It’s no surprise that thyroid disease is frequently missed in new moms. After all, being a new mom is naturally exhausting! There are sleepless nights. Overwhelm. Anxieties about caring for a baby. Irritability from being tired. Sometimes there are challenges producing enough breast milk. Hormonal swings. In fact, feeling a little blue is even considered a normal part of the process.

And that’s when everything is going normally.

Add to that the possibility that you’re recovering from a cesarean, having significant breastfeeding challenges, or you’re experiencing unexpected health challenges with your new baby. You may be living far from family support, juggling school or work with being a new mom, and in the USA maternity leave, frankly, sucks, compounding the lack of attention that is sorely needed in that first year of having a new baby. Instead, we’re given 8 weeks to adjust and make plans for how we’re going to continue to produce milk, pump it, and feed it to our babies when we return to work, or our partner does. And you might have older kids and other responsibilities that don’t stop just because you’ve had a baby.

Who wouldn’t be tired?

It’s true, having a baby is incredibly demanding physically, and at the same time, we’re going through a tremendous amount of personal, psychological, emotional, and social adjustment. But exhaustion, feeling down, difficulty losing weight, intense struggle to produce enough breast milk, and hair loss aren’t always just a normal part of having had a baby. They can also be telltale signs of hypothyroidism – and struggling with hypothyroidism in the setting of being a new mom is like you’re already pushing a boulder uphill, and now someone has put iron balls around your feet, too! It’s an almost impossible weight to bear. And on the flip side, feeling anxious, having an insatiable appetite, feeling manic and unable to sleep, and losing a lot of weight are common signs of hyperthyroidism.

Tens of thousands of new moms in their first 12 months after birth are struggling with undiagnosed thyroid problems after pregnancy, their symptoms being mistakenly chalked up to the normal challenges of new motherhood. Without a diagnosis, they might be feeling alone, miserable, or crazy. They might be trying valiantly to produce enough breast milk but just aren’t, leading to anxiety, stress, guilt, and a lot of unnecessary hard work.

I know, because I’ve taken care of dozens of such new mommas – each who is relieved to discover that she is not stuck with her symptoms, and that her symptoms are happening for a reason: she has a thyroid problem!

 

Prefer to listen?  Check out this episode on my podcast, Natural MD Radio – What New Moms Need to Know About Thyroid Problems

Why Are New Moms Susceptible to Thyroid Problems?

New moms are especially susceptible to developing thyroid problems, particularly Hashimoto’s disease (hypothyroidism, or low functioning thyroid) and Grave’s disease (hyperthyroidism, or hyper-functioning thyroid), both autoimmune conditions that commonly occur in the first 12 months after giving birth. In fact, the chance of developing a postpartum thyroid problem is pretty high, with the reported rate of new cases as high as 17%, and much higher in women who already have an autoimmune disease, particularly Type 1 Diabetes. Thyroid problems after birth occur in as many as 42% of women who previously had postpartum thyroid problems, who already had hypothyroidism going into pregnancy, or who have elevated anti-TPO antibodies without a diagnosed thyroid disorder.

Why is autoimmune thyroid disease so common after birth? When the normal immunologic changes that kept you from rejecting your baby as an alien being while she or he was in your uterus start to revert back to normal after birth, they can play some nasty little tricks on your own body tissue leading to autoimmune disease that targets the thyroid, especially in women who are already genetically susceptible.

What are the Symptoms of Postpartum Thyroid Disease? 

Autoimmune thyroid disease tends to roll out in one of three ways in the weeks or months after birth:

  1. 20-40% of women become hyperthyroid around 1-4 months after birth
  2. 20-30% become hyperthyroid for two to eight weeks, then become hypothyroid for anywhere from two weeks to six months
  3. And 40-50% become hypothyroid only, usually between 2 and 6 months after birth.

