The thyroid is a small butterfly-shaped gland located in the neck, just under the larynx. For a relatively small structure, the thyroid has a big job of influencing and regulating our metabolism. This means the health and function of our thyroid will impact energy levels, weight, digestion, cognition, mental health, and more. This is why recognizing and understanding the changes in thyroid function that can happen postpartum is essential to supporting the recovery and quality of life for a new mother. 

Pregnancy, as you can imagine, is a significant event for our physiology. Dramatic changes to  metabolism, immune system, nutrient allocation, and hormone cascades need to happen to accommodate and facilitate the growth of a baby. 

During pregnancy, the thyroid gland will naturally produce more T3 and T4 hormones. This is a normal process and the increase usually plateaus in the second trimester. When pregnancy is over, our body needs to adjust these hormones back to baseline. This process isn’t always seamless, which opens the door to the most common postpartum thyroid imbalances:

PostPartum Thyroiditis

Postpartum thyroiditis is a condition where the thyroid gland becomes inflamed, and affects 4-10% percent of women during the first year after giving birth.

This inflammation, which is the result of an autoimmune process, leads to a “rise then fall” pattern in circulating thyroid hormones. Initially, the inflammation of the thyroid gland will cause it to leak thyroid hormones (T3 and T4) into the bloodstream. This increase in circulating thyroid hormones can cause “hyperthyroid” symptoms like anxiety, irritability, unexplained weight loss, racing heart and fatigue. 

This hyperthyroid phase may last a few months, but eventually our stores of T3 and T4 become depleted. This depletion causes the fall into “hypothyroid” which may show up as symptoms like constipation, lethargy, weight gain, dry skin, brittle nails and hair, as well as depression. This phase can last several months before normalizing itself, but approximately half of women with postpartum thyroiditis will develop long-term hypothyroidism. This stresses the importance of seeking support and treatment during the postpartum phase.

PostPartum Autoimmune Hypothyroidism

While we know that hypothyroidism can develop from the “fall” phase of Postpartum Thyroiditis – it is also common to see hypothyroidism develop right away due to an autoimmune response following childbirth. 

The immune system goes through a major landscape shift during pregnancy in order to keep Mom and baby safe and healthy. However, labor is a BIG event for the body and can trigger our immune system to make antibodies (such as anti-thyroid peroxidase and anti-thyroglobulin) that attack the thyroid gland. 

Thyroid autoimmunity, particularly the presence of anti-thyroid peroxidase antibodies, has been shown to increase the risk of postpartum depression. This can be incredibly challenging for a new mother and is associated with an increased risk of adverse outcomes for both mother and child such as; impaired mother-infant bonding and emotional problems in childhood and adolescence.

Why It All Matters

Following the birth of a child, there is no doubt that there is a lot of excitement and focus on the health and well-being of your new baby. However, it is important to also realize that the first year postpartum is a critical time to advocate for yourself – check in on your health, identify what symptoms you may be experiencing, and seek investigation for potential thyroid changes. 

We can see that the most common postpartum thyroid conditions are autoimmune in nature, and although they can sometimes be transient, they can also impact your risk of developing a different autoimmune condition later in life, or in subsequent pregnancies.

With the right guidance, postpartum thyroid conditions can be identified and managed with medication, nutrient optimization, addressing inflammation and stress on the system, strengthening immunity and providing symptom relief.

How We Can Help

Naturopathic Doctors can help guide you from pre-conception, to pregnancy, to postpartum and beyond. We provide comprehensive work-ups to understand your metabolic and hormonal landscape and to recognize when thyroid function has shifted. For example, in the postpartum phase, your ND may run a full thyroid panel including TSH, T3, T4 hormones and screen for autoimmune antibodies such as anti-thyroid peroxidase and anti-thyroglobulin. 

As holistic practitioners, we look to all possible avenues to optimize the health of a new mother. This means taking into account both physical and mental/emotional symptoms, and providing the support you need to enjoy and care for your growing family. 

Author: Dr. Kaitlyn Holbrook, ND

References:

PMID: 31552596

PMID: 28751877

PMID: 27011366