Giving birth and looking after a new baby can be a miraculous, magical, rewarding, engrossing and exhausting roller coaster ride for a new mum. You are rushed off your feet by day, and awaiting the piercing alarm call of a baby’s cry by night – it’s no wonder that in the physical and mental maelstrom that has descended on your home, your old equilibrium feels difficult to recall. Did you used to feel so tired? Were you always this anxious? Did your muscles used to ache? In this disrupted state, it is not surprising that some symptoms that a new mum may be experiencing can be overlooked.
Mother-of-two Laura noticed some unusual symptoms soon after the birth of her first baby. She explains, “I started to lose loads of weight. It was dropping off me. I was in my pre-pregnancy clothes in no time, and soon they were too big for me. I thought it was a bit strange as you usually hear people talking about how hard it is to lose weight after a baby. I was also having trouble sleeping, but I put this down to the fact that I was up so often in the night, my body had either forgotten how to sleep properly, or just didn’t want to let me get too comfortable as it knew I could be woken up at any time. My heart was also racing, but I thought it might be because I was in a bit of a state of high alert as I was on such a steep learning curve, learning how to look after a new baby.”
With hindsight, Laura realises that she was experiencing some of the symptoms of postpartum thyroiditis – a condition that affects between five and ten per cent of new mums within the first year after childbirth. The condition occurs when the thyroid – a butterfly-shaped gland in the neck – becomes inflamed and the production and release of the thyroid hormone, thyroxine, fluctuates. Thyroid hormones play a vital role in regulating the body’s metabolic rate.
Figuring it out
Women can experience postpartum thyroiditis in three different ways. For some, it can start with a phase of “hyperthyroidism” where there is too much thyroxine in the bloodstream. This can result in symptoms of anxiety, insomnia, heart palpitations, weight loss, feeling hot, muscle weakness, a goitre (enlarged thyroid gland) and irritability. Sometimes, after a phase of hyperthyroidism, the thyroid gland recovers and returns to normal function. For others, the condition can begin with “hypothyroidism” where the thyroid gland does not produce enough thyroxine. Symptoms can include lethargy, weight gain, poor memory, depression, feeling cold, constipation, a goitre, or insomnia. For some women, the condition will begin with a phase of hyperthyroidism, followed by a phase of hypothyroidism.
Laura’s hyperthyroidism evolved to hypothyroidism. She explains, “Suddenly, I just felt overwhelmed with tiredness. I didn’t want to do anything – all I wanted to do was sleep, but when I went to bed at night, I couldn’t sleep. I didn’t feel as if I was on this planet. I was also gaining weight, and kept breaking down in tears.” Laura’s doctor diagnosed postnatal depression, and she struggled on and went back to work, but had to give up her job soon afterwards as she felt too exhausted to cope. “I just felt rubbish for ages,” she remembers. Laura had other symptoms, but at the time, did not see any of them individually as being worthy of a trip to the doctor. She says, “I had a puffy face, but I put that down to my weight gain. I had dry skin, but you wouldn’t go to the doctor’s just to tell him that. I also kept forgetting things, but I thought that could be ‘baby brain’. I also had constipation, but again I didn’t see that as serious.”
Eventually, Laura changed doctors and, after a blood test, was diagnosed with postpartum thyroiditis. She says, “Before, I had just looked at all the symptoms separately, but then they became pieces of a jigsaw that finally fitted together.”
Finding relief
Getting a diagnosis can be a relief, both because it confirms that the symptoms are real (and not just the anxiety or stress of caring for a new baby) and because effective treatments can begin. Although the symptoms of hyperthyroidism can be mild and may not require treatment, doctors may prescribe beta-blocking medication in some cases. For hypothyroidism, thyroxine might be prescribed, and after treatment symptoms may start to improve and you may be able to gradually stop taking thyroxine. Although the condition resolves within 12 to 18 months for the majority of women, some women will develop permanent hypothyroidism and will have to take thyroxine for life.
Laura is one of those women. She says, “Thyroxine [replacement] has been a life-changing treatment for me. I have to have regular blood tests, but I have gone on to have another pregnancy, which all went fine. I’m sure it’s not just because I’m more relaxed second time around, but with this baby I don’t feel like I’m under the fog that I was under last time – I can just enjoy my baby.”
