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Postpartum Thyroid or Hashimoto's ??

Bare with me on my novel..

Shortly after the birth of my fourth child ( August 2009 ) I began having frightening symptoms. I would feel very hot,shaky and had terrible anxiety, I really thought I was dieing. Serious!!. I also suffered terrible dizzy spells, confusion and a real lack of concentration. I actually forgot about cookies baking in the oven one day! This was really only a few of my worst symptoms. I had mentioned my symptoms a couple of times in my children's appointments but was told as a new Mom I was really tired and that sometimes after a bad virus ( I was sick when my daughter was born in August ) you can feel dizzy for months. I wasn't convinced.

It was about 3 months after my daughter was born all the symptoms came to head. I felt extremely weak and I almost dropped my 3 month old baby. I went right away to the clinic,  and they ran some blood-work. Again I was told I had four kids I was probably burning the candle at both ends and not to worry.. All was fine except my TSH was 0 and my T4s were approaching 40!!!  In Canada the ranges are 0.1 - 4.0 TSH and 9.7- 25.0 for T4 3.5 - 7.0 for T3 I had a ultrasound which showed my thyroid on the larger end of normal, but not a full on goiter by any means. I also have a nodule that had an FNA that was undiagnostic in 2006. There was nothing that showed. It has not changed and was not toxic

I was full on Hyperthyroid. I was referred to a internist right before Christmas who told me to quit nursing I should get a scan but he felt this was PPT ( Postpartum Thyroiditis ). I said no to weaning and he said I could wait 5 months at which time if I was still Hyper I would have to wean and get the uptake scan to rule out Graves. I was told the only help for me was beta blockers which I could not take while nursing or lots of rest because exerting myself would only exaggerate my symptoms.

Two months later in Feb, I suddenly felt great! For a whole week! :( I went in for blood work I was now borderline Hypothyroid. My TSH was 3.88 and my T4s had dropped to 9. It was like I was driving full speed down the highway and hit reverse. For months I suffered lagging symptoms of both Hyper and Hypo. Terrible symptoms, gastric pain, Migraines, hot and cold, the worst was the dizziness and brain fog which never went away.

Fast forward it is now February and year later from when I went border hypo.I occasionally have had fluctuating levels. My TSH being .06 to almost 4. Recently things seem to have stabilized. I am now technically euthyroid with elevated antibodies. I have still some lagging symptoms and my antibodies are still slowly creeping down. My thyroid levels are normal. My antibodies are 379 down from 462. ( Range is 0 - 34 )

I am not sure how long it takes for antibodies to go down but after much research it looks like I could have Hashimoto's. It is possible that my thyroid fluctuates a lot causing the ongoing symptoms. I cant help wonder now if the pregnancy triggered Hashimoto's, whether the PPT evolved into Hashimoto's or whether or not this is still just PPT resolving. It is now 18 months since I had my daughter. I was told that my situation PPT could last 2 years and some say it should have resolved in 6 months.?

I am slowly feeling better , I no longer have anxiety, and weakness. The fatigue has improved, and my brain fog. I still feel woozy however at times, not 100 % myself yet . I still suffer irregular cycles, ( 26 - 40 days ) and have terrible pains mid-cycle ( ovarian cysts are one suspicion, I do have an upcoming ultrasound to check on this ) which they believe to be related to the out of wack hormones. Either as a lagging affect or current symptom. I am looking into the research and looking for information from anyone who can talk to me about the benefits of being on thyroid or levothyroxine as a preventative to see if it helps resolve my case. I have found some suggestions that if this is Hashimoto's or even if it is thyroiditis, that a low dose thyroid may help to resolve, or if it is Hashimoto's , it could stop the progression and prevent me from going full on Hypo later on.

Sorry for the long novel but this is a short as I could make it. I hope I have provided enough detail that is understandable

If you have any info that you could share relating to my situation I would  gladly read it. I am really interested in the use of a low dose thyroid supplement and how it may be helpful... If my levels continue to sty elevated it will slowly destroy my thyroid. I need to do something.

I appreciate any insight anyone can offer!

Thank-you

D
8 Responses
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Avatar universal
Hi,
Your reg doctor can at least give you meds to deal with the symptoms until you can get into see an endo.  My anxiety was crippling with a new child (had PPT with both kids but didn't know what it was until before the second was on the way).  I also have the TPO antibodies. The endo told me it was highly unlikely that it would go away out of the postpartum period, but it would stabilize and have less swings back and forth.  I have a family history and it is genetic.  Not all drs are created equal - but- my endo has tried replacement synthroid on people without an abnormal TSH, but said that he really couldn't tell a difference with any of them, even with symptom control.  Not all drs use the same reference range with the TSH either, so make sure you research the current standards and compare your labs to it, rather than what your dr tells you.  You are your best advocate.  Also, research the autoimmune protocol diet.  It has some interesting and possibly helpful information.  I haven't taken the plunge, but I am considering it (its a temporary diet)
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Avatar universal
I know this is years later but what did you eventually figure out? I am suffering the same story as you. My endo is worthless and I am being referred to OSU to hopefully get some answers.
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Avatar universal
If either of the two main thyroid antibodies, TPOab (thyroid peroxidase antibody) or TGab (thyroglobulin antibody), is elevated, autoimmune thyroid disease is confirmed..  Only one has to be elevated.

You're right, the thyroid does sputter with Hash's, especially in the early stages.  There are often swings from hypo to hyper and back again.  

