditis.
In order to restore mental and physical wellness it is essential that any underlying thyroid dysfunction be identified and subsequently treated. Learning what postpartum thyroiditis is, how to recognize it, and ways to alleviate it may help those experiencing long-term postpartum difficulty obtain greater wellness.
What Is Postpartum Thyroiditis?
The thyroid gland is an essential component of numerous bodily functions. As a major regulator of hormones, the thyroid is particularly important during the periods leading up to, during, and just after childbirth. These times are accompanied by significant hormonal shifts many of which are influenced by the thyroid. Therefore, dysfunction of the small butterfly-shaped gland that is the thyroid often results in significant pregnancy and postpartum issues including thyroiditis.
Simply put, postpartum thyroiditis is caused by inflammation and/or malfunction of the thyroid gland.
Thyroid antibodies naturally circulate in the bloodstream and help regulate the release of thyroid hormone. An excess of these antibodies results in decreased thyroid function or hypothyroidism while a deficiency of thyroid antibodies typically results in an overactive thyroid or hyperthyroidism. As the number of thyroid antibodies increase so too does inflammation of the thyroid. This inhibits thyroid function and may even cause irreparable damage. The progression is similar to that of Hashimoto’s thyroiditis. In fact, postpartum thyroiditis is recognized as a variation of autoimmune thyroid disorder.
The Progression of Postpartum Thyroiditis
Postpartum thyroiditis occurs during the first year of childbirth, miscarriage, or induced abortion. During this time, thyroid levels shift resulting in major hormonal shifts triggering sometimes sudden mental and physical changes. Typically, imbalances are naturally resolved as the body adapts to the hormonal fluctuations. However, individual cases of postpartum thyroiditis can progress in a variety of ways.
An approximated 43% of postpartum cases involve isolated hypothyroidism lasting two to six weeks following childbirth. After this time, thyroid levels should begin to normalize, and symptoms dissipate. 32% of cases trigger hyperthyroidism that typically remains for one to four months after the baby is delivered. The third most common postpartum progression accounts for 25% of cases and is known as the classic form. The classic form of postpartum thyroiditis begins with a period of hyperthyroidism. However, in response to excess thyroid hormone, the body overcompensates and limits thyroid production too much resulting in symptoms of hypothyroidism that may remain for multiple weeks or months. As thyroid function normalizes, symptoms improve.
Even though these three common forms are exemplary of most cases of postpartum thyroiditis, many women have a different experience. Some report suffering from symptoms of postpartum thyroiditis for years, which is indicative of a greater underlying thyroid issue. Recognizing the abnormal continuation of postpartum thyroiditis requires familiarity with the signs and symptoms of thyroid dysfunction.
Identifying Postpartum Thyroiditis
During the early stages of postpartum thyroiditis, women may experience symptoms of hypothyroidism or hyperthyroidism – get the full list of thyroid disease symptoms here. As hormone balance remains in flux, symptoms may worsen or alternate between either condition as the body attempts to achieve equilibrium and restore thyroid function.
Symptoms of hyperthyroidism associated with postpartum difficulties include:
- Increased heartrate and palpitations
- Mood swings
- Muscle weakness
- Sudden unexplained weight loss
Symptoms of hypothyroidism or decreased thyroid function that may develop during the postpartum period include:
- Brittle hair and nails
- Dry flaky skin
- Heavier menstrual flow
- Muscle and joint pain/weakness
- Puffiness and swelling around the face and neck
- Sensitivity to cold temperatures
- Weight gain and difficulty losing weight
Regardless if thyroid function is reduced or accelerated, women suffering from postpartum thyroiditis may experience the following symptoms:
- Decreased production and volume of breast milk
- Development of a painless goiter
- Hair loss
- Mood swings
If a woman continues to experience symptoms for more than a year following child birth it is possible that they are suffering from a greater underlying thyroid issue.
The Risk of Postpartum Thyroiditis
Postpartum thyroiditis is quite common. According to a quantitative review of over 21 published articles, the prevalence of postpartum thyroid issues equated to just over eight percent. It is estimated that globally 1 out of every 12 women will develop postpartum thyroiditis. This number is improved slightly in the United States approximately 1 out of 17 women will develop postpartum thyroiditis.
Regardless of location, the risk of developing postpartum thyroiditis increases in certain populations. Those who have already experienced postpartum thyroiditis, or have a preexisting thyroid condition are more likely to develop postpartum complications and thyroiditis. Research also shows that women with type 1 diabetes have a 25 percent chance of experiencing thyroid-related postpartum dysfunction. Worse still, women who have elevated anti-peroxidase (anti-TPO) antibodies have a 50 percent chance of developing a postpartum thyroid issue. Those who fall into these categories or have a history of thyroid dysfunction should be particularly mindful and protective of thyroid function through pregnancy and postpartum.
Alleviate Postpartum Problems by Supporting the Thyroid
Pregnancy can be challenging, and many women experience difficulty during the postpartum period. Thyroid activity plays an important role during this time and imbalances can trigger greater dysfunction in the form of postpartum thyroiditis. Familiarizing yourself with this common condition and being able to recognize the various symptoms associated with thyroid dysfunction can aid in identification and subsequent treatment of postpartum issues. If you are suffering from difficult and long-lasting symptoms of postpartum thyroiditis, seek out the assistance of a thyroid expert to help assess and treat thyroid imbalances or underlying thyroid disorders – click here for resources to assist in your search for a knowledgeable thyroid doctor.
1. Nicholson, W.K., Robinson, K.A., Smallridge, R.C., Ladenson, P.W., Powe, N.R. “Prevalence of postpartum thyroid dysfunction: a quantitative review.” Thyroid 2006;16(6):573–82.
2. Stagnaro-Green, A., Abalovich, M., Alexander, E., Azizi, F., Mestman, J., Negro, R., Nixon, A., Pearce, E.N., Soldin, O.P., Sullivan, S., and Wiersinga, W. “Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum.” American Thyroid Association.
3. Stagnaro-Green A, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Negro R. “High rate of persistent hypothyroidism in a large-scale prospective study of postpartum thyroiditis in southern Italy.” J Clin Endocrinol Metab 2011; 96:652–657.
4. Alexander EK, et. al. “2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum.” Thyroid. 2017 Mar;27(3):315-389.