The symptoms of hyperthyroidism often go unnoticed by the new mom, until she reverts to hypothyroidism, at which time thinking back on it, the hyperthyroid symptoms seem more obvious.

Symptoms of hyperthyroidism include:

  • Fatigue
  • Weight loss
  • Heart palpitations (a feeling that makes you hyper-aware of your heart beat)
  • Weight loss
  • Heat intolerance
  • Anxiety
  • Irritability
  • Tachycardia, and
  • Tremor

The symptoms of Hashimoto’s disease (hypothyroidism) include:

  • Fatigue, sometimes exhaustion
  • Cold intolerance
  • Constipation
  • Sluggishness
  • Dry skin
  • Joint pain (note that carpal tunnel syndrome may be related to hypothyroidism)
  • Decreased breast milk volume

Additionally, most women with postpartum thyroiditis have a mildly enlarged, non-tender thyroid gland. This might be something you feel – the thyroid gland is in the front of your neck (see image). thyroid_parathyroid_anatomy_enlarge
You may also notice some difficulty swallowing or fullness in your throat telling you that your thyroid is swollen. Thyroid size usually returns to normal with recovery. In some women, a swollen thyroid gland may be the only symptom.

What Tests Should I Get & What Should the Results Be?

A diagnosis of postpartum thyroiditis is based on your symptoms and thyroid function tests. While routine testing is not necessary for all women after baby is born, thyroid antibodies could be tested for in early pregnancy, and I do recommend testing all women at high risk at 3 and 6 months after birth. You are high risk if you have: a history of Type 1 Diabetes or another autoimmune condition; a history of thyroid problems including before this pregnancy, during this pregnancy, or after a previous baby’s birth; a history of high serum anti-thyroid peroxidase antibody before or during pregnancy; or postpartum depression (now or after a previous baby’s birth).

The tests I recommend are:

  • TSH (thyroid-stimulating hormone) – it will be very low in hyperthyroidism and high in hypothyroidism. Note that many practitioners will only treat for hypothyroidism when TSH exceeds 10 mU/L; in my practice I treat if there are symptoms and TSH is over 2.5 mU/L.
  • Free T4 – will be high in hyperthyroidism
  • Free T3 – might be low or normal in hypothyroidism
  • Anti-TPO (antithyroid peroxidase antibody) – will be elevated in autoimmune thyroid disorders.

Women likely to develop postpartum thyroiditis usually have high anti-TPO antibodies early in pregnancy, which decline as pregnancy progresses, and then rise again after birth, so this could be tested in early pregnancy and again after birth. A normal test doesn’t eliminate the risk of postpartum thyroiditis developing, but a positive test (high levels) increases the likelihood, so you’ll be prepared and know what to look out for. Read here to learn more about test results.

Conventional Approaches to Treating Postpartum Thyroiditis

Treatment of postpartum thyroiditis depends on whether there is hyperthyroidism or hypothyroidism, and how troublesome the symptoms are. It also depends on how your provider interprets lab results, particularly the TSH, so read on…

If you have no symptoms, but abnormal thyroid labs, for example, elevated anti-TPO antibodies, then medication therapy is conventionally not recommended; thyroid labs are simply repeated every 4-8 weeks until they return to normal, or if thyroid symptoms develop at any point, treatment is directed appropriately.

If you have symptoms of hyperthyroidism, these can be treated with a blood pressure medication (40 to 120 mg propranolol is the preferred medication if you are breastfeeding) which also quiets hyperthyroidism symptoms, until labs are normal. However, I prefer trying the herbs I discuss in the next section first. Your primary doctor can prescribe this medication for you; note that atenolol may be recommended instead of propranolol, but is not the best choice for breastfeeding moms. Radioiodine treatment and antithyroid drugs are not useful in postpartum thyroiditis, so are not advised.

