How To Treat My Postpartum Thyroiditis?

Postpartum thyroiditis (PPT) is a condition where the thyroid gland becomes inflamed after pregnancy. This inflammation can lead to a disruption in the production of thyroid hormones. As a result, thyroid hormone levels are not stable, which causes some worrisome symptoms.

Are you experiencing one or more of the following?

• Weight loss, despite increased appetite.
• Increased heart rate (palpitations).
• Feeling hot even in cooler temperatures.
• Anxiety and irritability.
• Fatigue and muscle aches.
• Difficulty sleeping.

Postpartum thyroiditis is primarily caused by an autoimmune response. In this condition, the body’s immune system produces antibodies that attack the thyroid gland, leading to inflammation.

This autoimmune response is similar to what occurs in Hashimoto’s disease, the most common type of thyroiditis. This autoimmune response is also present in Grave’s disease, which may then result in thyroid eye disease.

The exact cause of the autoimmune response after pregnancy is still being researched, but it is believed that underlying autoimmune conditions may be triggered or exacerbated by hormonal changes during pregnancy.

1) Hyperthyroid (overactive thyroid)

The hyperthyroid phase usually occurs within the first 3 to 6 months postpartum and lasts for about 1 to 2 months. Symptoms are:

• Weight loss, despite increased appetite.
• Increased heart rate (palpitations).
• Feeling hot even in cooler temperatures.
• Anxiety and irritability.
• Fatigue and muscle aches.
• Difficulty sleeping.

The symptoms of hyperthyroidism in Postpartum Thyroiditis (PPT) are generally milder than those seen in Graves’ disease (GD). Some women may be asymptomatic during this phase.

2) Hypothyroidism (underactive thyroid)

The hypothyroid phase typically occurs 4 to 8 months postpartum and can last up to 9 to 12 months. Symptoms are:

• Feeling extremely tired or weak.
• Feeling cold even in warmer temperatures.
• Unexplained weight gain.
• Aches and pains in the muscles and joints.
• Difficulty with bowel movements (constipation)
• Difficulty concentrating or remembering things.
• Mood changes, including depression.

The hypothyroid phase is more common than the hyperthyroid phase. It is experienced by up to 50% of women with postpartum thyroiditis.

There are some other conditions that may present similarly. They include:

• Graves’ Disease: Lifelong autoimmune condition causing hyperthyroidism. Graves’ Disease can be treated using Chinese Medicine. 
• Hashimoto’s Thyroiditis: Autoimmune condition causing hypothyroidism.
• Postpartum Mood Disorder: Similar symptoms to hypothyroidism.

The management of postpartum thyroiditis focuses on alleviating symptoms and restoring normal thyroid function. With your endocrinologist, you will likely be monitoring the ongoing changes in your thyroid gland and responding with either anti-thyroid medications or levothyroxine. 

When the patient is in the hyperthyroid phase, medications like methimazole or propylthiouracil are given to inhibit the production of thyroid hormones. The dosage of these medications is carefully monitored and adjusted as needed to ensure that thyroid hormone levels remain within a normal range.

When the patient is in the hypothyroid phase, thyroid hormone replacement therapy is the primary treatment option. Synthetic thyroid hormones like levothyroxine are administered to bring up thyroid hormone levels in the body. Levothyroxine is a synthetic form of T4, which the body converts into T3. 

By using these pharmaceutical interventions, the endocrinologist is able to help you maintain normal levels of thyroid hormones, until the body is able to normalize on its own.

At Soma Clinic, we treat postpartum thyroiditis using acupuncture. Because most patients are already being managed by their endocrinologist with Thyrozol, Carbimazole or Levothyroxine, we take on a supportive role in treatment.

In the hyperthyroid phase of postpartum thyroiditis, we use approaches to bring down ‘fire’ in the system, while using points in the legs to build ‘water’ and ‘earth’, which often results in the patient feeling more ‘grounded.’

In the hypothyroid phase, which often overlaps with Hashimoto’s in terms of symptoms, we adopt approaches by Professor Wang Le Ting, whereby points that map onto the radial nerve are used to bring down inflammation.

Some of these points have historically been selected in the treatment of goitre by ancient Chinese physicians. They include the attachment of the deltoid muscle on the humerus, as well as another point medial to radiohumeral articulation. 

From the 2024 research study, we know that:

1. TGAb levels were significantly lower in the acupuncture group after 16 weeks of treatment.
2. The reduced antibody levels lasted more than 8 weeks after the end of treatment.