You’re losing your hair. You’ve never been so tired. You’re feeling down. You’re constipated. You can’t seem to lose the baby weight — or worse, you’re gaining. And your skin is so dry you feel like the alligator on that skin-cream commercial. Are these “normal” results of giving birth, or something more? For as many as 10 percent of all women, these symptoms signal a condition called postpartum thyroiditis (PPT). And for many of these women, their doctor’s lack of knowledge of this underdiagnosed condition can result in a missed opportunity for early relief.
Symptoms of PPT
Just like many other parts of your body, your thyroid gland changes during pregnancy. The thyroid, a small, butterfly-shaped gland in your neck, controls your metabolism and produces important hormones (called “T3” and “T4”), which help your body to properly use energy. When the thyroid isn’t working correctly, it can have a serious impact on the way you feel. If it is underactive (hypothyroidism), you may be exhausted and suffer from constipation, slower thinking, hair loss, muscle cramps, inability to lose weight and puffy eyes. An overactive thyroid (hyperthyroidism) can cause symptoms such as anxiety, heart palpitations, sleeplessness, sweating, weight loss, irritability and — surprisingly — fatigue.
Because of potential effects on the baby, most obstetricians routinely test for thyroid problems during the first weeks of pregnancy. After women give birth, most of their thyroids return to normal. But according to the American Thyroid Association, as many as one in ten will suffer PPT. The “classic” version starts with symptoms such as anxiety and insomnia, usually in the first few weeks or months after birth, followed by a short “normal” phase and then a period of fatigue, depression or both. According to Dr. Frances Broyles, a respected local endocrinologist, many women don’t really notice the first phase of the condition in the craziness of the first few weeks after birth; the first time they will start to notice that they feel “off” will be when the second set of symptoms kicks in.
‘Vastly underdiagnosed’
Some women’s symptoms go unchecked because of the difficulty in diagnosing PPT. And PPT is not the only thyroid problem that falls between the cracks; a groundbreaking 2000 study published in the Archives of Internal Medicine found that more than 13 million Americans — double the number previously suspected — have undiagnosed thyroid conditions. That number has since been revised up to 27 million, because old estimates were based on a scale of “normal” that has since been revised by the American Association of Clinical Endocrinologists.
Hardest hit by this sleeper epidemic? Women, who, some experts say, may account for as many as 80 percent of all undiagnosed cases. PPT itself is “vastly underdiagnosed,” Broyles says, in part because “women blame feeling exhausted and tired on having a new baby” rather than on a potential medical condition. Another problem, Broyles says, is that the symptoms of PPT and other thyroid conditions aren’t exclusive to those conditions, often mimicking other illnesses, such as postpartum depression. In fact, a 2008 study by the Oklahoma State University Center for Health Sciences found a relationship between thyroid disorders and depression symptoms, concluding that thyroid imbalance can cause such symptoms even when clinical depression is not present.
Do you have PPT?
If you think you might have PPT, don’t be afraid to ask your doctor about it, Broyles suggests, even if he or she doesn’t bring it up. And do it sooner rather than later; untreated thyroid conditions are more than just inconvenient — they have been linked to heart disease and other serious ailments. Further, while PPT is often temporary, some estimates find that as many as 25 percent of female PPT patients will end up with permanent thyroid conditions.
A simple blood test is usually all that’s needed to diagnose PPT, and in many cases, symptoms are well managed with medication. Getting answers now could get you on the right track to feeling better.
Kathryn Russell Selk lives, works, writes and treats her hypothyroidism — diagnosed years before her kids were born — in Seattle.
Common symptoms of postpartum thyroid problems
Hypothyroidism
Fatigue
Forgetfulness
Depression
Heavy menses
Dry, coarse hair
Mood swings
Weight gain
Inability to lose weight
Hoarse voice
Dry skin
Constipation
Hair loss
Decreased libido
Feeling cold all the time
Hyperthyroidism
Heat intolerance
Sweating
Weight loss
Appetite changes
Vision changes
Fatigue/muscle weakness
Disturbed menstruation
Sleep difficulties
Tremors
Frequent bowel movements
Palpitations
Racing heart
Source: American Association of Clinical Endocrinologists