I understand your frustration...too often doctors ignore your symptoms, look at nothing but TSH and proclaim you "fine".  But, you're miserable...

I read your linked article.  I'd just point out that the study cited is from 2001 and included 21 patients.  Ten years later, apparently no large-scale study has replicated the results.  A study of 21 patients is preliminary at best.  Antibody levels swing wildly, even intraday, so a "decrease" or "increase" is pretty insignificant, especially when the magnitude is unspecified.  As one of the conclusions, the researchers SPECULATE that meds can stop the progression of the disease.  It's always a good idea when reading these kinds of articles to read the original study for yourself.

That having been said, I'm willing to bet that you'd feel better on meds.  Do you have your most recent FT3, FT4 and TSH with ranges?
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Avatar universal
I should also add they have done a CAT scan of my brain to rule out tumors O.o.. That was scary also.. Sigh
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Avatar universal
Hi

I have had all the tests you mention. I have had full adrenal testing as well. All is normal except my symptoms and my antibodies. It is so strange.I also had a full hormone work up all is normal for where I was in my cycle. ( mid cycle at the time) Ferritin, Calcium Regular CBC, LSH, FSH, Prolactin, Albumin, and the list goes on and on. My Vitamin D is good, B is good, iron, hemoglobin everything is good. Nothing is abnormal except the latter. However at one time I was fluctuating quite wildly. 0 TSH up 4 . Free T$ and Free T3 were all wonky at one time.

What were the symptoms of your fibroids. This is one of the things my doctor is looking for..because of my irregular cycles and mid cycle pains.

I want to say too that when I am sick and or over tired I notice symptoms tend to get worse.

Another question. My OB has said that he thinks I could still have fluctuating levels, that we are not catching. How would one catch these, how regular would you have to do the blood work. It drives me crazy when I need to push them to do more then just the TSH. Also if the thyroid fluctuates how long can symptoms lag for. I here varying results on this. That symptoms can last months and months after abnormal levels, I have also heard that the antibodies themselves could be contributing to the symptoms..??

Are you as confused as I am yet?

Thanks so much for the replies.. I am just so lost!
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Avatar universal
Hi ,

please see this article. I have found others but had this one linked.. I cannot remember the antibodies in paticular.. I believe it could have been Antithyroid Globulin.. I do know out of all the antibody levels this is the only one that is abnormal. I cannot find anything any where that supports PPT lasting this long. 18 months now. I am beginning to believe that this is Hashimoto's not simply PPT. It is my understanding that the thyroid sputters before Hashimoto's settles into hypothyroid permanently. The reason I ask about meds is I have found a few medical entries and articles that seem to support this. I have not yet been to an endo, refered to an endo nor have I been treated at all for any of this. It *****. I am desperately seeking anyone who may have gone through PPT or yes silent thyroiditis,  to see if their case is similer. It is a lost feeling when one feels like crud still and yet no one can give an answer as to why? I still have many of the hypo and hyper symptoms. Oops sorry for sounding snotty. Not my intention. I am very frustrated with things.. Almost to a breaking point.
http://thyroid.about.com/cs/endocrinology/a/antibodies.htm
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Avatar universal
"My antibodies are 379 down from 462. ( Range is 0 - 34 )"  Is this TPOab (thyroid peroxidase antobodies)?

In PPT, also sometimes called "silent" thyroiditis, antibodies are not elevated.

No thyroid replacement hormones (levo, Synthroid, Cytomel, Armour, NT, ERFA, etc.) are a preventative.  Replacement hormones relieve symptoms by raising your FT3 and FT4 levels, but they do not address the underlying cause.  Replacement hormones will help you avoid the symptoms of going hypo later on, but will not stop the progression of the disease.

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Avatar universal
First, I'd like to wish you the best of luck, in diagnosis and treatment of what is going on with you.  My journey also began with the birth of my child, and the intial symptoms were scary indeed.  Fast forward 20 years later, and let me give you a thought or two.  First, mine went from a mild, moderate linear synthroid treatment. And then, I developed fibroids and had a hysterecomy at 36.  The ups and downs began after about a year, and the levels and symptoms fluctuated in such a way, they thought it was due to the Hysterectomy or depression.  I also went through a thyroid nodule mystery, and FNA biopsy, and an ambiguous Diagnosis.
A sharp female Jamaiacan Doc ran better tests, and found the highs and lowsto be Hashimotos-Which is something you would want to rule out, or address, in your case.  B-12, Vitamin D, Anemia, many things factor into the treatment, because, Hashimotos, while a thyroid issue, is also an immune disorder, where your body attacks your thyroid, perceiving it a foreign body.  Stress, illness, and diet have a greater impact with this disorder.
It is all too often easy to mis-diagnos and dismiss the symptmos as bi-polar, since some symptoms are similiar, and the depression that accompanies feeling so tired, achy and unfocused can be misleading that it is mental not physcial.  Everything to do with Thyroid disorder starts as physical.  
So, here is my recent discovery, and I hope it helps.  

Ask for the full testing:  Test the TPO, the Thyroid Ab, Free T-3, Free T 4, Reverse T-3and ask for the Adrenal Saliva test.  Adrenal function is a separate but linked issue.  Also newly brought to my attention, is the more natural approach, with Armour Thyroid,.  I am about to explore all of this, with a more homeopathic medical doctor.  Best of luck to you, and I will post my own results, so as maybe to help others that are experienced this nightmare.

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