Postpartum thyroiditis
On Wednesday (31st of August) another naturopath, Corinne, and I did a live on Instagram covering all things thyroid health where I chatted about postpartum thyroiditis. I decided to follow up with a blog as there was way too much information that I wanted to share with you and not enough time! So, here it is.
What is Postpartum thyroiditis?
Postpartum meaning the time after birth and thyroiditis meaning inflammation of the thyroid gland; so postpartum thyroiditis is essentially inflammation of the thyroid gland after birth. Women who experience postpartum thyroiditis usually develop symptoms within one year and have no history of thyroid disease. Within this year symptoms will often commence around the two-month mark after birth which means it is often missed at your six-week check-up [1].
How common is postpartum thyroiditis?
Postpartum thyroiditis is said to affect 5% of women; however, these are just diagnosed cases and I suspect this statistic to be much higher [2]. Often postpartum thyroiditis is dismissed as “you’re just adjusting to having a newborn baby”, “you’re just busy”, or “you’re just tired”. Sound familiar? The risks of developing postpartum thyroiditis are higher with multiple pregnancies, positive thyroid antibodies, family history, type one diabetes mellitus, previous thyroid issues, smoking and nutrient deficiencies such as selenium, iodine, iron and tyrosine [1, 2].
What are the symptoms of postpartum thyroiditis?
Postpartum thyroiditis causes the thyroid gland to become overactive first which often lasts 2-4 months. This is because the thyroid becomes damaged and begins to release hormones uncontrollably. Common symptoms of an overactive thyroid are anxiety, heart palpitations, irritability, unintentional weight loss, diarrhoea, difficulty falling asleep, increased sweating and heat intolerance [1]. As the inflammation and damage continues the gland begins to lose function and the opposite may be experienced like fatigue, weight gain, brain fog, constipation, hair loss, depression and cold intolerance [1]. Postpartum thyroiditis may last 12-18 months and go away on its own; or in up to 30% of cases it progresses to permanent hypothyroidism [1].
Why does postpartum thyroiditis occur?
Scientists have not yet come to a conclusion as to why postpartum thyroiditis occurs. However, there are a several theories. One of the theories discusses the shift in immunity during pregnancy. During the first and second trimester the immune system favours the T helper 2 response and this serves to supress and calm the immune system. During the late third trimester and postpartum the immune system changes rapidly and it favours the T helper 1 response which exacerbates immunity and may go on to cause postpartum thyroiditis in vulnerable people [3]. Another theory suggests that it is due to the shift in hormones [3]. During pregnancy progesterone is the dominant female sex hormone until after birth. After birth oestrogen rises which can often dysregulate the delicate balance that exists between these two hormones and may contribute to postpartum thyroiditis. The other theory suggests that the antibodies produced by the baby in the womb accumulates in the mother’s thyroid gland which can again trigger postpartum thyroiditis.
Other reasons why a thyroid condition may be missed
You may of had a thyroid condition before falling pregnant. Often a full thyroid panel is not requested during the preconception period and things may go unnoticed and missed.
During pregnancy beta-human chorionic gonadotropin (hCG) stimulates our thyroid receptors which can make the thyroid markers that we use determine thyroid disease look normal [4]. This is one of the reasons why thyroid problems are rarely identified during pregnancy.
If you had autoantibodies indicating an autoimmune thyroid condition these will unlikely be identified during pregnancy as they naturally decrease due to supressed immunity [5]. This means that they may increase again after pregnancy and require treatment.
Natural treatments
Identify and correct any nutritional deficiencies (your naturopath can test these for you).
Increase foods containing selenium such as brazil nuts, liver, salmon and turkey to protect your thyroid from damage [2].
Increase foods high in omega-3 fatty acids such salmon and flax seed oil to reduce inflammation [2].
Reduce inflammatory foods such as dairy, gluten, sugar, alcohol and vegetable oils.
Ensure that you are getting enough sleep. I know, easier said than done but sleep is essential to balance your immunity and shift it back to its calm state.
Exercise when you have the opportunity. Take your little one out for a nice stroll in the sunshine.
Keep stress levels at bay by meditating, walking, being creative, getting a massage, whatever works for you really. Stress can create inflammation and shift the immune system back into an inflammatory and exacerbated state.
You should always endeavour to work with a health practitioner where possible for individualised treatment as this ensures that you receive the best treatment advice that is suitable for you. There is so much that naturopathy has to offer postpartum mamas suffering from thyroiditis. Naturopathy can help to alleviate your symptoms and prevent permanent damage to the thyroid gland by identifying the causes and contributing factors of postpartum thyroiditis.
Remember, the best treatment for postpartum thyroiditis is prevention. Always allow a minimum of three months for preconception care, have a full thyroid panel tested (naturopaths can test for you for an out-of-pocket expense) and test relevant nutrients that play a role in thyroid health such as vitamin D, vitamin B12, folate, iron, iodine, selenium and zinc.
Yours in health and happiness,
Ebony x
References:
[1] Keely E. J. (2011). Postpartum thyroiditis: an autoimmune thyroid disorder which predicts future thyroid health. Obstetric medicine, 4(1), 7–11. https://doi.org/10.1258/om.2010.100041
[2] Di Bari, F., Granese, R., Le Donne, M., Vita, R., & Benvenga, S. (2017). Autoimmune abnormalities of postpartum thyroid diseases. Frontiers in Endocrinology, 8(166). https://doi.org/10.3389/fendo.2017.00166
[3] Kokandi, A. A., Parkes, A. B., Premawardhana, L. D. K. E., John, R., & Lazarus, J. H. (2003). Association of Postpartum Thyroid Dysfunction with Antepartum Hormonal and Immunological Changes. The Journal of Clinical Endocrinology & Metabolism, 88(3), 1126–1132. https://doi.org/10.1210/jc.2002-021219
[4] Smith, A., Eccles-Smith, J., d’Emden, M., & Lust, K. (2017). Thyroid disorders in pregnancy and postpartum. Australian Prescriber, 40, 214-219. https://doi.org/10.18773/austprescr.2017.075
[5] Prummel, M. F., & Wiersinga, W. M. (2005). Thyroid peroxidase autoantibodies in euthyroid subjects. Best practice & research. Clinical Endocrinology & Metabolism, 19(1), 1–15. https://doi.org/10.1016/j.beem.2004.11.003
