Best Thyroid Doctor San Diego - Dr. Jason Shumard, D.C.
Post-partum thyroiditis (PPT) is a condition that affects 10-22% of women and is often attributed to the “post-partum” blues. It is caused by an inflammation of the thyroid gland that happens shortly after birth of the baby.
This syndrome causes the woman to feel moody, depressed and teary-eyed especially because she thinks something is wrong with her and it is her fault.
It is often not caught by medical professionals and the woman may sink into post-partum depression. The diagnosis is confirmed by the presence of TPOaB in blood.
Post-partum thyroiditis happens in two phases:
- The first phase starts 1 to 4 months after giving birth and typically last 1 to 2 months. In this phase, you may have signs and symptoms of hyperthyroidism because the thyroid gland has been damaged and it leaks the hormones into the mom’s blood.
- The second phase starts approximately 4 to 8 months after delivery typically lasting 6-12 months. In this phase, you may have signs and symptoms of hypothyroidism because the thyroid has been depleted of its hormones and it is trying to recover function.
Who is at risk for post-partum thyroiditis?
If you already have an autoimmune disease or Type 1 diabetes, this places individuals at higher risk. If you have ever had it before, have gestational diabetes or it runs in your family, you may be at risk. Also, viral hepatitis places a woman at high risk for post-partum thyroiditis.
Another risk factor is living in an area of iodine or selenium depletion. Living in a region of high iodine but low selenium intake is also a risk factor. Iodine and selenium needs should be met, but not exceeded during pregnancy.
How is post-partum depression treated?
This disorder is usually symptomatically treated. In the first phase when symptoms of hyperthyroidism may be predominant, medications to slow down the heart rate may be needed. In the hypothyroid phase treatment with thyroid hormone and antidepressants may be necessary to address the symptoms along with the usual weight gain that most women experience when they shift into phase 2.
In phase 2, a combination of cardio and strength training program should be well into place and counseling on eating a balanced low calorie diet be performed so weight gain is not excessive.
How can Functional Medicine help?
Nutritionally, the following labs may help the clinician develop a tailored nutrition support plan:
Want to minimize your risks? Ask your doctor to check (at least) the following labs:
- Rbc folate
- B12, methylmalonic acid
Many multivitamins now come with the methylated form of the B vitamins which is what the MTHFR refers to. RBC folate has to do with the amount of folate in the cell and a lack of folate, common in pregnancy, may cause symptoms of depression even before tell-tale anemia sets in. Homocysteine (as is hsCRP) is an inflammatory marker and there are many dietary and nutraceutical methods to get this marker down. Homocysteine is also a functional marker for the status of B6, B9 and B12 status, all important nutrients for mood state This marker is an indicator that your body is not in a healthy, balanced state and the depression is probably a reflection of altered bodily status.
B12 and methylmalonic acid are both related to nutrient deficiencies of which depression is a prominent symptom and can best be corrected by injections or sublingual administrations of B12.
HgA1C, if elevated, indicates hyperglycemia which often results in fatigue and depression. Attending to the hyperglycemia will often improve the mood.
B12, B9, and B6, all of which have been fingered as important nutrients for mood and brain health, are directly involved in the “one-carbon cycle,” which recycles homocysteine. Hence, low intake of these nutrients can promote inflammation and mood destabilization.
How many women will develop permanent hypothyroidism?
Although limited evidence exists globally as to how many women who develop PPT will go on to develop permanent hypothyroidism later in life, at least one of two studies available show that 50% will go on to develop and have to treat permanent hypothyroidism.
It is not clear that if the PPT is successfully treated if hypothyroidism is just as likely to reoccur or not, but any woman who has experienced PPT will tell you they are grateful for any treatment that provides relief from the deep dark tunnel they often feel they are trapped in as a result of dysregulated neurochemicals and hormones as well as prevalent nutrient deficiencies.
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