Maybe It’s Not Postpartum Blues

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3 Postpartum ENG

It is often a joyous occasion for the family when a new baby is born. But amidst all the joy, it can also be a stressful time for the mother as she adapts to caring for her newborn.

Many women have the baby blues following childbirth. You may feel sad, anxious or overwhelmed, have crying spells, lose your appetite, or have trouble sleeping. The baby blues most often go away within a few days or a week. The symptoms are not severe and do not need treatment.1

Some women may develop postnatal depression (PND) which is more severe and lasts longer than the blues. You may feel hopeless and worthless, and lose interest in the baby. These women often require treatment.1

Apart from the blues and PND, women could also develop postpartum thyroiditis (PPT), an inflammation of the thyroid gland, within the first year of giving birth although their thyroid gland was previously healthy. The exact cause of PPT isn’t clear but it is likely that women with this condition have an underlying autoimmune thyroid condition that flares after childbirth due to fluctuations in immune function.2

PPT is often a transient condition and might involve 2 phases, hyperthyroidism and hypothyroidism. With hyperthyroidism, women may feel anxious, irritable and have rapid weight loss. Those who develop the hypothyroid phase may feel lethargic, sensitive to cold and constipated.3

Hence, it is not surprising when women often mistakenly attribute the symptoms of PPT to the demands of caring for an infant, struggles with weight postpartum and drastic changes in routine that occurs with new mothers. Some women may even confuse PPT with postpartum depression. These may cause them to not seek medical advice .4

For most women who develop PPT, thyroid function returns to normal within 12 to 18 months of the start of symptoms.5 However, these women may have an increased risk of developing permanent hypothyroidism later in life.3 In some women, the thyroid is too damaged to regain normal function and their hypothyroidism is permanent, requiring lifelong treatment with synthetic thyroid hormone.6

Reference

  1. Postpartum Depression [Internet]. 2016 [cited 2016 Apr 28]. Available from: https://www.nlm.nih.gov/medlineplus/postpartumdepression.html
  2. Stagnaro-Green A. Postpartum thyroiditis. The Journal of Clinical Endocrinology & Metabolism. 2002; 87(9):4042–4047.
  3. Abalovich M, Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D, Mandel SJ, and Stagnaro-Green A. Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism. 2007. 92(8) (Supplement):S1–S47
  4. Pereira K; Brown AJ. Postpartum Thyroiditis: Not Just a Worn Out Mom. Journal for Nurse Practitioners. 2008;4(3):175-182.
  5. Mayo Clinic. Postpartum Thyroiditis: Definition [Internet]. 2013 [cited 2016 Apr 28]. Available from: http://www.mayoclinic.org/diseases-conditions/postpartum-thyroiditis/basics/definition/con-20035474
  6. National Institute of Diabetes and Digestive and Kidney Diseases. Pregnancy and Thyroid Disease [Internet]. 2013 [cited 2016 Apr 28]. Available from: http://www.niddk.nih.gov/health-information/health-topics/endocrine/pregnancy-and-thyroid-disease/Pages/fact-sheet.aspx#sup2