For the first few weeks postpartum, new mothers exist in a fog of euphoria and exhaustion. But what happens to women when the euphoria wears off, but the exhaustion remains? Is that just the "baby blues" or is something else at play? Postpartum depression is a real thing that affects thousands of women every year, but a more likely possibility for your baby blues is something called Postpartum Thyroiditis (PPT).
How the Thyroid Changes During Pregnancy
While you are pregnant, your thyroid goes into overdrive to develop and maintain the hormones you need to ensure a safe pregnancy and a healthy baby. These hormones--human chorionic gonadotropin (hCG) and estrogen--are surging through your body the entire 40 weeks of your pregnancy, so your thyroid is stimulated to work all the time. Your placenta actually makes the hCG, but the thyroid has to send the signals to keep it going. Increased estrogen production creates higher levels of the globulin that circulates the thyroid hormones. These hormones are critical to your baby's brain and central nervous system development, and in the first few weeks of pregnancy, the placenta is producing these hormones in the direction of your thyroid. After the first trimester, the baby's thyroid can take over this hormone production, but your thyroid is still producing more hormones in these 40 weeks than the rest of your reproductive life.
What Happens to the Thyroid After Giving Birth?
Once you give birth, the pregnancy hormones that have been raging in your body for close to a year just shut down--rather a shock to the thyroid, which has been the control center for all that hormone production. Your body gets used to all those hormones, and when they just disappear it's hard on you--not only has the hormone production just stopped but your body is tasked with a crash detox when it has to get rid of all this estrogen. Thus, the crying jags, mood swings, and other joys of new motherhood threaten your well-being. During this time, your immune system is ripe for over or under compensating, so a thyroid malfunction is a distinct possibility.
What is Postpartum Thyroiditis?
According to the experts at Johns Hopkins, "Postpartum thyroiditis happens when a woman's thyroid becomes inflamed after having a baby. It may first cause your thyroid to be overactive. But over time it leads to an underactive thyroid." What this means is that as your body adjusts to a pre-pregnancy state, your thyroid may take longer to reset.
As you may remember, the thyroid is the tiny but mighty endocrine gland at the front of your neck. Its delicate butterfly shape belies its enormous responsibilities--it helps your body create energy, regulate your body temperature, and keep your vital organs working at peak performance. When your thyroid resets itself, things can go awry and result in PPT.
PPT manifests itself first as hyperthyroidism--the thyroid keeps producing pregnancy-level hormones well after childbirth/ Hypothyroidism follows a few weeks later when it slows down so much that it doesn't produce normal hormone levels.
What Causes Postpartum Thyroiditis?
There are some inherent risk factors for Postpartum Thyroiditis. If you had high antithyroid antibodies in your blood during your pregnancy you are more likely to get PPT. Women with Type 1 diabetes, obesity, or an individual or family history of thyroid problems are also at risk. PPT is often the initial signal that you have an undiagnosed underlying autoimmune condition that flares up for the first time after you give birth.
What Should I Look Out for?
The symptoms of PPT don't appear for a while, usually not until after you've had your first postpartum check-up. Early signs are anxiety, unusually warm body temperature, muscle weakness, and loss of focus--it’s easy to mistake these signs for the general exhaustion of new motherhood. Many women assume the symptoms are just normal postpartum adjustments and don't realize there's really a problem until the second phase of PPT kicks in, with symptoms that include fatigue, muscle weakness, cramps, and memory loss.
Symptoms of Postpartum Thyroiditis
There are other symptoms of PPT that can make your recovery from childbirth more difficult, so if you have any of these, you should consult your doctor. The first signs of PPT happen from one to four months after childbirth and last another month or so.
Signs of Hyperthyroidism
- Muscle weakness
- Unusually warm body temps
- Nervousness
- Weight Loss
- Anxiety
- Loss of focus
- Rapid heartbeat
Signs of Hypothyroidism
- Fatigue
- Memory loss
- Aversion to cold weather
- Muscle cramps
- Constipation
- Weight gain
- Overall weakness
These symptoms begin a few weeks after the hyperthyroidism symptoms dissipate, and last six months to a year.
Not all women have both sets of symptoms--some only experience one or the other.
How to Detect and Diagnose Postpartum Thyroiditis
One of the signs that you may have Postpartum Thyroiditis is swollen lymph nodes in your throat. Your doctor may refer you to an endocrinologist to confirm PPT. They will take a history of your symptoms and run blood tests to assess the levels of thyroid hormones in your blood. If the diagnosis is PPT, the first thing you need to understand is that this is typically a temporary condition that medication will resolve--80% of women with PPT eventually will recover completely. In the meantime, they will monitor your hormone levels with routine bloodwork until you are back to a baseline normal.
How to Treat PPT
The treatment protocols your doctor chooses depends on the severity of your symptoms and the phase of the disease.
Hyperthyroidism
Also known as an overactive thyroid, when you have hyperthyroidism you want to slow down your heart rate and reduce the inflammation of your thyroid. Prednisone and beta blockers are typically prescribed for these symptoms.
Hypothyroidism
Hormone replacement therapy is usually prescribed for an underactive thyroid, with the goal being to stimulate the thyroid into producing its own THR (thyroid producing hormone) again.
If you're diagnosed with PPT, you can expect your thyroid to be functioning normally within a year to 18 months.
Can Vitamins Help My Thyroid?
A vitamin regimen can certainly help maintain thyroid health. Endocrinologists recommend several vitamins and supplements for women with thyroid problems; even low-level Hashimoto's Disease can be managed with the right vitamins.
Iodine is critical for thyroid function--so far, it's the only known use for the mineral in the human body. In fact, an iodine deficiency causes thyroid disease.
Iron is also critical for maximum thyroid health, and a deficiency also results in thyroid disease.
Selenium is a mineral that is found in high concentrations in normal thyroids. Low levels of selenium lead to thyroid damage from oxidative stress and thyroid dysfunction.
Zinc is also necessary for optimal thyroid production, especially for healthy levels of T3, T4, and TSH.
Omega-3s--the fatty acids in so much fish oil and algae oil--also support thyroid health by decreasing the inflammation that causes glandular malfunction. Vitamins A, E, and B are also key for your thyroid to function at its best.
Binto creates custom supplement packets designed for your individual thyroid health. We work with you to assess your unique thyroid needs, and our in-house team of experts will develop a combination of vitamins and supplements just for you. We have created a new supplement designed specifically for thyroid health. Our Base Blend contains selenium, iodine, and calcium--all things that women with PPT need.
Binto also recognizes that community is a huge part of health management, so we have health professionals on staff to support you through your PPT journey. We work with women during all stages of fertility and menopause, offering individualized supplement packets wherever you are in your life cycle. Contact Binto for advice for your PPT issues and we will not only help you navigate your postpartum issues but support your thyroid health for your next pregnancy.