If you have symptomatic hypothyroidism, thyroid hormone medication is the optimal treatment to get you feeling back to normal quickly, is safe while breastfeeding, and can make a huge difference in breast milk production if low supply is one of your thyroid symptoms. Levothyroxine (T4) at a dose of 50 to 100 mcg/day is usually recommended regardless of the level of TSH, though individual dosing adjustments may need to be made. Other medications, including Armour Thyroid, can be considered; it may take several attempts to find the right dose and medication that fully improves your symptoms and brings your TSH to a normal level (I recommend between 2 and 4 mU/L for optimization).

Functional Medicine and Natural Approaches to Treating Postpartum Thyroiditis

As a functional medicine doctor, I have access to a full range of options for treating my patients struggling with postpartum thyroiditis. Prevention is always the best medicine, and when problems do arise,  I find a combination of medications and natural approaches optimal for treating hypothyroidism, whereas with postpartum hyperthyroidism, because it is usually transient (though often turning into hypothyroidism), I use herbs whenever possible for relieving symptoms, while addressing underlying causes, as I do with all autoimmune diseases, and which I discuss below.

When there are elevated anti-TPO antibodies, I begin by reducing inflammation in the system and removing any triggers that increase the risk of developing thyroid disease, particularly gluten, because celiac disease can also develop at any time and is a known trigger of autoimmune thyroid disease. So at this point I recommend a strictly gluten free diet and the addition of Curcumin, the active ingredient in the anti-inflammatory herb turmeric, 1000 mg, twice daily. This is safe while breastfeeding.

Selenium supplementation, 200 mcg daily, may decrease inflammatory activity in pregnant women with autoimmune hypothyroidism and may reduce the risk of postpartum thyroiditis in women who are positive for anti-TPO antibodies, and can be started during pregnancy and continued into the postpartum to reduce risk. Iodine supplementation has not been found to be helpful in preventing postpartum thyroid disease, and in women with Hashimoto’s giving iodine might actually aggravate symptoms; however, all pregnant women should ideally receive 200-300 mcg of iodine in pregnancy for the development and health of the baby. This amount is routinely found in prenatal vitamins.

Circulating levels of vitamin D3 have been found to be very low in those with Hashimoto’s disease and other autoimmune conditions. Supplementing with vitamin D3 at 2000 units per day in pregnancy and up to 4000 units per day while breastfeeding, to achieve a serum level of 50-70nM, may help prevent or reverse autoimmune thyroid disease. Levels can be rechecked every 6 weeks to measure improvement in vitamin D levels and indicate when to stay at a steady dose or decrease the dose. (I don’t recommend exceeding serum levels of 70 nM.) Up to 6000 units of vitamin D3 per day can be continued during the postpartum period if you are breastfeeding instead of giving baby vitamin D3 directly.

An herb called Guggul (Commiphora mukul) has been shown to have positive effects in improving thyroid function in Hashimoto’s disease, increasing conversion of T4, the inactive form of thyroid hormone, to T3, the active form. This herb should not be taken in pregnancy, but 750 mg can be taken daily while breastfeeding; discontinue if baby has an tummy upset when you take the herb, and discontinue when thyroid levels normalize.

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Fluoride and bromide, the latter found in tap water and products made with tap water, and bromide, an additive to some breads and other foodstuffs, interfere with normal thyroid function, so I recommend avoiding these by using filtered water, non-fluoridated toothpaste, and reading labels to avoid bromides, before, during, and after pregnancy.

For hyperthyroidism symptoms, my go-to is to use herbs first for controlling symptoms whenever possible, rather than having mom take propranolol initially. The two most helpful herbs are Motherwort (Leonorus cardiaca) and Lemon balm (Melissa officinalis), 30-60 drops of the liquid extract of each, 2-6 times/day, safe while breastfeeding, to control irritability, agitation, anxiety, and heart racing. These herbs can be purchased from Herb Pharm or Gaia Herbs. If you are unable to use an alcohol extract, look for capsules of these herbs and take 1-2 capsules of each, 2-6 times/day as needed for symptom control.

