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Guide to Postpartum Thyroiditis: Why you may not be feeling like yourself!

April 11, 2017
thyroid, irregular periods, postpartum thyroiditis, naturopathic doctor toronto, female friday, naturopathic doctor danforth

Becoming a mom for the first time (or again!) can be incredibly exhausting. Not only are you raising a human being, but you’re also in the postpartum recovery phase! Moreover, you’re likely exhausted from a lack of sleep, worried about producing enough breast milk, losing hair, having difficulty losing weight and may be experiencing symptoms of postpartum depression. Many of the symptoms that new moms experience are also seen in thyroid conditions – like postpartum thyroiditis.

Postpartum thyroiditis is a thyroid condition that occurs in women who previously had a thyroid disease or just delivered a baby. This is a disease of the thyroid gland, a butterfly-shaped gland located at the front of the neck which produces hormones that regulate metabolism and helps control the body’s organs. 

Phases of Postpartum Thyroiditis

During postpartum thyroiditis, a mom might switch between hyperthyroidism and hypothyroidism. Hyperthyroidism may occur 1-4 months after delivery, while hypothyroidism may occur 4-8 months after delivery. 

Hyperthyroidism

Hyperthyroidism occurs when the thyroid is overactive and overproducing T3 and T4 (thyroid hormones), with a low thyroid stimulating hormone (TSH). 

Symptoms of Hyperthyroidism

  • Anxiety
  • Fatigue
  • Heart palpitations
  • Insomnia
  • Irritability
  • Nervousness
  • Sensitivity to heat
  • Tremor
  • Weight loss

Signs of Hyperthyroidism

  • Shortness of breath
  • Increased appetite
  • Increased sweating
  • Fast heart rate
  • Frequent bowel movements
  • Fine, brittle hair
  • Thinning skin
  • Increased menstrual cycle length
  • Scanty menstrual flow

Hypothyroidism

Hypothyroidism occurs when the thyroid function is under active and isn’t producing enough T3 or T4. Moreover, TSH level is elevated because it’s trying to ‘turn’ the thyroid on and produce more hormones. 

Symptoms of Hypothyroidism

  • Fatigue or low energy
  • Unexplained weight gain or 
  • Difficulty losing weight
  • Constipation
  • Intolerance to cold temperature
  • Tender, stiff or weak muscles
  • Pain, stiffness or swelling in joints
  • Depression
  • Difficulty concentrating and impaired memory
  • Irritability
  • Decreased libido
  • Infertility

Signs of Hypothyroidism

  • Reduced resting body temperature
  • Goitre
  • Slow heart rate
  • Hair loss
  • Brittle nails
  • Dry skin
  • Heavy menstrual periods
  • Irregular menstrual periods

Lab Tests for the Thyroid

Diagnosis of a thyroid condition involves both symptoms and blood work. Ideally women should be getting a thyroid function test prior to pregnancy (as the thyroid can have important implications in neonatal neurodevelopment), and should be tested at least 3-6 months postpartum. 

Moms should be tested if they have a history of autoimmune conditions (like Type 1 Diabetes), a history of thyroid disease before or during (any) pregnancy, or experiencing postpartum depression. 

  • TSH: Thyroid stimulating hormone is the best test for both hyperthyroidism and hypothyroidism. In hyperthyroidism, TSH will be decreased while in hypothyroidism TSH will be increased.
    • Optimal range for TSH is 1-2 mIU/L (non-pregnant patients)
  • Free T4: This is the storage form of the thyroid hormone.
    • Optimal range is 14-18 pmol/L (non-pregnant patients)
  • Free T3: This is the active form of thyroid hormone. The thyroid should be making T3 and the peripheral tissues (like the liver and kidneys) should be converting T4 to T3.
    • Optimal range is 5-6 pmol/L (non-pregnant patients)
  • Anti-TPO: This is the antithyroid peroxidase antibody, which will be elevated in autoimmune thyroid disorders. It signifies autoimmune thyroid disease, and the higher the level, the greater oxidative stress within the thyroid gland. It is an indicator of future thyroid disease. 

