While a lot of health complications tend to go away after you deliver your baby, some conditions like postpartum thyroiditis can occur within the first year. While rare, this thyroid condition can impact your physical health and energy levels until treatment is complete. Here’s everything you need to know about postpartum thyroiditis, including its causes, symptoms, and how to treat it.
What Is Postpartum Thyroiditis?
Postpartum thyroiditis occurs in roughly five to 10% of women after childbirth. This inflammation of the thyroid gland, affects the way your body makes the hormones that control energy use, help keep your body temperature stable and comfortable, and keep your organs functioning properly. When the thyroid gland, located in the front of the neck, creates too many or too few hormones, your body can have trouble regulating these functions.
Postpartum thyroiditis affects women in different ways. Typically it begins by making your thyroid overactive, which causes it to produce too many hormones (called hyperthyroidism, or thyrotoxicosis). However, the thyroid may then become damaged and under-active (hypothyroidism), producing too few thyroid hormones, causing important functions of the body to slow down. Not all women with postpartum thyroiditis will experience both phases, although roughly one in three will experience both hyper- and hypothyroidism.
What Causes Postpartum Thyroiditis?
When anti-thyroid antibodies attack the thyroid gland, it becomes inflamed and increases or decreases hormone output. It’s not known exactly why antibodies attack the thyroid; however, an unknown/undiagnosed autoimmune thyroid condition may be at play. Due to changes in the body’s immune function following childbirth, any unknown conditions may potentially flare up following baby’s birth, causing postpartum thyroiditis.
What Are the Symptoms of Postpartum Thyroiditis?
Symptoms of postpartum thyroiditis vary, and are often confused with typical postpartum recovery symptoms.
The thyrotoxic, or hyperthyroidism phase typically occurs one to four months after the birth of your baby, and can last up to three months. Symptoms of hyperthyroidism may include:
- Feeling unusually warm
- Muscle weakness
- Anxiety or nervousness
- Insomnia
- Heart palpitations
- Weight loss
- Irritability
- Hair loss
People tend to notice symptoms of postpartum thyroiditis more often during the hypothyroidism, or under-active thyroid phase. These symptoms usually occur four to eight months postpartum, but could last up to a year following childbirth. Symptoms may include:
- Fatigue or lack of energy
- Weight gain
- Constipation
- Depression
- Dry skin
- Muscle cramps
- Difficulty handling cold temperatures
Is Postpartum Thyroiditis the Same as Hashimoto’s Disease?
While postpartum thyroiditis is very similar to Hashimoto’s thyroiditis, they are not the same. Both are associated with the presence of anti-thyroid antibodies and chronic inflammation of the thyroid. Postpartum thyroiditis typically resolves within 18 months after beginning treatment for the majority of women diagnosed, while there is no cure for Hashimoto’s thyroiditis.
What Are the Risk Factors for Postpartum Thyroiditis?
The risk of developing postpartum thyroiditis after delivering your baby is higher in those who have:
- Autoimmune disorders (such as type 1 diabetes)
- Positive anti-thyroid antibodies (the higher the antibody count, the higher the risk)
- History of previous thyroid conditions or dysfunction
- History of previous postpartum thyroiditis (20% recurrence rate)
- A family history of thyroid dysfunction
How is Postpartum Thyroiditis Treated?
While treatment differs depending on a number of factors (including age, symptoms, and overall health), it also depends on the phase of the disease. Your provider will likely order a blood test to understand if your thyroid is over- or under-active.
Those who are in thyrotoxicosis, or an overactive thyroid, may receive treatment to address symptoms such as tremors, heart palpitations, and inflammation. Common treatments for these symptoms include beta blockers or prednisone. Because thyrotoxicosis isn’t a permanent state during postpartum thyroiditis, hormone therapies aren’t as likely to be recommended.
Women experiencing hypothyroidism, or an under-active thyroid, may undergo hormone therapy to treat major symptoms. If there are only mild to moderate symptoms of hypothyroidism, it’s possible that no treatments are necessary.
New moms undergoing treatment for postpartum thyroiditis can typically breastfeed without issue. However, it’s important to discuss any medication or hormone therapies with your provider to ensure the baby's safety.
Can Postpartum Thyroiditis Be Cured?
Luckily, most women who experience postpartum thyroiditis return to normal thyroid function within 12 to 18 months after symptoms begin. However, 20% of women who experience a hypothyroid phase will remain in this condition. It’s important for anyone who experienced postpartum thyroiditis to continue thyroid monitoring throughout (and potentially past) treatment.
Doctors typically recommend those undergoing hormone therapy gradually reduce treatments to understand whether thyroid hormone treatments must continue indefinitely. Women with a high amount of thyroid antibodies are more likely to experience continued hypothyroidism and may need hormone replacement therapy for the rest of their lives.
If you suspect you may be suffering from postpartum thyroiditis or another postpartum complication, it’s important to contact your provider for an assessment immediately. Learn more about Penn Medicine Lancaster General Health’s endocrinology practice, and how to request a referral from your provider.