Postpartum Thyroiditis (PPT) and Thyroid Conditions

Around 5-9% of women will suffer from Postpartum Thyroiditis (PPT). Since the symptoms mimic those that are normal for all new mothers after the birth of their baby, this condition often goes undiagnosed. It may start anywhere from one to three months after you have your baby and is often accompanied by a brief period of hyperthyroidism (which is too much thyroid hormone).

Hyperthyroidism causes too much thyroid to circulate in the bloodstream. This may last a few weeks. During this time you may feel:

• Tired,
• Irritable,
• Nervous
• You may feel really warm and experience increased sweating  
• Insomnia
• Increased appetite
• Nervousness
• Rapid heart rate and palpitations 
• Weight loss

Sounds normal for a new mom, I know. Treatment isn't usually necessary for this point.

After this period, you will then get hypothyroidism (since hyper- means too much, hypo- will mean you're getting too little thyroid hormone).

Hypothyroidism will result in:

• Fatigue along with depression (which will be more severe and last longer than "Baby Blues"
• Poor appetite
• You'll also notice muscle aches,
• excessive hair loss,
• dry skin,
• cold intolerance,
• poor memory, and
• an inability to lose weight

If this sounds like you, call your doctor. You can be tested. Be sure to mention any family history of thyroid problems (there is a strong genetic link).

Most women recover from PPT within a year. Supplementary thyroid hormone can help you feel much better, much faster. Around 25% of the women who receive treatment do remain hypothyroid, which will require lifetime treatment. This will require taking a pill daily and getting a yearly blood test. Thyroiditis is likely to reoccur with future pregnancies. Some may develop hypothyroidism or Graves disease (hyperthyroidism) later in life.

If you are diagnosed with PPT you should have a yearly thyroid screening. If you plan to get pregnant again you should be screened before you conceive again and during pregnancy. An untreated thyroid condition can interfere with conception and cause problems during pregnancy.

Additionally:

Hyperthyroidism will present itself with an enlarged thyroid gland. Hyperthyroidism can interfere with ovulation, making it difficult to conceive. If you are pregnant you are at risk of developing thyroid storm - a severe form of hyperthyroidism that is associated with premature delivery and low birth weight babies; it can also put the mother's life at risk.
If you are breastfeeding you will have to stop for at least 48 hours (pump and dispose) when radioactive iodine is used for diagnostic testing. There are some other tests that you could do that wouldn't require you to stop breastfeeding. If you are taking medication for an overactive thyroid gland you can continue to breastfeed as long as your medication is safe. PTU (propylthiouracil) is the drug of choice (it has the least effect on the baby's thyroid gland). The baby's thyroid gland should be monitored. Another drug is methimazole. Methimazole in moderate to large doses can be dangerous to a breastfed baby. Low doses appear to be safe.

Hypothyroidism doesn't care any risks while pregnant as long as you take your prescribed thyroid medication. If left untreated you are at risk of experiencing infertility, miscarriage, and giving birth to a baby with growth or developmental abnormalities. Hypothyroidism may decrease your milk supply. Thyroid replacement will reverse the problem quickly. You can safely take these drugs while breastfeeding.