Thyroiditis diagnosed after baby's birth
I was diagnosed with postpartum thyroiditis a few weeks ago; my question is this: in a few years can/should I have another child? In retrospect, I developed this after my first was born, though the symptoms and signs were not nearly as severe. Luckily my midwife was able to interpret my complaints as hyper ones, and, after seeing an endocrinologist, I'm taking 40 mg propranolol every 24 hours.
Also, are there any books that detail the physical changes from hyper to hypo? At times I feel very dizzy and light headed and it seems as though my body can't adjust fast enough to the thyroid changes.
From your experience, are there any psycho/physical trends in women who develop this? I'm very curious.
(I'm still breastfeeding. Dr. Ruth Lawrence at the U of Rochester says that's okay)
Thanks in advance for your help. I really appreciate it.Question:
Postpartum thyroiditis (PPT) affects half of the 10 percent of women who have elevated circulating thyroid autoantibodies during the postpartum year. There are similarities between PPT and Hashimoto's thyroiditis which I have written about before.
The postpartum period is a time when manifestations of thyroid dysfunction can be particularly obvious and diagnosis of a thyroid problem is made when the condition was actually present but was apparently "subclinical" before or during the pregnancy.
During pregnancy, there is a type of lowered immunity which normally occurs. Therefore a thyroid problem caused by your body's hyper immune response may actually improve during that pregnancy. But it can become more severe after the delivery.
The usual pattern that occurs is an initial state of hyperthyroidism followed by a short period of hypothyroidism with recovery following. Sometimes during the first few months postpartum, a small goiter develops in the neck which is painless. You may also experience fatigue and heart palpitations. Treatment often consists of a beta blocker medication (propranolol) only if the symptoms are severe. About 2/3 of women who develop this short term hyper state return to a normal state but about 1/3 go on to develop hypothroidism. The hyperthryoid state can last up to 8 months postpartum and can actually act like a postpartum psychosis.
You do need thyroid studies on a regular basis (every six months or so) to make sure this is resolving. The likelihood of this reoccurring in subsequent pregnancies is great. Because the condition usually resolves, there is no problem conceiving again but in those for whom the condition becomes chronic, infertility may be a slight risk.
Although postpartum thyroiditis is usually transient, this condition, even if the thyroid values are back to normal, may be associated with symptoms, including an increased incidence of minor to moderate depression. Early recognition of this syndrome by antenatal screening of thyroid antibodies may contribute to improved management during the postpartum period.
Ipodate therapy (500 mg daily) has been given for 6 to 10 weeks until restoration of thyroid function to normal. In one study, an almost complete resolution of symptoms occurred by the third day of ipodate treatment. This treatment does not replace beta blocker therapy but is used with it.
Hyperthyroid symptoms include: weight loss, palpitation, tremors, heat intolerance, sweating, and scant menses. Hypothryoidism symptoms include: weight gain, fatigue, cold intolerance and muscle cramps, - occasionally constipation, anemia, sometimes facial puffiness, hair loss, and brittle nails.
I hope this helps and I wish you a speedy recovery. It can be a confusing state.Answer: