What is Postpartum Thyroiditis (+ what to do if you think you have it)

Today I am going to tackle –or, begin to tackle– a BIG topic: Postpartum Thyroiditis.

Why am I writing about this?

Because so many moms (5-10% of U.S. women) suffer from it, but aren’t being diagnosed and therefore don’t receive proper treatment.

Hypothyroidism can be brought on by pregnancy (possibly connected to nutritional deficiencies from pregnancy and/or a change in your immune system) and so it’s really important that you know about and if you think you have it, take it serious and make sure that you get the medical attention and testing you need.

If you experience any symptoms (see below), please make sure you insist on getting proper testing done (see below) and not let your symptoms be chalked up to simply being a new mom. Unfortunately this happens all too often.

My goal with this post is not to teach you EVERYTHING you need to know about your thyroid (there are thick books about the complexity of the thyroid), but to educate you on some basics and share some natural ways of supporting your thyroid health.

In my private coaching as well as in my Well Mama program, the thyroid continues to be a topic of concern and confusion for many mamas. And rightfully so. When something is up with your thyroid and you either don’t know about it, have been misdiagnosed, or are not being treated, chances are that you feel like sh*t.

That is because the thyroid affects literally every single cell in your body because every cell in your body has receptor sites for thyroid hormone.

In addition, your thyroid health, which is primarily responsible for your metabolism, is intimately linked to your adrenals (think: how you respond to stress… hello motherhood) and your ovaries (think: fertility, sex drive, a healthy menstrual cycle… ya know, all the good stuff we want working for us). (3)

Thyroid hormone also directly acts on the brain, the G.I. tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gall bladder and liver function, steroid hormone production, glucose metabolism, lipid and cholesterol metabolism, protein metabolism and body temperature regulation… to name a few more. (1)

SO, your thyroid really matters for your greater health. As in, REALLY matters.

What are the symptoms of hypothyroidism, the most common form of postpartum thyroiditis?

• weight gain

• fatigue

• constipation

• dry skin

• brain fog or trouble concentrating

• depression

• anxiety

• hair loss

• joint and muscle aches (even carpal tunnel syndrome and tendonitis!)

• generalized swelling

• cold intolerance (or you always feel a little cold)

• an excessively low heart rate

• hoarse voice

• irregular menstruation

• infertility

• muscle stiffness and pain

NOTE: We commonly see that moms who develop postpartum thyroiditis first develop symptoms of hyperthyroidism (an overactive thyroid that produces too much thyroid hormone) which results in symptoms like sudden and rapid weight loss, rapid heartbeat (tachycardia), irregular heartbeat (arrhythmia) or pounding of your heart (palpitations), increased appetite, nervousness, anxiety and irritability, sweating, changes in menstrual patterns, increased sensitivity to heat, more frequent bowel movements, fatigue, muscle weakness, difficulty sleeping, skin thinning and fine, brittle hair… before she then develops hypothyroidism (see symptoms above).

Here are some facts everyone should know:

1. An estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of these people are unaware of their condition. Women are more affected than men. One in eight women will develop a thyroid disorder during her lifetime. (1)

2. With regard to postpartum thyroiditis specifically, it occurs in approximately 5-10% of U.S. women after they had a baby. The incidence can be greater in certain high-risk populations (ex. those with a family history or other auto-immune diseases). (2)

3. Hypothyroidism (compared to hyperthyroidism) is the more common thyroid disorder. And 95% of hypothyroid patients also have Hashimoto’s, the autoimmune version of hypothyroidism and the most common autoimmune disorder in the US. In essence, this means that your immune system is attacking and destroying your thyroid. (4)

Why is knowing about and testing for Hashimoto’s crucial?

If you have Hashimoto’s, the autoimmune version of hypothyroidism, your problem is NOT your thyroid, the problem is your immune system attacking your thyroid. Do you see the difference? This needs to be a crucial piece when it comes to developing your treatment plan.

What does a full thyroid panel lab test consist of?

Unfortunately conventional medicine typically only tests for TSH (thyroid stimulating hormone) and sometimes for T4, which is the inactive thyroid hormone that still needs to be converted to T3 (this conversion is often inhibited by too much cortisol aka stress among other factors). Neither TSH or T4 tell you anything about antibodies that may be indicating Hashimoto’s, which can be present before you develop any of the classic hypothyroid symptoms.

Here is what a complete thyroid panel should include:

TSH (*optimal range: The normal range is debated, but evidence favors 0.3 to 2.5 mIU/L. In women who still feel symptoms or have a diagnosis of autoimmune thyroiditis, you may want to optimize to 0.1-2.0. Ideal is to know the baseline TSH from an earlier age when client feels great and in balance.)

Free T3 (*optimal range: Top half of normal range (varies by lab), for ZRT 4.5-6.5)

Free T4 (*optimal range: Top half of normal range (varies by lab), for ZRT 1.45-2.5)

Thyroid Peroxidase Antibodies (TPO) (*optimal range if taken via bloodspot: <70)

Reverse T3

* optimal ranges are from Dr. Sara Gottfried (5)

I want to strongly urge you to trust your symptoms and ask for proper testing. If your doctor is not willing to listen, you have every right to find a different doctor who will work with you.

The functional medicine community is pushing for full thyroid panels to be performed on all women before pregnancy, at the end of the first trimester and after pregnancy. Why? Because a woman’s thyroid health is crucial for a healthy pregnancy, for healthy fetal development and for the mother’s health including her ability to bond with her baby postpartum. SO, there’s hope!!!

Natural approaches to support thyroid function (even if you have to take medication)

Step 1: Remove gluten. Several studies show a strong link between autoimmune thyroid disease (both Hashimoto’s and Graves’) and gluten intolerance. The link is so well- established that researchers suggest all people with autoimmune thyroid disease be screened for gluten intolerance, and vice versa. (1)

Step 2: Keep your stress levels in check. For real.

Step 3: Adapt a low inflammatory diet by reducing or eliminating sugar, dairy, alcohol, caffeine at the very least.

Step 4: Focus on replenishing nutrients that are commonly deficient: zinc, selenium, iron, copper, vitamin A, vitamin D3 and possibly iodine (be sure to always balance iodine with selenium and work with your doctor to get these nutrients tested).

Step 5: Educate yourself and become your own advocate by insisting on proper testing, medication adjustments as necessary, and special attention during your pregnancies (for ex. thyroid medication will have to be adjusted throughout).

I hope this article helped to shed some light on the complexity that is your thyroid. Take your symptoms serious and don’t stop looking for what’s wrong until you found the cause. You deserve to feel well… really well!

Love,

Caroline

Sources:

1. https://chriskresser.com/thyroid/

2. https://www.thyroid.org/postpartum-thyroiditis/

3. “The Adrenal Thyroid Revolution” by Aviva Romm

4. https://thyroidpharmacist.com/articles/do-you-have-hypothyroidism-or-hashimotos-or-both/

5. http://saragottfried.com/