Thyroid Problems After Pregnancy

Thyroid Problems After Pregnancy

One of every twenty women develop thyroid inflammation within a few months after delivery of their baby, a condition called postpartum thyroiditis. This form of thyroid inflammation is painless and causes little or no gland enlargement. However, the condition interferes with the gland's production of thyroid hormones. Thyroid hormone may leak out of the inflamed gland in large amounts, causing hyperthyroidism that lasts for several weeks. Later on, the injured gland may not be able to make enough thyroid hormone, resulting in temporary hypothyroidism. Symptoms of hyperthyroidism and hypothyroidism may not be recognized when they occur in a new mother. They may be simply attributed to lack of sleep, nervousness, or depression.

Thyroid Symptoms Occasionally Overlooked in New Mothers
Hyperthyroidism

Fatigue
Insomnia
Nervousness
Irritability

Hypothyroidism

Fatigue
Depression
Easily upset
Trouble losing weight

Postpartum thyroiditis goes away on its own after one to four months. While it is active, however, women often benefit from treatment for their thyroid hormone excess or deficiency. Some of the symptoms caused by too much thyroid hormone, such as tremor or palpitations, can be improved promptly by medications called beta-blockers (e.g., propranolol). Antithyroid drugs, radioactive iodine, and surgery do not need to be considered because this form of hyperthyroidism is only temporary. If thyroid hormone deficiency develops, it can be treated for one to six months with levothyroxine. Women who have had an episode of postpartum thyroiditis are very likely to develop the problem again after future pregnancies. Although each episode usually resolves completely, one out of four women with postpartum thyroiditis goes on to develop a permanently underactive thyroid gland in future. Of course, levothyroxine fully corrects their thyroid hormone deficiency, and when used in the correct dose, can be safely taken without side effects or complications.

Thyroid Problems in the Baby
Rarely, a baby may be born without a thyroid gland. This birth defect is not caused by thyroid problems in the mother. If an infant's hypothyroidism is not recognized and treated promptly, he/she will not develop normally. Therefore, all newborn babies in the United States routinely have a blood test to be sure that hypothyroidism is diagnosed and treated. Most thyroid medications will have no effect on the baby. The exception to this generality is the administration of radioactive iodine to the mother during pregnancy. Radioactive iodine can cross the placenta and it can destroy thyroid cells in the fetus.

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