I was lucky I knew what to look for —

But did I really think I’d be diagnosed with a thyroid disorder when getting lab work done 6 months after giving birth?

Not at all.

That being said, one of the most common conditions new mamas face is exactly what I have.

Postpartum thyroiditis (PPT) is an autoimmune condition occurring in approximately 5-8% of the pregnant population. Essentially, the immune system rebounds after being naturally suppressed during pregnancy and attacks the thyroid (a butterfly-shaped gland in the throat that controls metabolism). This causes thyroid hormones to swing between a hyper (high) and hypo (low) state. Women predisposed to autoimmune conditions are at the highest risk.

Often times PPT goes undiagnosed for months or years as classic symptoms include feeling tired/lethargic and an inability to lose weight — all common issues new moms face and are often shoved to the side in our bounce-back society.

Additionally, PPT seldom manifests prior to the six-week postpartum check-up and most doctors do not inform their patients to watch for symptoms in the coming months. Complications when left untreated include fertility issues, hormone imbalances, chronic hypothyroidism, and increased cardiovascular disease risk.

Thankfully, for ~80% of cases, PPT rectifies itself within one year of being diagnosed. Depending on symptomatology and lab values, the condition is either treated with medication or practitioners will take a “wait and see” approach, retesting every 4-6 weeks to see if thyroid levels stabilize.

My personal Story

I’m a bloodwork junkie — I love going to Quest and getting those little vials drawn. They tell so much about what’s happening inside your body and how to be proactive with your health so you can address any potential issues before they get out of control.

My thyroid levels have always been within range, even during fertility treatments and pregnancy — so I wasn’t expecting anything different when I had my postpartum labs done. Everything looked great, except when we got to the thyroid panel. Literally, every marker was bolded in red as out of range. I had a TSH of 0.04 (incredibly fast) and elevated antibodies denoting an autoimmune reaction. As PPT is usually a transient condition and I’d just finished breastfeeding, we decided to take the wait-and-see approach as my body was likely adjusting.

Four weeks later, I went back for repeat labs and my TSH swung up to 54.0 (!) and my antibodies tripled — meaning I was now clinically hypothyroid. For reference, optimal levels for TSH should be 1.0 and 2.5.

Because my TSH was so high, I had to be medicated with levothyroxine and we’re currently in the process of adjusting my dose every 3-4 weeks until we get my TSH back into range and antibodies under control. Then, once stabilized for six months to one year, we’ll consider weaning off the meds to see if the condition fixes itself. Those with elevated antibodies in addition to TSH however have a higher chance of developing chronic hypothyroidism.

Classic Symptoms

Incredibly, I had virtually no symptoms because I caught it so early on in the process. If anything, I noticed mild constipation and more restless sleep, but that’s about it.

Hyperthyroid Stage (1-6 months after giving birth)

Weight loss
Feeling warm
Rapid heart rate
Nervousness, anxiety, irritability
Intense appetite
Frequent or loose stools

Hypothyroid Stage (4-8 months after giving birth)

Weight gain, or inability to lose “baby weight”
Fatigue, exhaustion
Depression
Dry skin, brittle hair/nails
Excessive hair loss
Constipation
Puffy face
Muscle aches/pain/weakness
Increased sensitivity to the cold
Decreased milk production

Lab Tests to Request

Most practitioners only test TSH, but that’s only a small part of the picture. For an accurate view of how your thyroid is functioning, you’ll need to request the following:

TSH
T4, Total
T4, Free
T3, Total
T3, Free
T3, Reverse
Thyroglobulin Antibodies
Thyroid Peroxidase Antibodies (TPO)

What to do if diagnosed

If it’s a wait-and-see approach, request labs to be drawn in 4-weeks, not longer. Generally, if TSH is higher than 10 medication is recommended, however, some functional medicine practitioners suggest treatment if levels are above 2.5 and the patient is symptomatic.

Nutrition-wise —

+ Eat an anti-inflammatory diet loaded with fruits, vegetables, high-quality protein, and fats.
+ Avoid gluten and dairy, especially if you have elevated thyroid antibodies
+ Avoid raw cruciferous vegetables (broccoli, cauliflower, kale, cabbage, etc). Cooked is fine.
+ Avoid high iodine intake from seaweed, fish, and table salt.
Supplementing with 200 micrograms of selenium daily during pregnancy has also been shown to reduce the chance of a woman developing PPT. Most prenatal vitamins include selenium. You can also consume 2-3 Brazil nuts for the same benefit.

It’s also important to reduce non-food inflammatory triggers such as stress and environmental toxin exposure through plastics, make-up, etc.

My Postpartum Thyroiditis Diagnosis