Heavy metal toxicity has been linked to autoimmune thyroid disease. While I do not recommend any chelation (removal from the body using herbs, supplements, or medications) of metals in pregnancy or while breastfeeding – unless also elevated on conventional testing for lead or mercury, in which case this would be guided by your obstetrician or family doctor – if you have a history of postpartum thyroid problems, or thyroid problems in general, then testing for metals and eliminating exposures and chelating naturally if necessary is something you might consider doing 6-12 months before trying to conceive your next baby, or doing if you don’t plan to have any more children, to protect your thyroid from further damage.

BPA and other related chemicals can also have a deleterious impact on the thyroid; avoid plastic packaging when you purchase, store, and reheat your foods, and drink beverages out of glass, paper, and stainless steel only (not plastic). High levels of, or persistent stress, can also impact the adrenal system, with resultant effects on the thyroid, and gut inflammation, leaky gut, and food sensitivities in addition to gluten can trigger thyroid autoantibodies leading to autoimmune thyroid conditions.

Will I Always Be Hypothyroid & Have to Take Medication Forever?

Most women will recover from postpartum thyroid problems within 6-12 months, at which time medication can be weaned by half for a couple of weeks, and then discontinued. If symptoms persist beyond 18 months after onset, it is more likely that you’ve developed permanent hypothyroidism, and long-term medication might be needed. About 30% of women who develop postpartum thyroiditis develop permanent thyroid problems. For women who have fully recovered from postpartum thyroiditis, repeat thyroid testing within 5 to 10 years after the initial diagnosis, or should you develop symptoms of thyroid problems as described above.

What Can I Do About Low Milk Supply, Exhaustion, Anxiety, & Postpartum Depression?

If these symptoms are being caused by your hypothyroidism, which is quite likely, then optimizing your medication dose to bring your thyroid function into the normal range is going to be the easiest, quickest, and most effective thing you can do to resolve all of these symptoms. Your breast milk supply should increase, your fatigue improve, and your depression lift. If anxiety is being caused by hyperthyroidism, then the medication or herbs I mentioned earlier (motherwort and lemon balm) are a good option, along with breathing exercises, meditation, and yoga.

Adaptogens are a class of herbs that can help your body to not only regulate the stress response and improve your energy by supporting adrenal gland function, but can also help to reduce autoimmunity by shifting your immune system’s reactivity and reducing inflammation. To learn more about the adaptogens you can use, head on over to this article. Adaptogens are safe while you are breastfeeding and can be taken with thyroid medications. I generally don’t recommend Chinese ginseng while breastfeeding as it can be over-stimulating for the baby. I usually recommend continuing the adpatogens for a few months after all thyroid symptoms resolve.

If postpartum depression really has you down, in addition to supporting your thyroid by removing potential triggers of autoimmunity and starting on medication and supplements, consider the approaches in this article. While this article addresses depression in pregnancy, the therapies are applicable after baby is born. Also please be good to you and get a copy of my book Natural Health After Birth, where I take you on a journey of natural new momma care – it will give you a sense of support along with information and recipes to make being a new momma a bit easier.

Postpartum can be a challenging time for all new mommas, and especially so for women with hypothyroidism. The importance of postpartum care is almost completely overlooked in our culture. Having dedicated family or friend support not just in the first 8 weeks after baby is born, but also in the months to come, can make a huge difference in your energy and outlook. As women we’re notoriously bad at asking for help when we need it – now’s the time to get over that and let the people who love help you! If you are far from loved ones and don’t have strong community support, hire the help you need with housekeeping, errands like shopping, and consider a postpartum mother’s companion (doula) to help you with baby and household needs so you can get the rest you need.

Wishing you ease and health,

AJR Sig

 

 

 

Get the first chapter of my new book The Adrenal Thyroid Revolution, FREE right here.

