The Basics of Postpartum Thyroiditis

Postpartum Thyroiditis is considered as the most common disorder of the endocrine system which is associated with pregnancy. It is not certain what causes this disease in mothers but the American Thyroid Association thinks it is quite similar to Hashimoto’s Thyroiditis which is an autoimmune disease.[1] According to a 2011 medical journal written by Dr Erin Joanne Keely for The Departments of Medicine and Obstetrics/Gynecology at the University of Ottawa, Ontario, Canada, it could be a damaging lymphocytic thyroiditis that affects about eight per cent of the pregnant population. Women who are affected also have a 25 to 30 per cent risk of getting hypothyroidism later in life.[2]

Causes of Postpartum Thyroiditis

Similar to Hashimoto’s Thyroiditis, the direct cause of Postpartum Thyroiditis is not known. It is characterized by the presence of anti-thyroid antibodies, which are also observed in other autoimmune diseases of the thyroid gland such as Graves’ disease.

Prevalence of this disease is seen more in women who are already predisposed with other autoimmune diseases or have shown signs of thyroid autoimmunity even long before their pregnancy. It is also believed that women who develop postpartum thyroiditis have underlying or undiagnosed autoimmune diseases, which are aggravated by the instabilities in the immune system during childbirth.

Women who have type 1 diabetes also have a higher risk to develop postpartum thyroiditis, according to the Cleveland Clinic. A family history of thyroid dysfunctions is also a red flag.[3]

Symptoms of Postpartum Thyroiditis

The Mayo Clinic has listed symptoms of postpartum thyroiditis, which come in two phases. The first phase, much like in hyperthyroidism (overactive thyroid), is when there is an inflammation of the thyroid gland due to the release of excess thyroid hormones. This condition can bring about unexplained weight loss, palpitations, insomnia, anxiety, and irritability, which occur within one to four months after delivery and last within one to three months.

After a bout of hyperthyroidism, signs and symptoms of hypothyroidism will be felt including constipation, dry skin, lack of energy, and lack of concentration. These symptoms occur within the fourth thru eighth month after delivery and usually last from nine to twelve months.[4]

Possible treatment for Postpartum Thyroiditis

Accurate diagnosis of postpartum thyroiditis is essential, as it is very difficult to distinguish this against other thyroid-related autoimmune diseases. The Children’s Hospital of Philadelphia advises that diagnostic procedures must be done depending on what phase the disease is in at the time of discovery. Running a blood test can help determine if the woman has hyperthyroidism or hypothyroidism then further tests may be prescribed after then.

Treatment depends on how severe the symptoms are and at which phase it was diagnosed. Women who experience hyperthyroidism months after childbirth may be treated with beta blockers to regulate heart rate and reduce symptoms. On the other hand, Thyroid hormone replacement is prescribed to those who have stronger symptoms of hypothyroidism[5].

As long as the condition is properly monitored and treated by a health professional, eighty per cent of cases of postpartum thyroiditis graduate to normal thyroid functioning within twelve (12) to eighteen (18) months after start of symptoms. Treatment may be stopped as long as advised by the attending physician.

 

[1] Postpartum Thyroiditis. American Thyroid Association. https://www.thyroid.org/postpartum-thyroiditis/

[2] Postpartum thyroiditis: an autoimmune thyroid disorder which predicts future thyroid health. Keely, E. J. (2011 March 1). Obstetric Medicine. US National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989649/

[3] Postpartum Thyroiditis. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15294-postpartum-thyroiditis

[4] Postpartum Thyroiditis. The Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/postpartum-thyroiditis/symptoms-causes/syc-20376675

[5] Postpartum Thyroiditis. Children’s Hospital of Philadelphia. https://www.chop.edu/conditions-diseases/postpartum-thyroiditis

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