Table of Contents
What is postpartum thyroiditis?
Thyroiditis is a general term that refers to “inflammation of the thyroid gland”; therefore, postpartum thyroiditis means inflammation of the mother’s thyroid gland after giving birth to a baby. Thyroiditis can cause thyrotoxicosis (high levels of thyroid hormone in the blood) and hypothyroidism (low levels of thyroid hormone in the blood). Postpartum thyroiditis may first lead to hyperthyroidism and eventually to hypothyroidism.
Stages of postpartum thyroiditis
Postpartum thyroiditis usually progresses through several stages or phases.
Stage 1: Hyperthyroidism (thyrotoxicosis): In this stage, inflammation of the thyroid gland causes the production and secretion of excessive thyroid hormones.
Stage 2: Hypothyroidism (hypothyroidism): In this stage, the thyroid gland does not produce enough hormones and is called underactive.
Stage 3: Return to Normal: In most cases, thyroid function gradually returns to normal.
It is important to note that not everyone experiences all of these stages in order. Some mothers do not enter the hypothyroid phase at all; they only have hyperthyroidism and then their thyroid function returns to normal.
In rare cases, people may remain in the hypothyroid phase. In this case, they will need to receive hormone replacement therapy (levothyroxine tablets) to compensate for the lack of thyroid hormones.
Symptoms of postpartum thyroiditis
The symptoms of postpartum thyroiditis are varied and are often confused with the usual symptoms of postpartum recovery. When the thyroid becomes inflamed, it first releases large amounts of thyroid hormone into the bloodstream, causing hyperthyroidism. During this stage, mild, short-lived symptoms appear that most women will not notice. However, after this initial phase, the person either recovers completely or has damage to the thyroid gland.
If the thyroid gland is damaged, this damage, along with reduced thyroid hormone stores, can lead to hypothyroidism. This condition may resolve or cause permanent hypothyroidism, requiring hormone replacement.
The thyrotoxic or hyperthyroid phase usually occurs one to four months after the baby is born and can last up to three months. Symptoms of hyperthyroidism may include:
- Feeling unusually warm
- Muscle weakness
- Anxiety or nervousness
- Insomnia
- Palpitations
- Weight loss
- Irritability
- Hair loss
However, most people will experience symptoms of postpartum thyroiditis more during the hypothyroid or hypothyroid phase. These symptoms usually occur four to eight months after delivery; but they may last up to a year after delivery. These symptoms usually include:
- Fatigue or lack of energy
- Weight gain
- Constipation
- Depression
- Dry skin
- Muscle cramps
- Difficulty tolerating cold
Causes of postpartum thyroiditis
Postpartum thyroiditis is caused by anti-thyroid antibodies attacking the thyroid gland. These antibodies are supposed to protect your body and fight off pathogens. But in postpartum thyroiditis, the antibodies go out of control and instead of protecting you, they attack your thyroid gland. This attack causes inflammation in the thyroid and increases or decreases the production of thyroid hormones.
It is not known exactly why the antibodies attack the thyroid; however, it may be related to an unknown/undiagnosed autoimmune thyroid disease. Due to changes in immune system function after delivery, any unknown illness may flare up after the baby is born and cause postpartum thyroiditis.
Risk factors for postpartum thyroiditis
The risk of postpartum thyroiditis increases if you have one or more of the following conditions:
- Autoimmune disorders, such as type 1 diabetes
- Antithyroid antibodies; the higher the number of these antibodies, the higher the risk.
- Previous thyroid problems: including thyroid disease or previous thyroid dysfunction
- Previous postpartum thyroiditis in previous pregnancies; the risk of recurrence is about 20 percent.
- Family history of thyroid disorders; a family history of thyroid problems increases your risk of developing the condition.
Diagnosing postpartum thyroiditis
If postpartum thyroiditis is suspected, your doctor will perform a physical exam and ask about your symptoms. The tests used to diagnose postpartum thyroiditis depend on the stage of the disease and the doctor’s diagnosis. In almost all cases, a blood test is used to check the levels of thyroid hormones (TSH, T3, and T4).
This blood test can determine whether the thyroid is overactive or underactive and is sufficient to diagnose postpartum thyroiditis. It can also help rule out similar conditions, such as Graves’ disease. Graves’ disease is a lifelong condition that causes symptoms similar to postpartum thyroiditis.
Treatment for postpartum thyroiditis
Treatment for this condition depends on several factors, including the patient’s age, symptoms, and general health, as well as the stage of the disease. People who are in the stage of hyperthyroidism (thyrotoxicosis) may be treated to treat symptoms such as tremors, palpitations, and inflammation. Common treatments for these symptoms include beta-blockers or prednisone. Since hyperthyroidism in postpartum thyroiditis is not a permanent condition, hormone treatments are probably not recommended.
Women with hypothyroidism may be given hormone therapy to treat the main symptoms. If the symptoms of hypothyroidism are mild to moderate, treatment may not be necessary. Breastfeeding mothers who are being treated for postpartum thyroiditis can usually continue to breastfeed without any problems. However, it is important to check with your doctor before taking any medications or hormone therapy while breastfeeding to make sure that they are safe for your baby.
Is postpartum thyroiditis completely curable?
Fortunately, most women who experience postpartum thyroiditis return to normal thyroid function within 12 to 18 months of the onset of symptoms. However, 20 percent of women who develop hypothyroidism will remain in this condition. Doctors recommend that you have your thyroid hormone levels checked regularly after treatment to make sure that your thyroid function has returned to normal.
If you are taking thyroid medication, your doctor may gradually reduce your dose to see if your body can maintain normal thyroid function on its own. People with high levels of antithyroid antibodies are more likely to develop permanent hypothyroidism and may need hormone replacement therapy for the rest of their lives.
Note:
Postpartum hypothyroidism also increases your risk of future thyroid problems, including hypothyroidism or an enlarged thyroid gland (goiter). So even if your thyroid function returns to normal, it is important to have your thyroid checked regularly.
How common is postpartum thyroiditis?
About 5 to 10 percent of women develop it in the first year after giving birth. People with type 1 diabetes or a history of thyroid problems are more likely to develop postpartum thyroiditis.
Is postpartum thyroiditis the same as Hashimoto’s disease?
While postpartum thyroiditis is very similar to Hashimoto’s thyroiditis, the two conditions are not the same. Both conditions are associated with the presence of antithyroid antibodies and chronic inflammation of the thyroid. However, postpartum thyroiditis usually resolves within 18 months of treatment for most women, while there is no cure for Hashimoto’s thyroiditis, and if you develop it, you will need to take levothyroxine for the rest of your life.
Summary
Postpartum thyroiditis occurs when a woman’s thyroid gland becomes inflamed after giving birth or having a miscarriage. This condition may initially cause hyperthyroidism, but over time it can lead to hypothyroidism. Experts don’t know exactly what causes the condition. If you had high levels of antithyroid antibodies before you became pregnant, you are more likely to develop the condition. Other risk factors include having type 1 diabetes, a history of thyroid problems, or other autoimmune diseases.
No comment