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References

Amino N, Tada H, Hidaka Y, et al. Therapeutic controversy: Screening for postpartum thyroiditis. J Clin Endocrinol Metab 1999; 84:1813.

Azizi F. The occurrence of permanent thyroid failure in patients with subclinical postpartum thyroiditis. Eur J Endocrinol 2005; 153:367.

Beardmore KS, Morris JM, Gallery ED. Excretion of antihypertensive medication into human breast milk: a systematic review. Hypertens Pregnancy 2002; 21:85.

Caixàs A, Albareda M, García-Patterson A, et al. Postpartum thyroiditis in women with hypothyroidism antedating pregnancy? J Clin Endocrinol Metab 1999; 84:4000.

De Groot L, Abalovich M, Alexander EK, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012; 97:2543.

Gerstein HC. How common is postpartum thyroiditis? A methodologic overview of the literature. Arch Intern Med 1990; 150:1397.

Friedman, Micheal. Thyroid autoimmune disease. J Restor Med. 2013; 2(1): 70-81.

Kämpe O, Jansson R, Karlsson FA. Effects of L-thyroxine and iodide on the development of autoimmune postpartum thyroiditis. J Clin Endocrinol Metab 1990; 70:1014.

Lucas A, Pizarro E, Granada ML, et al. Postpartum thyroid dysfunction and postpartum depression: are they two linked disorders? Clin Endocrinol (Oxf) 2001; 55:809.

Lucas A, Pizarro E, Granada ML, et al. Postpartum thyroiditis: long-term follow-up. Thyroid 2005; 15:1177.

Mazokopakis EE, Papadakis JA, Papadomanolaki MG, et al. Effects of 12 months treatment with L-selenomethionine on serum anti-TPO Levels in Patients with Hashimoto’s thyroiditis. Thyroid 2007; 17:609.

Negro R, Greco G, Mangieri T, et al. The influence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies. J Clin Endocrinol Metab 2007; 92:1263.

Nicholson WK, Robinson KA, Smallridge RC, et al. Prevalence of postpartum thyroid dysfunction: a quantitative review. Thyroid 2006; 16:573.

Nøhr SB, Jørgensen A, Pedersen KM, Laurberg P. Postpartum thyroid dysfunction in pregnant thyroid peroxidase antibody-positive women living in an area with mild to moderate iodine deficiency: is iodine supplementation safe? J Clin Endocrinol Metab 2000; 85:3191.

Premawardhana LD, Parkes AB, Ammari F, et al. Postpartum thyroiditis and long-term thyroid status: prognostic influence of thyroid peroxidase antibodies and ultrasound echogenicity. J Clin Endocrinol Metab 2000; 85:71.

Premawardhana LD, Parkes AB, John R, et al. Thyroid peroxidase antibodies in early pregnancy: utility for prediction of postpartum thyroid dysfunction and implications for screening. Thyroid 2004; 14:610.

Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011; 21:1081.

Stagnaro-Green A. Approach to the patient with postpartum thyroiditis. J Clin Endocrinol Metab 2012; 97:334.

Stuckey BG, Kent GN, Ward LC, et al. Postpartum thyroid dysfunction and the long-term risk of hypothyroidism: results from a 12-year follow-up study of women with and without postpartum thyroid dysfunction. Clin Endocrinol (Oxf) 2010; 73:389.

23 Comments

  1. Thank you so much for this comprehensive article! Despite having normal labs recently (my baby is almost 6 months old), I believe I have been suffering from postpartum thyroiditis since he was about 6 weeks old. I am on the beta blocker and – because the allopathic doctors I have seen don’t want to do anything because my labs are currently normal, not sure what they were four months ago – I have been in the care of a great acupuncturist/herbalist. I thought I was losing my mind because nothing is “wrong” with me, but am grateful for your insight!

