Postpartum thyroiditis is a multi-phase inflammation of the thyroid gland that can occur immediately after pregnancy and is now regarded as a special form of autoimmune Hashimoto’s thyroiditis. In the first phase of the disease, those affected suffer from an overactive endocrine gland, which is followed by an underactive one. Normalization usually sets in without treatment.
What is postpartum thyroiditis?
The thyroid is one of the most important endocrine glands in the human body. The gland produces the thyroid hormones triiodothyronine T3 and thyroxine T4, which affect almost all body cells and stimulate the vital energy metabolism in the cells. The activity of the thyroid gland is regulated by the hypothalamic hormone TSH releasing hormone and is also functionally regulated by the pituitary hormone TSH. See howsmb for Radius Fracture Definition and Meaning.
Various diseases can impair the function of the thyroid gland. One of them is thyroiditis or inflammation of the thyroid gland. Different diseases with different causes are characterized by inflammation of the thyroid gland.
Postpartum thyroiditis or postpartum thyroiditis is one such condition and usually occurs shortly after pregnancy. About seven percent of all new mothers develop postpartum thyroiditis. The disease is an inflammation of the thyroid gland with a comparatively mild course, which is associated with a favorable prognosis.
Causes
The causes of postpartum thyroiditis have not been finally clarified. However, researchers now suspect an autoimmune disease behind the phenomenon. For example, many scientists are currently assuming that the disease is to be regarded as a special form of chronic lymphocytic thyroiditis in the sense of Hashimoto’s thyroiditis.
Some risk factors can promote the occurrence of postpartum thyroiditis after pregnancy. For example, women with type I diabetes mellitus develop thyroiditis in up to 25 percent of all cases. Patients with thyroid antibodies also have an increased risk of developing the disease.
Familial aggregation has been reported for autoimmune thyroid disease and specifically postpartum thyroiditis. Therefore, women with relevant cases in the family are also at increased risk. If postpartum thyroiditis occurs after a previous pregnancy, there is a probability of up to 70 percent that those affected will contract it again in subsequent pregnancies.
Symptoms, Ailments & Signs
Women with postpartum thyroiditis have a variable clinical picture that may be similar to silent thyroiditis. The disease usually progresses in three phases. Up to six months after giving birth to a child, new mothers develop an overactive thyroid gland that lasts for around two months, which is followed by four to eight months of underactive thyroid glands.
After the first two phases, the thyroid function normalizes for the time being. In other cases, the inflammatory disease has manifested itself exclusively in the form of hypothyroidism or hyperthyroidism. After one year, almost all patients were symptom-free again. However, the transition to persistent hypothyroidism cannot be completely ruled out.
Symptomatic of the disease can be metabolic abnormalities, hyperthyroidism, hypothyroidism, mood swings, disturbed temperature sensitivity and similar ailments. As a rule, pain does not occur in the context of postpartum thyroiditis.
Diagnosis & course of disease
The diagnosis of postpartum thyroiditis is made by the doctor on the basis of the medical history and the hormonal status. Depending on the phase in question, the hormonal status can be used to demonstrate whether the thyroid gland is overactive or underactive. Imaging of the thyroid gland and histological examination of the affected thyroid tissue can be performed to demonstrate the inflammatory basis.
Basically, there is a favorable prognosis for affected women. The symptoms usually subside by themselves within the next few months. Only in the rarest of cases does a permanent disturbance of the thyroid function occur.
Complications
In postpartum thyroiditis, those affected suffer from inflammation of the thyroid gland. In most cases, no special treatment is necessary, so that the symptoms disappear completely on their own. Complications usually do not arise. The patients briefly suffer from an underactive thyroid gland and then finally an overactive thyroid gland.
The duration of this disease cannot generally be predicted. In most cases, however, the production of hormones by the thyroid gland returns to normal. However, postpartum thyroiditis can lead to slight obesity and a disturbed metabolism. Mood swings or a disturbed sense of temperature can also occur and have a negative effect on the quality of life of those affected.
Most patients do not experience pain due to postpartum thyroiditis. Direct treatment is not necessary in many cases. However, the disease can be supported by taking hormones and other medications.
Appropriate therapy is necessary in the case of depression or other psychological complaints. However, there is always a positive course of the disease in postpartum thyroiditis. The life expectancy of the patient is usually not affected by the disease.
When should you go to the doctor?
Immediately after childbirth, the hormonal system in the female organism changes. This leads to changes, health problems and irregularities. In the case of postpartum thyroiditis, no doctor is normally required, as the disorders regulate themselves independently as the disease progresses.
