It is common for women to feel tired, experience mood swings, and have a lot of other strange symptoms for several months after giving birth. But in some cases, the symptoms can become painful and may indicate a problem with the thyroid gland known as postpartum thyroiditis.
What is postpartum thyroiditis?
Postpartum thyroiditis is an inflammation of the thyroid gland which initially occurs in the first year after childbirth, a miscarriage, or abortion. It’s a kind of autoimmune thyroiditis, also known as Hashimoto’s thyroiditis.
Who is at risk of postpartum thyroiditis?
Any woman can face the problem of postpartum thyroiditis after pregnancy – this condition is quite common. The most recent data has shown that about 7-8% of women develop this condition. The women diagnosed with the following health problems and markers of the thyroid gland also belong to a risk group:
- 25% of women with type 1 diabetes develop postpartum thyroiditis;
- 25% of women whose antithyroid antibodies are elevated and the levels of thyroid hormones are normal are diagnosed with the disease;
- 50% of women with elevated antibodies to thyroid peroxidase (anti-TPO) experience postpartum thyroiditis;
- Postpartum thyroiditis is also much more common in women who had a previous episode of the condition.
Signs and symptoms of postpartum thyroiditis
There is a number of symptoms of postpartum thyroiditis which can appear during the phase of hyperthyroidism and during the phase of hypothyroidism. They include:
- Decreased volume of breast milk in lactating women;
- Hair loss;
- Goiter (enlargement of the thyroid gland);
- Depression, irritability.
The symptoms of postpartum thyroiditis during the phase of hyperthyroidism are usually milder versions of the general symptoms of hyperthyroidism, including anxiety, muscle weakness, irritability, heart palpitations, tremors, weight loss, and diarrhea.
The symptoms of postpartum thyroiditis during the phase of hypothyroidism are usually milder versions of the general symptoms of hypothyroidism, including lethargy, dry skin, weight gain, constipation, low body temperature, and swelling of the eyes, face, and hands.
Postpartum thyroiditis treatment
Most women diagnosed with postpartum thyroiditis don’t need treatment during the hyperthyroid or hypothyroid phase of their illness. The symptoms are usually moderate, and the condition often settles on its own in several months (up to a year) after diagnosis.
If the symptoms of hyperthyroidism cause inconvenience, doctors sometimes prescribe a beta-blocker, for example, propranolol or atenolol. (However, if you are taking beta-blockers breastfeeding is not recommended). The antithyroid drugs are not used for treating symptoms of hyperthyroidism.
If hypothyroidism during postpartum thyroiditis causes harm experts recommend hormone replacement therapy. Typically, the treatment is carried out for three months, then stopped, and another course is started after four to six weeks.
After postpartum thyroiditis, a woman has a significantly increased risk of developing it again after subsequent pregnancies.
After the successful treatment of postpartum thyroiditis, the woman still faces a significantly increased risk of developing late hypothyroidism or goiter. Some experts estimate that about a half of the women who have hypothyroidism with puerperal thyroidin will have an ever-lowered secretion of the thyroid gland for seven years.
A woman who’s had postpartum thyroiditis needs to check her thyroid gland every year. In particular, she should take blood tests that evaluate thyroid function because of the increased risk of permanent hypothyroidism or goiter.