    • Hi Amelia,
      Thank you for writing! So happy you were able to identify what was going on for you super quickly so you realized you weren’t losing your mind at all! Hope you’re enjoying baby!!! The days can be so long with a newborn, but sister, I can’t believe that my oldest is 30 years old. Sounds so cliche but it goes so fast, even if it doesn’t seem like it right now. 🙂 Aviva

  2. Thank you so much for the work you do everyday and what you shared in your article. After my first son it was determined that I had had an “undiagnosed postpartum thyroiditis”. I swung from hyperthyroid to hypo, things then normalized after the first year, at about 18 months, and then I dipped into hypothyroidism at the beginning of my second pregnancy. Thyroid health was on my radar for baby number two who will be 1 year old in 3 weeks. That being said, my TPO antibodies still reared their little heads more so the second time around than after my first child. I just received my test results so the timeliness of your blog post in my email inbox is beautifully synchronistic. I love how that works. Thank you for this invaluable information! I am dedicated to supporting my health in the most natural ways possible and love your information.

    • There are a number of great companies with guggul products. Banyan Botanicals, Pure Encapsulations, and Planetary Formulas are all great!

  3. I just want to point out that treating hypothyroidism with natural desiccated thyroid meds, like Armour or Naturethroid, will almost always suppress TSH to “hyper” levels in order to get free T3 and T4 in the optimal range, which is what will reduce or eliminate the symptoms of being hypo. According to my immunologist, suppressing TSH is fine, and even desirable because it stops your body from attempting to make thyroid hormones by itself and your levels will remain more stable by taking the same amount of replacement hormones daily. Taking only enough NDT to get your TSH in the normal/optimal range means your hormone production isn’t suppressed completely, and your body will produce an inconsistent and inadequate amount of hormones that isn’t boosted enough by the replacement hormones to get rid of hypo symptoms. In fact, when I started NDT and hadn’t yet titrated up to the correct dosage, my free T3 and T4 were both lower than they were when I was unmedicated. And in my case, my TSH was already suppressed to very little at that point, so a lot of doctors would have said my dose was too high, not too low. Going up to the correct dose was a night and day difference in how I felt.

  4. I had my son (only child) 27 years ago. While pregnant, I gained 19 pounds but lost 11 before he was born, and then continued losing weight afterward. During pregnancy and thereafter, my life was topsy-turvy as my marriage was ending, so my emotions were extremely raw. After the birth, I experienced what I now know was postpartum thyroiditis but at the time my doctor said I had a UTI that must be spreading bacteria into my bloodstream, as well as mitral valve prolapse (which has never been mentioned by doctors thereafter) and causing sudden, horrible spells of pounding heart palpitations and feelings of extreme heat and as if I had been injected with poison that I could feel quickly spreading throughout my body. It was so frightening! My doctor put me on atenolol, which I take to this day 🙁 In my life thereafter, I was diagnosed with multiple sclerosis (another autoimmune disease), which is blamed for my severe and ongoing fatigue and depression, although I don’t have many severe symptoms of that. I have suffered quite few really traumatic events throughout my life, always resulting in massive and unintentional weight loss (the last trauma resulted in losing 30 pounds in less than 2 months). Since childbirth all those years ago, and after I finished breastfeeding, I remained making milk (galactorrhea) to this day, which doctors were never concerned about. My father had hyperthyroidism when I was a teen, and had radioactive iodine treatment, so is now hypothyroid. My mother is hypothyroid, as were both sets of grandparents. Cousins and aunts have had thyroid cancer. Since menopause and even with eating sensibly, I have gained a lot of weight (now 30# overweight) and continue with severe depression and fatigue. I am losing my hair and have lost most of my eyelashes on my left eye. I have had multiple doctors test my thyroid function, always at MY request (they never suggest it…?!?). Despite this strong family history, and all of my symptoms, my thyroid numbers, to the doctors, are “normal”. Nobody will treat me for thyroid dysfunction. With all of this lifetime of symptoms, I still believed the doctors when they said my thyroid was fine and so I wondered why in the world I had all of these symptoms, which in my mind could not ALL be ascribed to m.s.! It is only since I finally (recently) read a book on thyroid disease (The Thyroid Solution by Ridha Arem, M.D.) that I now know that I must have had thyroid disease for the past almost three decades. Still, my physician will not admit that I have a thyroid problem because my numbers are “within normal limits”. I know of no endocrinologists in my area (Baton Rouge, Louisiana) who are willing to treat based on symptoms rather than strictly by the numbers. I have begun taking Nutri-Meds Porcine Thyroid Health tablets, but don’t really know how much to take and am scared to overdo it. I am currently cutting one in half daily and letting it partially dissolve under my tongue before swallowing it (semi-sublingual, I suppose). I’ve been doing this for about a week but don’t feel any better. The bottle says to take no more than 5 per day. I am now retired on disability from the m.s., fatigue, depression and balance/walking issues, as well as severe spinal pain caused by a fall related to these symptoms and have very limited income, so can’t afford to buy this more than once a month. I will up the dose to taking 2 per day, but I just don’t want to overdo it and mess up things worse than I already have to deal with. I just want to feel better! If someone is familiar with this supplement and/or with functional doctors in my area, any advice would be so helpful. Thank you!