Treating Thyroid Disorders

Treating the thyroid can be incredibly tricky and should be accompanied by support through a MD or ND. Nevertheless, there are things you can start to do at home to support and optimize thyroid health!

Decreasing Inflammation

Because it’s thought that women who develop postpartum thyroiditis likely have an underlying autoimmune thyroid condition, it’s best to adopt as much of an anti-inflammatory diet as possible.

THE FIX: Eliminating gluten and dairy (which can be highly inflammatory), may be positive step towards improving thyroid health. 

Chronic stress is incredibly inflammatory and affects our thyroid by actually ‘slowing’ the body down to conserve energy. The stress hormone, cortisol, causes an increase in thyroid binding globulin (TBG) which binds the active thyroid hormone and prevents it from doing its job. 

THE FIX: We all know that being a new mom can be incredibly stressful, so communicating with your partner, asking for help, and taking a bit of time for yourself whenever you can may help in reducing stress levels.

Decreasing Toxic Load

Toxins may interfere with thyroid function. This includes heavy metals (cadmium, mercury, lead) which may lower T3 levels, halogens (fluorine, chlorine, bromine) which may interfere with iodine uptake, and BPA which interferes with endocrine function. 

THE FIXCostume jewellery has been shown to contain cadmium, and can be absorbed via our skin through chronic exposure. Fluorine can be found in tap water, as well as toothpaste. Whereas bromine may be found as an additive in food products such as dough. Check out this post for some simple substitutions!

Keep in mind that if your interested in completing a heavy metal detox, it’s is not advised during breastfeeding, as breastmilk is a route of elimination for metals.

Tracking Body Temperature

Normal body temperature is 37.0C (98.6F). As previously mentioned, it will be low in hypothyroidism (everything is slowing down) and high in hyperthyroidism (everything is speeding up).

THE FIX: We want to restore the body’s normal temperature. This is not a treatment per se, however tracking your body temperature throughout the day (at waking, in the afternoon, and in the evening) will help give us a baseline average of what your temperature is. As you progress with treatment, we can continue to track the temperature to see how your body is responding! 

Next Steps

As I previously mentioned, in order to determine if you have postpartum thyroiditis it’s best to look at your symptoms and blood work. Moms should also remember that many factors can affect the health of the thyroid – for instance an iron deficiency can decrease levels of thyroid hormone and prevent conversion from the inactive to active form. Plus, iron deficiency can also be a cause for fatigue and hair loss!

Because the thyroid plays such a critical role in our health, it’s important to work together with a health professional (like a ND!) to go about healing and restoring normal thyroid function. With my patients, I take a look at their entire health history to see what exactly is being affected by suboptimal thyroid levels and how to go about healing – rather than tackling everything at once and potentially causing the body more stress. 

So if you’re a mom experiencing exhaustion, hair loss, depression or even a low body temperature – it could be because of your thyroid! Book an appointment with a ND because this doesn’t need to be your new ‘normal!’

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3 Responses

  1. Lili says:

    Hello I got PP thyroiditis. Many symptoms: normal and strange ones I took bloodtest every month but it wasn’t until 5 mnd postpartum that my bloodtest showed that I did have overactive thyroid. Few days ago I got my numbers in the normal range but not in My optimal. How long does it take to get optimal and recover? Thanks.

    • Hi Lili, many factors can affect thyroid function and unfortunately I haven’t come across any data suggesting a timeline for optimal thyroid health. Generally I would ensure that women are following a plan to keep their thyroid in the best shape and would retest in 3 months to see how the treatments are working.

      • Lili says:

        I write from Norway. I don’t have treatment. I don’t have antibodies. I experienced the hyperthyroidism phase. Now I am in normal ranges but I have not come to MY normal ranges. T4 is at 10.7 but I know my T4 shall be 14. My TSH is 2.5 but I know my optimal is 1.7 – 2. According to you answer you don’t think the thyroid will manage to be in my own normal range? Thanks

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