Laura Faber of Soho was surprised by how tired she had become since giving birth. As a first-time mom, she initially denied her fatigue until it became unbearable. During her six-week checkup, she mentioned that she had been so tired she couldn't function. "I first thought that I should feel that tired because I was up all night with the baby, but even when I got sleep, I still felt wiped out," Faber explains. Because of this and her other complaints of body aches and dry skin, her doctor decided to run a quick thyroid panel in her labs that day. By 2pm the following day, Laura's doctor called to tell her that she had postpartum thyroiditis, a disease that commonly affects new mothers.
What is Postpartum Thyroiditis?
The thyroid is a central gland in the body, so it's no surprise that when it has problems, your whole body is affected. According to the American Thyroid Society, more than 12 percent of the U.S. population will develop a thyroid condition during their lifetime, a significant finding considering the thyroid produces a hormone that influences every cell, tissue, and organ in the body.
In postpartum thyroiditis, the thyroid becomes inflamed, which impairs function. The hypothyroid phase occurs when your thyroid gland does not produce enough thyroid hormone to supply the body. The hyperthyroid phase is diagnosed when the thyroid produces too much hormone.
Why Does It Happen?
Postpartum thyroiditis occurs when a woman's antibodies attack the thyroid and cause inflammation. It occurs in approximately five to 10 percent of women. If you suffer from an autoimmune disorder, diabetes, or have a previous history of thyroid problems, your risk is higher. It is typically diagnosed two to four months postpartum but can develop up to eight months after you deliver.
Signs and Symptoms
In the hyperthyroid phase, which usually lasts one to three months, a woman may experience insomnia, palpitations, fatigue, weight loss, and irritability. During the hypothyroid phase, which lasts nine to 12 months, symptoms involve fatigue, weight gain, constipation, dry skin, and depression.
Dr. Moshe Dekel, is a board-certified OB-GYN who is in private practice in Oceanside, Long Island, and treats thyroid patients regularly. He believes that not all mothers are being properly diagnosed. "There are many more women exhibiting clear clinical sings of hypothyroidism that are not being treated," Dr. Dekel says. Furthermore, thyroid testing is not part of the routine six-week checkup, and, according to Dr. Dekel, many OB-GYN doctors are not trained to look for it. He recommends that moms "see a physician who is willing and able to think 'out of the box,' and who is also willing to do the necessary testing and pay attention to the clinical presentation."
Pamela Constantine, a mom of two from Greenwich, CT, says she would be awakened by heart palpitations and feared she was having a heart attack shortly after giving birth to her second daughter. "I became very nervous and thought I was losing my mind," Constantine says. "I told my doctor, who initially told me to just get more rest. But the symptoms continued, so I saw another doctor who immediately tested my thyroid and that's when I knew I wasn't crazy." Constantine advises moms who experience symptoms to request a thyroid test. Often doctors dismiss the symptoms as a by-product of being up all night with a new baby. "As in every medical situation, you are your own best advocate," Constantine says, "so don't take 'no' for an answer. A diagnosis can be determined through one simple blood test."
How is it Treated?
Treatment is key. Most symptoms can be alleviated through medication, including levothyroxine, analgesics, or steroids, depending on the phase you are in. The good news is that, with treatment, most moms can expect to return to normal thyroid function within 12-18 months of the onset of symptoms. As Faber says, "Thyroid disorder isn't fatal, but it can make you feel pretty miserable, so it makes no sense to let something so easily treatable take any time away from enjoying your new baby."
Thyroid Disorder in Newborns
Testing for congenital hypothyroidism is part of the typical newborn screening panel performed shortly after birth. If the baby tests positive, he/she will be treated with oral doses of hormone to ensure proper brain development and growth. Babies not treated can suffer from a multitude of issues, including stunted growth and impaired brain function. In severe cases, brain damage may occur.
For more information:
American Association of Clinical Endocrinologists
American Association of Endocrine Surgeons
Clinical Center, National Institutes of Health