Thyroid Imbalance Postpartum
Postpartum thyroiditis is often undiagnosed when the symptoms of exhaustion and moodiness are mistaken for postpartum ‘blues’. If symptoms of fatigue and lethargy do not go away within a few weeks, or a woman develops postpartum depression, she should talk with her health care provider, preferably one who understands thyroid imbalance 1, 3.
Onset of a thyroid imbalance may occur 1 - 2 months after delivery, presents with different patterns and affects 4% to 10% of women 1, 2, 3.
The most typical pattern is a transient or temporary hyperthyroidism for 2 - 6 months followed by hypothyroidism around 3 - 12 months, then return to normal. 25% - 30% of women with postpartum thyroiditis follow this pattern 2, 3. What is occurring in this pattern is an initial destruction of thyroid cells creating a release of thyroid hormones causing symptoms of hyperthyroidism. Then as destruction subsides, hypothyroidism occurs as the cells can’t maintain normal levels. Cells then begin to regenerate and thyroid recovery occurs 1, 2.
In some women, normal function will follow the initial hyperthyroidism. In others, permanent hypothyroidism will develop 1, 2, 3. Low grade hypothyroidism, even transient, increases the risk of thyroid problems later in life 1, 2. 4.
Experiencing postpartum thyroid dysfunction once, increases the risk in future pregnancies and thyroid problems later in life. Multiple pregnancies and previous miscarriages also increase the risk of ongoing hypothyroidism 1, 2.
Postpartum Symptoms of Thyroid Imbalance
Postpartum symptoms of thyroid imbalance depend on whether the phase of imbalance is hyperthyroid (overactive) or hypothyroid (underactive).
For those with Hashimoto’s Thyroiditis, this can cycle between the two 5a, 5b.
Symptoms of hyperthyroid include fatigue, anxiety, insomnia, diarrhoea, weight loss, fast heartbeat and palpitations, migraines, sweating, tremor, muscle weakness, while those of hypothyroid are depression, fatigue, sluggishness, constipation, weight gain, puffy face, pale dry skin, cold sensitivity, muscle ache, hair loss. However many more may also be experienced 3, 4, 5a, 5b, 6, 7. It is estimated there are “300+ Hypothyroid symptoms” 7.
Breastfeeding and Thyroid Imbalance
Breastfeeding may be impacted by thyroid imbalance. Many women with hyperthyroidism report a large milk supply, yet others may have some difficulty with their let down reflex. As thyroid hormones play a role in normal breast development and helping breasts to make milk, hypothyroidism may influence the ability to produce a full milk supply. However, for many this is not the case and they have no problem with their milk supply with or without medication. Women who have been properly treated for hypothyroidism say they have no problems with their milk supply 8, 9. Some women report their thyroid hormone level needed to be within the upper range of normal but this depends on your body and response 8.
Research shows that the thyroid hormones you take, only cross over into your breast milk in minute quantities and are not considered harmful to your baby. For some mothers, changing to natural desiccated thyroid can increase their breast milk supply 9.
These are discussions to have with your doctor. If you are receiving treatment for your hyperthyroid, Thomas Hale, the world’s expert on medications and breastfeeding, suggests that your doctor monitor your infant’s thyroid function while you are breastfeeding 9.
Thyroid imbalance can also result in postpartum depression.
In Part 4 we will explore Postpartum Depression and Thyroid Imbalance
1. NIH. (2012). Pregnancy & Thyroid Disease. https://www.niddk.nih.gov/health-information/endocrine-diseases/pregnancy-thyroid-disease
2. Arem, R. (2007). The Thyroid Solution. Ballantine Books: New York.
3. Trentini, D. (2012). Your Postpartum Fatigue Could Be A Sign Of Thyroid Problems. http://hypothyroidmom.com/your-postpartum-fatigue-could-be-a-sign-of-thyroid-problems/
4. Shomon, M. (2016). Thyroid Problem After Pregnancy: Postpartum Thyroiditis. https://www.verywell.com/thyroid-problems-after-pregnancy-3231767
5a. Hansen, G. M. (2016). Hashimoto's Thyroiditis - A New Path of Learning and Discovery (Parts 1 - 4). http://www.nurturingnaturally.nz/blog
5b. Hansen, G. M. (2017). Thyroid Imbalance within a Mind Body Brain Perspective. ebook.
6. Hashimoto’s Awareness. http://www.hashimotosawareness.org/
7. Trentini, D. (2012). 300+ Hypothyroidism Symptoms…Yes REALLY http://hypothyroidmom.com/300-hypothyroidism-symptoms-yes-really/
8. Australian Breastfeeding Association. (2014). Breastfeeding and thyroid disease. https://www.breastfeeding.asn.au/bfinfo/breastfeeding-and-thyroid-disease
9. STTM. Being a Hypothyroid Mother and Nursing. https://stopthethyroidmadness.com/hypothyroid-mother-and-nursing/