Timely and comprehensive information about the physical changes after birth is advisable. This can be done virtually through corresponding articles on the Internet or through the use of specialist literature about birth. Discussions with the gynecologist or midwife beforehand can also help. In many cases, consultation with women who have already given birth can be sufficient. In mutual exchange, open questions are clarified and doubts are dispelled. In addition, the prospect of further development can be helpful in deciding whether a doctor’s visit is indicated.
It is advisable to consult a doctor if there are persistent uncertainties or fears. If the existing questions cannot be clarified by people from the environment, it is advisable to consult a doctor. If worries, needs or irregularities increase in intensity or scope, it is recommended to seek help. If the symptoms lead to irregularities in handling the baby, a visit to the doctor is also recommended.
Treatment & Therapy
In most cases, women with postpartum thyroiditis do not need further therapy. The symptoms often disappear completely after just a few days. Normal thyroid function returns. Since the causes of the disease have not yet been finally clarified, a causal therapy is not available anyway.
In severe cases, however, symptomatic therapy can make sense. In the case of hypothyroidism, this symptomatic therapy usually corresponds to conservative drug-based hormone substitution with drugs such as levothyroxine. In the case of an overactive thyroid, symptomatic treatment with antithyroid drugs is usually sought.
These drugs inhibit the production of thyroid hormones. Sulphur-containing antithyroid drugs such as propylthiouracil or carbimazole have a one-week latency of action and must be combined with other drugs for a faster effect. However, in the past, antithyroid drugs have often proven to be less effective in hyperthyroidism in the context of thyroid inflammation.
Hormones are stored within the thyroid gland, which can be released despite the inhibited formation. For this reason, the symptomatic treatment of an inflammation-related hyperfunction turns out to be significantly more difficult than the symptomatic treatment of an inflammation-related hypofunction.
If the thyroid dysfunction causes mood swings or even depressive moods, psychotherapeutic care of the affected women is conceivable. Since many women suffer from mood crises immediately after pregnancy anyway, the step of psychotherapy makes all the more sense.
Prevention
Up to now, postpartum thyroiditis can hardly be prevented. The causes have not yet been sufficiently clarified for preventive measures to exist. Although the familial connection allows the probability of an illness to be estimated, it does not provide any starting points for prevention.
The affected women can now have their own risk of postpartum thyroiditis assessed more or less precisely and thus prepare themselves psychologically for the event of the disease, but they have not been able to actively avoid the disease so far.
Aftercare
Aftercare for postpartum thyroiditis consists primarily of regular visits to the family doctor or endocrinologist. The treating gynecologist can also be an ideal contact point here. Aftercare is primarily about taking blood at short intervals to determine that the thyroiditis has healed.
If there is a permanent secondary disease, lifelong treatment with thyroid drugs may be necessary. Another point of the aftercare treatment is the imaging of the thyroid gland. The first thing to do here is the ultrasound, which can often be done directly by the family doctor. Late sequelae changes to the thyroid gland can be detected here, such as enlargement or reduction or the formation of nodules.
In some cases, an examination by a radiologist may also be necessary. This is particularly indicated if there are indications of insufficient healing, unclear findings in the ultrasound or a renewed flare-up of the postpartum thyroiditis or the occurrence of a secondary disease. The patient should conscientiously appear for the agreed follow-up examinations, since a thyroid disease that is not treated or not sufficiently treated can have serious consequences for the entire body and metabolic processes.
You can do that yourself
Close relatives should be informed about the course of postpartum thyroiditis. Depressive moods, inner restlessness, weight changes and hair loss are met with understanding in the patient’s environment. Additional stress and feelings of guilt are avoided. Help with the care of the baby also makes everyday life easier for the patient. The need for further measures to cope with everyday life depends on the symptoms. If euthyroidism is present, no further measures are necessary.
Excessive weight gain in hypothyroidism can be reduced by adjusting eating habits to reflect reduced hunger pangs. Rest and sufficient sleep enable you to cope with everyday life despite a slowed metabolism. Massages and warm pads help with muscle tension . Moisturizers and sufficient fluid intake are recommended for dry skin. Constipation symptoms are counteracted by drinking plenty of fluids, eating a high-fiber, stool-inducing diet, exercise, abdominal rubs, and avoiding constipating foods.
If hyperthyroidism is present, sports, yoga, Pilates and relaxation exercises are suitable for overcoming inner restlessness. Increased calorie intake in line with increased appetite prevents excessive weight loss due to accelerated metabolism. Informing healthcare professionals about the desire to have more children ensures that thyroid levels are within the normal range before conception occurs again.
