Hypothyroidism After Pregnancy
Hypothyroidism is an endocrine disorder characterized by low production of thyroid hormone. This is sometimes called thyroid hormone deficiency. It greatly affects women more than men, usually at ages between thirty five and sixty; however, it can occur in all ages at different stages of life. Women sometimes develop hypothyroidism after pregnancy, a condition called postpartum hypothyroidism, and is believed to be associated with postpartum depression.
Thyroid hormone is produced by thyroid gland. It circulates throughout the human body, and it plays an essential role in developing and differentiating all cells of the body. There are different types of thyroid hormones, all of which function mainly in regulating the metabolism.
Postpartum hypothyroidism develops within 4 to 12 months after childbirth and typically resolves without treatment. However, when symptoms are persistent, you must consult your doctor for proper medication. There is no need to worry though as this condition is not life threatening. The signs and symptoms to watch for include goiter or swelling of the thyroid gland, weight gain, hoarseness of voice, constipation, increased cold sensitivity, muscle cramping, fatigue, and depression.
During pregnancy, human gonadotropin (hCG) and estrogen levels increase. The hCG produced as the conceptus implants into the uterine lining rises in the early stage of pregnancy. This hormone stimulates the thyroid gland to generate more thyroid hormones. On the other hand, estrogen produced mainly by the placenta also increases, which in turn generates higher levels of thyroid-binding globulin. This protein acts as a carrier of the thyroid hormone into the bloodstream. This mechanism normally happens during pregnancy to aid in the babys development.
One to eight months after delivery, the mother is said to be in the preliminary hyperthyroid state wherein there is very high level of thyroid hormones in the blood. The normal functioning of the gland usually goes back to normal after this. However, in the case of lymphocytic thyroiditis, the gland enters into a hypothyroid state. Lymphocytic thyroiditis is an autoimmune disease wherein there is inflammation of the thyroid gland due to the lymphocytes infiltrating into the gland. It then alters the function of the gland, thus producing less thyroid hormones.
Since the main function of the thyroid hormone is to regulate metabolism, less amount of it leads to low energy among women who just gave birth. Thus, they may be sleeping too much but still wake up feeling unrefreshed. Hypothyroidism after pregnancy also causes the new mothers to gain more weight even with proper diet and exercise because their bodies are no longer able to process the extra calories. As a result, their moods may be affected. Due to the degree of mood change and fatigue experienced by women after delivery, they may end up being in a depressed state characterized by feelings of sadness and hopelessness, sense of worthlessness and guilt, lack of interest in taking care of the baby, appetite disturbance, mood swings, and anxiety.
Women experiencing the aforementioned signs and symptoms of postpartum hypothyroidism should consult their doctors to undergo diagnostic testing such as blood tests. In some cases, they may undergo an ultrasound to determine the presence of an enlarged thyroid gland. The treatment depends on the underlying cause and the severity of the condition. In mild cases, it would just resolve on its own after 4 months to a year. However, hormone replacement therapy may sometimes be needed. In severe cases, permanent hypothyroidism after pregnancy may occur if the thyroid gland is too damaged to regain its normal function. Therefore, ongoing monitoring and lifelong treatment will be required.
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