    • Hi Jessica,
      Sounds like you’ve been through it, sister! And that’s a lot to sort through on your own. I recommend looking on the website of the Institute for Functional Medicine for a practitioner in your community. If you are unable to find someone suitable, or would like to consult with me My NEW! Integrative TeleWellness Consultations may be a great option for you if you’d like to discuss your health and wellness concerns with an expert in Integrative and Functional Medicine for women and children, and you don’t have this option in your community, or if you are unable see me in western MA when my practice opens in late autumn (2015). Although I cannot diagnose you, order labs or prescriptions, or treat you without an initial in person appointment, I can provide a thorough discussion of your current health-related questions and concerns, including reviewing your health history and laboratory results, helping you to make sense of how you might bring an Integrative, Functional Wellness approach into your health and wellness goals.Based on our conversation and information you might provide ahead of time, I can offer a set of Integrative/Functional Medicine suggestions that you can discuss with your local doctors to see whether those would fit into your current health plan.

      If you would like more information, or to schedule an appointment, please go here:

      http://avivaromm.wpengine.com/integrative-telewellness-consultations

      If you would like to join my practice in the autumn, please check back on my website in late October for booking information.

      Wishing you the best of health!
      Aviva

  5. Aviva, I am so grateful to have found this post! Your natural pregnancy book was my go to handbook during my healthy first pregnancy. I recommend it to everyone I know that becomes pregnant. I have thoroughly enjoyed your postpartum book and “Naturally healthy babies and children” as well. I just want to point out that I scrutinized my prenatals which I am still taking postpartum (my baby is now 7 1/2 months old) and the Selenium is 50 mcg. The iodine content is 150 mcg. I recently looked at several other prenatals at the store and found that they contain equally low amounts of selenium. Is there a risk of toxicity from Selenium if I am eating a healthy gluten free diet and taking an additional 200 mcg of Selenium a day on top of my prenatal 50 mcg? Would you recommend switching to another pre/postnatal that has a lower dose of Iodine and higher Selenium content? I should also add that none of my thyroid labs were checked either in pregnancy or postpartum until last week. My TSH came back extremely elevated at 70.5, so I am encouraged that if I can try the suggestions you have proposed in addition to using a thyroid replacement hormone, like synthroid, I can alleviate many of the symptoms I’ve been having – fatigue, depression, low milk supply, irritability. Thank you again so much for the contributions you have made to pregnancy and postpartum wellness!

  6. I honestly found this article most helpful so far. I just had my second child and had a hyperthyroid 4 months after she was born. We retested 2 months later (now her being 6 mo old) and my TSH came back even lower(<0.01) .. I have been feeling pretty helpless with this whole issue. I have not been "diagnosed" with anything yet. I have never been diagnosed with any thyroid issue or autoimmune issues in the past and I am only 25 yrs old. I want to believe this is related to the pregnancy and my body will naturally regulate on its own, but to be honest I am kind of scared.

