Dr. Daniella Perri Blog
Postpartum Health & Wellness
Dr. Daniella Perri Blog
Postpartum Health & Wellness
It’s no wonder why you’re so exhausted. Sleep deprivation and poor eating habits are huge contributors. Now, you’re 8 months in and you still feel drained! What’s the deal? You might have Postpartum Thyroiditis.
Postpartum Thyroiditis is an autoimmune—when your body attacks itself—condition that affects 5-10% of women in the first year after giving birth. Many women are often misdiagnosed with postpartum depression. Symptoms of fatigue and mood swings overlap heavily with thyroid dysfunction. Li, Y
Postpartum Thyroiditis is often seen as a “silent” precursor to chronic thyroid issues, such as Hashimoto’s Thyroiditis, which is why early detection and diagnosis is vital for your long-term health.
Women who test positive for Thyroid Peroxidase (TPO) antibodies during the first trimester have a 33-50% risk for developing postpartum thyroiditis. Peng. A recent study demonstrated that having TPO antibodies is the most reliable predictor, which suggests that early screening can help with postpartum management. Liu 2024
Peng, C C-H, and E N Pearce. “An update on thyroid disorders in the postpartum period.” Journal of endocrinological investigation vol. 45,8 (2022): 1497-1506. doi:10.1007/s40618-022-01762-1
In order to protect the baby during pregnancy, the body naturally suppresses the immune system. During postpartum, the immune system rebounds and triggers an autoimmune attack on the thyroid gland.
Physiologically, postpartum thyroiditis is a “destructive thyroiditis,” where the thyroid gland is damaged and leaks stored thyroid hormone into the blood. This damage can lead to permanent hypothyroidism. Souto 2022
Postpartum thyroiditis follows a very predictable course and it occurs over 3 unique phases. Knowing these phases can help you understand why you may feel wired one month and completely exhausted the next.
Phase 1: Hyperthyroid (Thyrotoxicosis): This happens 1-4 months postpartum and symptoms include heat intolerance, heart palpitations, and anxiety.
Phase 2: Hypothyroid: This occurs 4-8 months postpartum and the symptoms are weight gain, extreme lethargy, and brain fog.
Phase 3: Euthyroid (Recovery): By the end of the first year postpartum, the thyroid gland function returns to normal, but this doesn’t happen for every woman.
High or low thyroid hormone levels can directly affect neurotransmitter function. This can either mimic or worsen clinical depression and anxiety. This highlights the importance of screening postpartum women for thyroid function.
Liu, Qiuhong et al. “Effect of thyroid peroxidase antibody titers trajectories during pregnancy and postpartum on postpartum thyroid dysfunction.” Archives of gynecology and obstetrics vol. 310,6 (2024): 3229-3238.
The following tests are most commonly ordered by your family doctor to help diagnose postpartum thyroiditis.
| Test | Reason for Testing |
|---|---|
| TSH (Thyroid Stimulating Hormone) | “Gold standard” screening test for identifying the communication between the brain and thyroid gland; High TSH suggests hypothyroidism, Low TSH suggests hyperthyroidism |
| Free T4 (Free Thyroxine) | Measure the amount of hormone available for your tissues to use; can help identify if medication is required |
| TPOAb (Thyroid Peroxidase Antibodies) | If these antibodies are present, it confirms the autoimmune condition and is the #1 predictor for postpartum thyroiditis |
| TRAb (Thyroid Receptor Antibodies) | If these antibodies are present, it may suggest a chronic thyroid autoimmune condition known as Graves’ Disease |
| Thyroid Ultrasound with Doppler | This test is done if the bloodwork is confusing and doesn’t match your symptoms. |
When symptoms are present, periodic testing will ensure prompt treatment and recovery. If TPOAbs were present during pregnancy, there’s a high chance that you will experience postpartum thyroiditis. Knowing this can help you and your healthcare team plan your treatment.
There are many ways to support thyroid function, whether you need medication or not. The following plan outlines 5 simple steps you can take to improve energy, support overall well-being, and prevent future flare-ups.
Anti-inflammatory Diet: This doesn’t have to be fancy. The goal is to reduce systemic (whole body) inflammation by focusing on foods such as wild caught fish, leafy dark greens, and cooked cruciferous vegetables.
Replenish thyroid supporting micronutrients like Selenium: Research shows that 200 mcg/d can help reduce autoimmune antibodies.
Gut Microbiome and Thyroid Connection: When your gut is inflamed, it can lead to enhanced thyroid dysfunction. Supplementing with probiotics can help thyroid function in general and benefit thyroid hormone production.
Adrenal Gland Support: Stress means high cortisol. High cortisol can inhibit thyroid hormone production, which can exacerbate symptoms. Adding in meditation or getting specific adrenal support can be worthwhile.
Periodic Testing: Testing the thyroid parameters discussed above every 8-12 weeks can ensure prompt treatment and thyroid function recovery.
Book an appointment with me here and lets start the investigation. Testing can take some time. Let's figure out the numbers together so you can start feeling your best!
Knezevic, J., Starchl, C., Tmava Berisha, A., & Amrein, K. (2020). “Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?” Nutrients, 12(6), 1769. https://doi.org/10.3390/nu12061769
So, when your gut is telling you something is off, go get checked. Your intuition is almost always right, even when you are stressed, exhausted, and feel like you have brain fog. Get your energy back so you can focus on being a confident mom!