Postpartum Thyroiditis

First of all, what the hell is your thyroid gland?

I’ll be the first to admit that not only am I not a doctor, but that in all my years of taking science classes through nursing school, I have always found the endocrine system to be very complex and very confusing. My motto was always “explain this to me like I’m five,” so that is how I’ll attempt to break it down for you here.

Your thyroid gland is a small (about 2 inches wide) gland in your neck. But while it is small, it is mighty.  

According to the Merck Manual, your thyroid gland does a ****load of things for your body, all by sending hormones throughout your body that control your metabolism. This means your thyroid plays an essential function in controlling:

• your heart rate
• how quickly (or slowly) you burn calories
• skin maintenance
• growth
• heat production
• fertility
• digestion
• protein production in your body
• how much oxygen your body is using

So basically, your thyroid gland  interacts with every single organ system in your body. It does a lot. It’s also worth noting that your thyroid function heavily impacts your mood. And – as someone who has suffered from hypothyroidism (an underactive thyroid) my whole life, trust me when I say that when your thyroid gland is not working as it should, it sucks.

What does it feel like when your thyroid isn’t working as it should?

The image here shows you some of the symptoms you might have if you are suffering from hypothyroidism (an underactive thyroid or too little thyroid hormone) vs hyperthyroidism (an overactive thyroid or too much thyroid hormone). Both are terrible, and both cause quite a few undesirable symptoms. Diagnosis involves getting blood work (aka a thyroid panel) done and evaluating how much or how little thyroid hormone is present in your bloodstream.

So what does this have to do with pregnancy / postpartum?

In the first year after giving birth, some women – especially those with a history of thyroid dysfunction or type 1 diabetes – can develop postpartum thyroiditis, or inflammation of the thyroid gland. Though treatable, it essentially combines the worst of two worlds – you develop hyperthyroidism FOLLOWED BY hypothyroidism, and the symptoms can be VERY difficult to differentiate from postpartum mood disorders.

Why does this happen? The short answer is: Hormones. Your body is essentially in overdrive for 9 months, and that includes your thyroid gland. As a result, your body gets really excited and can start attacking itself (otherwise known as an autoimmune disorder.)

So why is this important for you – a new mom who has a million other priorities – to know?

Because according to the NIH,

Postpartum thyroiditis often goes undiagnosed because the symptoms are mistaken for postpartum blues—the exhaustion and moodiness that sometimes follow delivery.

This great article by the Cleveland Clinic details postpartum thyroiditis even further:

In the first phase of postpartum thyroid – hyperthyroidism – most women will not notice any symptoms. This phase usually takes place between 1 to 6 months after giving birth. It is not until the second phase of postpartum thyroid — hypothyroidism — that most women will notice symptoms. This phase usually takes place 4 to 8 months after giving birth. It can last as long as a year and then resolve by itself. A small group of women continue to stay hypothyroid for the rest of their lives.

Just to give you a refresher, some symptoms of hyperthyroidism might include:

• Weight loss (but you just had a baby so you’ve definitely lost some weight, especially if you’re breastfeeding)
• Anxiety (helloooo having a new baby)
• Feeling warm (can you say postpartum sweats?)
• Feeling anxious (again, just became a mom)
• Rapid heart rate (hello anxiety)
• Excessive hair loss (also a postpartum thing of course)

A little confusing huh?

So how do you know if you’re having postpartum thyroiditis or just feeling the baby blues?

Do what I say and not what I do: Get.Your.Labs. Allow me to explain.

Like a lot of people, I had a lot of random things happen throughout my pregnancy: A wonky placenta requiring twice weekly NSTs, nausea that would not quit, unexplained bleeding resulting in a scary ER visit, and a baby whose head was sitting so low I thought she might just shoot out into the toilet one day.

Surprisingly, the one thing I did not have throughout my pregnancy was trouble with my thyroid. Have you heard the phrase “nurses make the worst patients?” Well, needless to say, I got cocky and thought that meant I was in the clear. So by the time I had to get my postpartum thyroid levels checked, all I could think was: I’m tired and depressed, my baby won’t stop screaming, and I’ve been poked and prodded for 9 long months. Please leave me alone.

So although I couldn’t keep weight on, couldn’t stop sweating, was exhausted beyond what I knew was normal, and was the most anxious I have ever been, I chalked all of my symptoms up to being postpartum. The labs were not done.

I am here to shout my PSA from the rooftops: Do not blow off getting lab work done. Your providers are ordering it for a reason. If you feel these symptoms and want to confirm if something in your body is contributing to postpartum depression, I urge you to do so.

After months of feeling awful, I finally went and got my thyroid checked

Plot twist: My HYPOthyroid had turned into HYPERthyroid, which I had never experienced before, didn’t know was a potential complication in the postpartum period, and therefore didn’t really consider as an option. My thyroid medications have been adjusted (which is the usual treatment, by the way), I am regularly getting lab work done and more actively staying on top of my postpartum health needs, and am finally on the mend.

Moral of the story? Don’t dismiss yourself just because you are postpartum. Contact your provider.