Any new mom will tell you that feeling tired, hormonal and uncertain comes with the newborn. But how do you know when those feelings are more than just the delicate dance of finding your footing with a new baby?
It starts, doctors say, with a conversation with your obstetrician. According to the American Pregnancy Association, about 70 to 80 percent of new mothers experience some negative feelings or mood swings after having a baby.
But those symptoms of “baby blues” also mimic another condition—postpartum thyroiditis—making it important that new mothers talk to their doctors about their fatigue, lack of concentration, irritability, mood swings, weight loss and/or insomnia.
“The thyroid is located near the front surface of the neck,” explains Jessica Brown, M.D., OB/GYN and physician on the medical staff at Texas Health Arlington Memorial. “The major targets of thyroid hormone are the skeleton, heart and metabolic regulation.”
According to the American Thyroid Association (ATA), the exact cause is not known but it is believed to be an autoimmune disease very similar to Hashimoto’s thyroiditis. Like Hashimoto’s, postpartum thyroiditis is associated with the development of antibodies that attack the thyroid.
Women with positive anti-thyroid antibodies are at an elevated risk of developing postpartum thyroiditis compared to women who do not.
“Women generally do not develop new thyroid disorders in pregnancy,” Brown explains. “They may have underlying or undiagnosed thyroid disorders that are found during pregnancy. There are some natural physiologic changes that happen to the thyroid gland and thyroid hormones during pregnancy.
“For this reason, the normal hormone values for a pregnant patient are different than a non-pregnant patient,” she adds.
The ATA says that in the United States, postpartum thyroiditis occurs in about five to 10 percent of women, but the risk is higher in certain populations, which include:
- Women with autoimmune disorders (such as Type 1, or juvenile onset, diabetes)
- Women with positive anti-thyroid antibodies (risk correlates with antibody levels; the higher the antibody the higher the risk)
- Women with a history of previous thyroid dysfunction
- Women with a history of previous postpartum thyroiditis (20% of women will have recurrence of thyroiditis with subsequent pregnancies)
- Women with a family history of thyroid dysfunction
“Postpartum thyroiditis can present as hyperthyroidism followed by hypothyroidism, hypothyroidism alone or hyperthyroidism,” Brown explains. “While the mood symptoms can appear similar to ‘baby blues,’ patients with thyroid disorders can develop heat or cold intolerance, dry skin, and tremors, too.”
Brown says the symptoms generally develop months after delivery, and can be vague or may be masked by the general fatigue and stresses of motherhood, which is why it is important to check in with your doctor regularly to make sure the symptoms you are experiencing are not caused by something else.
To diagnose postpartum thyroiditis, your doctor will perform tests that measure the levels of thyroid-stimulating hormone (TSH) and the thyroid hormone thyroxine in your blood. If those results come back abnormal, additional testing may be done.
“Treatment is not usually given for the hyperthyroid phase with the exception of symptomatic management of palpitations and/or tachycardia,” Brown says. “During the hypothyroid phase, treatment consists of thyroxine replacement for six to 12 months.”
In fact, the ATA says that about 80 percent of patients are able to discontinue medication during that time frame.
Talking to your OB/GYN is the first step in determining whether your lingering feelings are baby blues or a thyroid issue—and finding the correct course of treatment.
Do you need a primary care physician or OB/GYN to help manage your health and answer any of your concerns? Find a THR physician in your area with our “Find a Physician” tool.
For more information and other resources, visit TexasHealth.org or call 1-877-THR-WELL (1-877-847-9355).