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Trudi's Story

Four months after the birth of her first baby, Trudi felt more tired than she ever remembered feeling before. She often felt depressed and anxious. However, she didn't pay much attention and attributed her symptoms to a combination of the demands of a new baby, postpartum blues and chronic lack of sleep. After another four months, she finally felt like her old self again.

About four months after the birth of her second baby, Trudi again began to feel the same kind of marked fatigue and depression and also noticed a painless swelling in the front of her neck. This time she consulted her physician. He found her thyroid gland to be enlarged and ordered some blood tests. These tests showed that Trudi's thyroid gland was underactive or hypothyroid. He prescribed synthetic thyroid hormone for her, which she took for six months and felt enormously better. One year after her delivery, her thyroid gland was back to normal, and she went off the medication.

Postpartum Thyroiditis

Trudi had been suffering from a condition only recently recognized by the medical profession called postpartum thyroiditis or transient thyroiditis. This condition is a disturbance of thyroid function where the gland becomes overactive or underactive or both, and then eventually returns to normal.

The thyroid gland is a small, powerful organ located in the neck just below the Adam's apple. It consists of two lobes with a central part between them giving it a butterfly appearance. It weighs a little under an ounce. This gland is the energy regulator of the body. It secretes hormones that determine the rate at which cells burn up food and oxygen to produce energy and body heat. The thyroid hormones also promote growth and development generally.

In a manner of speaking, during pregnancy, the immune system goes on holiday. This is so the mother won't form antibodies to her own baby. So women who have immune disorders will not have them flare up until after the pregnancy is over.

After birth, for reasons still poorly understood, one out of 20 women or more will have a disorder of the immune system and develop antibodies against her own thyroid glands (The immune system is the defense system of the body and forms antibodies against bacteria or viruses or anything foreign to the body). These thyroid antibodies cause some damage to the thyroid gland causing it to temporarily malfunction. The damaged gland then puts out higher than normal levels of thyroid hormone. This period lasts one or two months. Then for a brief period, the gland returns to normal. Then three to six months after delivery, thyroid hormones drop below normal. Finally, usually within a year after delivery, the thyroid gland usually, but not always, returns to normal.

Underactive Or Overactive Thyroid ?

When the thyroid gland malfunctions, it usually swells up. This swelling is called a goiter. A goiter may be associated with underactivity (hypothyroidism) or overactivity (hyperthyroidism).

Early symptoms of underactivity of the gland include:

• Fatigue, weakness, nervousness, constipation, intolerance to cold, sluggishness, hoarseness, and menstrual abnormalities. These symptoms are non-specific and may have a lot of other potential causes as well.

Later signs and symptoms include:

• Slow speech, modest weight gain, muscular aches and pains, chest pain, puffiness of the face and eyelids, dry skin, thin hair, thinning of the outer third of the eyebrows and slow heart rate.