Thyroid problems after pregnancy

You’ve just had a baby. You’re tired, exhausted – of course you are.  But is that all it is or are you showing symptoms of thyroid problems?

Having a baby is incredibly tiring. There is precious little chance to sleep, plus all the new demands on you that caring for a tiny being involves, plus all kinds of worries that you never even knew existed – hormonal swings, how to produce enough milk, is the baby feeding properly? The list goes on…….

Add to that the possibility that you’re recovering from a caesarean or other stitches, and you might have older kids and other responsibilities that don’t stop just because you’ve had a baby. You may be living far from family support, juggling school or work with being a new mum.

Who wouldn’t be tired?

It’s true, having a baby is incredibly demanding physically, and at the same time, you’re going through a tremendous amount of personal, psychological, emotional, and social adjustment.

But exhaustion, feeling down, difficulty losing weight, intense struggle to produce enough breast milk, and hair loss aren’t always just a normal part of having had a baby. They can also be signs of hypothyroidism – and struggling with thyroid problems when you are a new mum is like you’re already pushing a boulder uphill, and now someone has put iron balls around your feet, too!

It’s an almost impossible weight to bear. And on top of that, feeling anxious, having an insatiable appetite, feeling manic and unable to sleep, and losing a lot of weight are also common signs of hyperthyroidism.

Many new mums in the first 12 months after birth are struggling with undiagnosed thyroid problems, their symptoms being mistakenly put down to the normal challenges of new motherhood. Without a diagnosis, they might be feeling alone, miserable, or crazy. They might be trying valiantly to produce enough breast milk but just aren’t, leading to anxiety, stress, guilt, and a lot of unnecessary hard work.

Why Are New Mums Susceptible to Thyroid Problems?

The chance of developing a postpartum thyroid problem is pretty high, with the reported rate of new cases as high as 17% in the USA, and much higher in women who already have an autoimmune disease, particularly Type 1 Diabetes.

Thyroid problems after birth occur in as many as 42% of women who previously had postpartum thyroid abnormalities, who already had hypothyroidism going into pregnancy, or who have elevated anti-TPO antibodies without a diagnosed thyroid disorder.

When the normal immunologic changes that kept you from rejecting your baby as an alien being while she or he was in your uterus start to go back to normal after birth, they can play some nasty little tricks on your own body tissue leading to autoimmune disease that targets the thyroid, especially in women who are already genetically susceptible.

What are the Symptoms of Postpartum Thyroid Disease?

Autoimmune thyroid disease tends to roll out in one of three ways in the weeks or months after birth:

• 20-40% of women become hyperthyroid around 1-4 months after birth
• 20-30% become hyperthyroidfor two to eight weeks, then become hypothyroid for anywhere from two weeks to six months
• And 40-50% become hypothyroid only, usually between 2 and 6 months after birth.

The symptoms of hyperthyroidism often go unnoticed by the new mum, until she reverts to hypothyroidism, at which time thinking back on it, the hyperthyroid symptoms seem more obvious.

Symptoms of hyperthyroidism (over active thyroid) include:

• Fatigue
• Weight loss
• Heart palpitations (a feeling that makes you hyper-aware of your heart beat)
• Weight loss
• Heat intolerance
• Anxiety
• Irritability

The symptoms of Hashimoto’s disease (hypothyroidismor under active thyroid) include:

• Fatigue, sometimes exhaustion
• Cold intolerance
• Constipation
• Sluggishness
• Dry skin
• Joint pain (note that carpal tunnel syndrome may be related to hypothyroidism)
• Decreased breast milk volume

You may also notice some difficulty swallowing or fullness in your throat telling you that your thyroid is swollen. Thyroid size usually returns to normal with recovery. In some women, a swollen thyroid gland may be the only symptom.

Conventional Approaches to Treating Postpartum Thyroiditis

Treatment of postpartum thyroiditis depends on whether there is hyperthyroidism or hypothyroidism, and how troublesome the symptoms are

If you have no symptoms, but abnormal thyroid tests, for example, elevated anti-TPO antibodies, then medication is generally not recommended; thyroid tests are simply repeated every 4-8 weeks until they return to normal, or if thyroid symptoms develop at any point, treatment is directed appropriately.