  7. It is vital for every woman who is struggling to become a mother or has experienced miscarriages before to get a thyroid diagnosis done as soon as possible. Take care of your health and ensure that your thyroid levels are good enough to sustain a healthy pregnancy.

  8. Absolutely loved your article. I recently have had my first baby. I happened to find out that i have hyperthyroid from the tests. Its been a very scary thing so far since i dont know of anyone in my family to have suffered thyroid relatex issues. I have booked to be seen by endocronologist. Hopefully things will get back fine. Ray of hope, your knowledge based article. Hugs.

    • Hi Rabia,

      Thank you so much for the kind words. Aviva sees each and every comment it means the world to her to hear that she has brought you hope! Best of luck and stay tuned for more on this subject in her new book due out early next year!!

      Warmly,
      Megan- Aviva Romm’s Executive Assistant and Online Nutrition Expert

  9. Hello, I wonder if you can help. I am 10 months postpartum. I was diagnosed hypothyroidism 5 months ago and since then I’ve been on Levothyroxin and my hormones are now stable. However, I still do not have my period back. I’m still breastfeeding but only twice a day. I read many stories about hypothyroidism or Levothyroxin causing early menopause, can that be true? I’m desperate to get pregnant again but wonder if that is at all going to be possible? Could you advise? many thanks

    • Hi Zuzana, Breastfeeding can still suppress your cycle, also get your thyroid levels checked. But no, this wouldn’t likely be a cause of early menopause at all! That would be highly unusual from either hypothyroidism or Levothyroxine. I do recommend waiting at least 18 months between pregnancies for optimal momma and baby health, though. 😉

  10. Aviva,
    Cannot thank you enough for having this informative and hopeful post. I was diagnosed with Hashimotos before my first baby and was on meds during the pregnancy and at the beginning of my 2nd pregnancy. Yet with my second I had to go off the meds in the first trimester with normal thyroid function, and did not need any more meds. Yet, about 4 months post partum I began to have hyper symptoms and now that my son is 9 months I finally was diagnosed with Graves. I am pretty confused and devastated to know I have both antibodies. I would love to get your help. My biggest concern is how Graves seems to have treatments that are so against holistic treatment with radioactive iodine?? I was not prescribed meds yet since my endo hopes things with get better after weaning my son in the next couple months. I am most upset since I was hoping to try for another baby soon, since I am an older mom. Yet, know that my thyroid must be in check to conceive and sustain a healthy baby. I would love to be a patient but you are very far and it would be a challenge. Any help would be so appreciated. Thank you so much for all you do!

  11. Thank you for this article! I recently watched “The Thyroid Secret”, and was concerned to see that my 3 month-old exhibits 5 symptoms of hypothyroid. Since she had a checkup scheduled a couple of days later, I asked for a thyroid panel to be done on her. I was told the results were normal, but I just got a copy in the mail and am horrified to see her TSH is 9.024! FT4 is 1.21, and FT3 is 3.7. Are the numbers different for a baby than for an adult?

    • Hi Beth!
      I am the nurse practitioner in Dr Romm’s practice, and I help out with answering comments and questions since Dr Romm can’t always get to all of them! Please remember that our answers are not meant as a substitute for medical care.
      Reference ranges often differ between labs and age groups, so we can’t comment specifically on your daughter’s results. Please reach out to your medical provider ASAP to seek assistance. We wish you the best!
      ~amanda, APRN

  12. Aviva–are lemon balm and motherwort safe to take during pregnancy? I’ve been unable to find an answer to this question. Thank you so much!

    • Lemon balm yes – motherwort no. And so sorry for the delay in responding! Just catching up on blog comments this morning!

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