Post-partum Thyroiditis: Knowing the facts

Post-partum Thyroiditis: Knowing the facts

Many complex and amazing bodily changes occur during pregnancy to create a new human life. While welcoming a new child is an exciting and joyous time for mothers, it can also be followed by some unwelcome side effects that many women need assistance in understanding.

Post-partum depression, for example, has been raised as a topic of conversation more and more in recent years. This has done wonders for raising awareness.  More people, especially women, are now increasingly aware of it and the symptoms that accompany it. This enables them to recognize the signs and proactively seek help and support.

Unlike post-partum depression, however, post-partum thyroiditis has not received as much attention and many pregnant women are unaware that this should be something to look out for too.

Dr. Justus Apffelstaedt, specialist surgeon with an interest in breast, thyroid and parathyroid health management, has unpacked some frequently asked questions regarding post-partum thyroiditis.

What is post-partum thyroiditis? 

To start, one must understand the essential functionality of the thyroid. The thyroid is a small gland located at the base of the neck that is part of our endocrine system. The thyroid, small as it is, is a crucial gland. It affects, directly or indirectly, almost every function in our bodies: our temperature, our digestive system and mental development.

Post-partum thyroiditis can occur following pregnancy when a woman’s thyroid gland becomes inflamed after giving birth. This condition affects a small percentage of pregnant women, or about 3 in 100 to 2 in 25. It may involve mild pain in the neck and discomfort when swallowing. As for thyroid function, transient hyperthyroidism, hypothyroidism, or both consecutively occur. In most cases, the first phase is typically mild hyperthyroidism which either returns to normal with time or – in about a third of women – progresses to hypothyroidism.

Hyperthyroidism involves an increase of thyroid hormones released into the body. Weight is lost despite a good appetite. Other symptoms include nervousness and anxiety up to full-blown psychosis, tremors, palpitations, high blood pressure, increased sweating and neck enlargement. 

At the opposite end of the spectrum is hypothyroidism, which results from a lack of thyroid hormones secreted into the body. When this happens, the body seems to ‘slow down’. 

What symptoms should one look out for?

The inflammation and release of thyroid hormone (hyperthyroidism) might first cause the following symptoms:

  • Anxiety.
  • Irritability.
  • Rapid heartbeat or palpitations.
  • Weight loss.
  • Increased sensitivity to heat.
  • Fatigue.
  • Tremors.
  • Insomnia.

These symptoms often don’t raise alarm bells as they can easily be misinterpreted to be regular occurrences for mothers who have recently given birth.

Common symptoms of hypothyroidism include:

  • Reduced heart rate.
  • Intense fatigue.
  • Dry skin.
  • Hair loss.
  • Weight gain that cannot be explained by improper diet.
  • Slow mental activity.
  • Enlargement of the neck.


When might post-partum thyroiditis occur? 

It is not until the second phase of post-partum thyroiditis that most women will notice symptoms.

This typically occurs four to eight months after delivery and could last for up to nine months to a year. Women should be encouraged to use this broad timeline as a framework to check in with their bodies as time progresses following giving birth and be on the lookout for common symptoms.

How is post-partum thyroiditis diagnosed? 

Diagnostic procedures used to detect post-partum thyroiditis depend on the phase of the disease. A blood test to measure levels of thyroid hormones (T3 and T4) and thyroid-stimulating hormones (TSH) determines whether a mother is experiencing hyperthyroidism or hypothyroidism. Thyroid antibodies then support the diagnosis of thyroiditis.

How is post-partum thyroiditis treated? 

Fortunately, most women will regain normal thyroid functionality within a year to eighteen months after the onset of symptoms.

Pain in the neck rarely requires more than minor anti-inflammatory drugs for a short period.

Hyperthyroidism due to thyroiditis often is so mild that it does not require active treatment. At times beta-blockers are given to reduce palpitations and anxiety.

Statistics from Cleveland Clinic indicate that post-partum hypothyroidism is usually temporary. Seventy to 80% of people eventually no longer need medication because their thyroid starts making hormones at normal levels again. The other 20% to 30% stay in the hypothyroid phase. They’ll need thyroid long-term hormone replacement therapy.

If a mother develops signs and symptoms of hypothyroidism, she will need thyroid hormone therapy for between six and twelve months. This treatment, which involves daily use of the synthetic (man-made) thyroid hormone levothyroxine, normalizes the metabolic rate of cells of all tissues in the body.

As can be seen, post-partum hypothyroidism is temporary, however, it can make you more likely to develop future thyroid issues, so it’s recommended that you continue to monitor your thyroid once normal functioning has returned.



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