Thyroid dysfunction is commonly missed or overlooked in new moms. It’s easy to see why. Having a baby is exhausting, can cause changes in mood, and challenges with breastfeeding are all too common. How do you know when it is going beyond just normal postpartum exhaustion and into the realm of “there could be something wrong with my thyroid”? That is the question we are going to answer in today’s blog post.
Many thyroid conditions are caused by autoimmunity. Both Hashimoto’s, when you thyroid is underactive, and Grave’s Disease, when your thyroid is over active are autoimmune in nature. There is a spike in autoimmune conditions after giving birth because your body has been having to work overtime for the last 9 months to keep itself from attacking the baby as a foreign object. After birth, there sometimes can be some crossed wires in the body adjusting back to only having to look after itself and not having to protect baby. Autoimmune thyroid conditions tend to occur within the first 12 months after giving birth. Your chance of developing a thyroid problem postpartum is higher if you already have an autoimmune condition.
Similarly, if you had problems with your thyroid after a previous birth, you have an almost 50% chance of developing thyroid problems with your subsequent births.
So why are so many thyroid problems being missed? Many women become hyperthyroid first and then transition to hypothyroid. If the woman’s thyroid stimulating hormone (TSH) is tested at her 6 week check up, it is highly likely that her thyroid problems haven’t started yet or are just beginning to start. Similarly, if TSH is tested 3-6 months postpartum, when most women start to experience hair loss, there is a good chance the woman is transitioning from hyperthyroid to hypothyroid and therefore her TSH will come back as normal.
The other reason many of these cases are missed, in Canada in particular, is most often TSH is the only marker tested. I will talk more about proper testing a little further down.
Stats on Postpartum Thyroid Problems
- Approximately 25% of women become hyperthyroid 1-4 months postpartum
- 25% of women stay hyperthyroid for 2 weeks- 6 months, then go hypothyroid
- 40-50% of women just become hypothyroid 2-6 months postpartum
Symptoms of Hyperthyroidism
- Weight Loss
- Fatigue
- Palpitations (Irregular Heartbeat)
- Anxiety
- Restlessness
- Irritability
- Heat Intolerance
Symptoms of Hypothyroidism
- Fatigue
- Weight Gain
- Decreased Milk Supply
- Depression
- Hair Loss
- Cold Hands and Feet
- Constipation
- Joint Pain
Testing For Your Thyroid
As I mentioned above, in Canada, most doctors only test TSH. TSH is the signal from your brain to your thyroid to release thyroid hormone. The thyroid hormone that gets released is T4. T4 is the less active (utilized) form of thyroid hormone. The body needs to be able to convert T4 to T3, which is 5x more active.
- TSH- will come back low in women with hyperthyroidism and high in women with hypothyroidism. Many practitioners in Canada only treat when TSH is higher than 5 mU/L. The optimal level is between 1-2 mU/L.
- Free T4- High in hyperthyroidism
- Free T3- may be low or normal in hypothyroidism
- Anti TPO (antithyroid peroxidase antibodies)- This is the test that tells you if your thyroid problem is autoimmune. If autoimmune, your levels will be elevated.
Natural Treatment Options
- Autoimmune Thyroid Conditions- Gluten is a known trigger for autoimmune thyroid problems. If you are suffering from an autoimmune thyroid problem, you need to do a 100% elimination of gluten. Reducing inflammation is also critical in autoimmune conditions. Two ways you can do this safely while breastfeeding is by taking a good quality fish oil that contains 1000 mg DHA. DHA also helps reduce the risk of postpartum depression and helps with baby’s brain development. Adding Turmeric to foods or drinking golden milk is also very anti-inflammatory. Ginger is also a great anti-inflammatory
- Stay on Your Prenatal Vitamin- There are 10 key nutrients that your thyroid needs to function properly. Speak to your naturopathic doctor to make sure you are getting enough. The 10 nutrients are:
- Nettle Tea- is particularly helpful for those with hypothyroidism, as it helps to prevent iodine deficiency. It is also a good tonic for the adrenal glands
- Vitamin D- Helpful for mood for everyone. Tends to be low in autoimmune conditions
- Uncooked Brassicas- The brassicas which include Broccoli, Cauliflower, Brussel Sprouts, Kale, Collards, can reduce thyroid function if eaten raw. They are perfectly healthy to eat cooked
Most women can recover from postpartum thyroid problems within 6-12 months postpartum
If your thyroid problems are often the root cause of postpartum anxiety, depression, fatigue and low milk supply. If thyroid problems are properly treated, the above mentioned symptoms usually improve on their own.
What Should Be Your Next Step?
Make an appointment with your Naturopathic Doctor. They can order TSH, T4, T3 and Anti-TPO and get to the bottom of what is going on.
Talk Soon,
Dr. Alexis
Dr Alexis practices via telemedicine and is accepting new patients who live in Ontario. To schedule your appointment, click here.