If you have symptoms of hyperthyroidism, these can be treated with a blood pressure medication.  If you have symptomatic hypothyroidism, thyroid hormone medication is the optimal treatment to get you feeling back to normal quickly, is safe while breastfeeding, and can make a huge difference in breast milk production if low supply is one of your thyroid symptoms.

Functional Medicine and Natural Approaches to Treating Postpartum Thyroiditis

Functional Medicine offers some alternative/complementary methods of treating thyroid symptoms, using herbs and dietary changes. Consult a functional medicine practitioner to discuss your individual symptoms and needs before you try any of these remedies.

• A strictly gluten free diet and the addition of Curcumin, the active ingredient in the anti-inflammatory herb turmeric, 1000 mg, twice daily can be helpful, because coeliac disease can also develop at any time and is a known trigger of autoimmune thyroid disease. This is safe while breastfeeding.
• Selenium supplementation, 200 mcg daily, may decrease inflammatory activity in pregnant women with autoimmune hypothyroidism and may reduce the risk of postpartum thyroiditis.
• Circulating levels of vitamin D3 have been found to be very low in those with Hashimoto’s disease and other autoimmune conditions. Supplementing with vitamin D3 may help prevent or reverse autoimmune thyroid disease.
• A herb called Guggul (Commiphora mukul)has been shown to have positive effects in improving thyroid function in Hashimoto’s disease. This herb should not be taken in pregnancy, but can be taken while breastfeeding; discontinue if baby has a tummy upset when you take the herb.
• Fluoride, found in tap water and products made with tap water, and bromide, an additive to some breads and other foodstuffs, interfere with normal thyroid function, so I recommend avoiding these by using filtered water, non-fluoridated toothpaste, and reading labels to avoid bromides, before, during, and after pregnancy.
• For hyperthyroidism symptoms, the two most helpful herbs are Motherwort (Leonorus cardiaca) and Lemon balm (Melissa officinalis), 30-60 drops of the liquid extract of each, 2-6 times/day, safe while breastfeeding, to control irritability, agitation, anxiety, and heart racing.
• BPA and other related chemicals can also have a damaging impact on the thyroid; avoid plastic packaging when you purchase, store, and reheat your foods, and drink beverages out of glass, paper, and stainless steel only (not plastic).
• High levels of, or persistent stress, can also impact the adrenal system, with resultant effects on the thyroid, and gut inflammation, leaky gut, and food sensitivities in addition to gluten can trigger thyroid autoantibodies leading to autoimmune thyroid conditions.

Will I Always Be Hypothyroid & Have to Take Medication Forever?

Most women will recover from postpartum thyroid problems within 6-12 months. If symptoms persist beyond 18 months after onset, it is more likely that you’ve developed permanent hypothyroidism, and long-term medication might be needed. About 30% of women who develop postpartum thyroiditis develop permanent thyroid problems. For women who have fully recovered from postpartum thyroiditis, repeat thyroid testing within 5 to 10 years after the initial diagnosis, or should you develop symptoms of thyroid abnormalities as described above.

What Can I Do About Low Milk Supply, Exhaustion, Anxiety, & Postpartum Depression?

If these symptoms are being caused by your hypothyroidism, which is quite likely, then optimising your medication dose to bring your thyroid function into the normal range is going to be the easiest, quickest, and most effective thing you can do to resolve all of these symptoms. Your breast milk supply should increase, your fatigue improve, and your depression lift. If anxiety is being caused by hyperthyroidism, then the medication or herbs I mentioned earlier (motherwort and lemon balm) are a good option, along with breathing exercises, meditation, and yoga.

Postpartum can be a challenging time for all new mums, and especially so for women with hypothyroidism. The importance of postpartum care is almost completely overlooked in our culture. Having dedicated family or friend support not just in the first 8 weeks after baby is born, but also in the months to come, can make a huge difference in your energy and outlook. As women, we’re notoriously bad at asking for help when we need it – now’s the time to get over that and let the people who love help you! If you are far from loved ones and don’t have strong community support, hire the help you need with housekeeping, errands like shopping, and take any help you can, with baby and household needs so you can get the rest you need.

These suggestions plus many others can be found in Aviva Romm’s book, the Adrenal Thyroid Revolution Click the image to view this book on Amazon (affiliate link). Aviva is a doctor, midwife and complementary medicine practitioner, who brings together the best of conventional and alternative treatments.