According to Dr. Nguyen Van Manh - Department of Endocrinology, Central Military Hospital 108, during pregnancy, the mother's immune system tends to adjust to reduce activity to adapt to the fetus. After giving birth, the immune system returns to activity and can create an autoimmune reaction, causing the body to attack the thyroid gland itself.
Postpartum thyroiditis usually appears in about 3-12 months after birth. The incidence rate recorded in the world ranges from about 1.1-11.4%, depending on race, geographical area and the level of postpartum health screening of women.
The risk of the disease is higher in women with autoimmune diseases, especially type 1 diabetes, who have had natural miscarriages or have thyroid peroxidase (TPOAb) antibodies in their blood. Among them, women positive for TPOAb have a significantly higher risk of postpartum thyroiditis than those without this antibody.
Postpartum thyroiditis has relatively characteristic developments with two consecutive stages: hyperthyroidism and hypothyroidism. However, not all patients experience both stages fully.
The first stage is hyperthyroidism, which usually appears most clearly in the 3rd month after birth, from the first month to the 6th month, and lasts about 1-2 months.
The cause is inflammation that damages thyroid cells, releasing stored hormones into the blood. Patients may experience symptoms such as rapid heartbeat, palpitations, heart palpitations, fear of heat, profuse sweating, irritability or anxiety.
After that, the thyroid gland may enter the hypothyroidism stage, usually occurring around the 6th month after birth, in the period from the 3rd to the 8th month. When thyroid hormone levels decrease, patients may experience prolonged fatigue, constipation, poor memory, difficulty concentrating, reduced energy and manifestations similar to depression appear.
The similarity between these symptoms and sleep deprivation, stress or postpartum depression makes the disease easily overlooked. Therefore, cases of prolonged fatigue or abnormal signs of cardiovascular, mood, and concentration need to be assessed by doctors to determine the cause.
Most women with postpartum thyroiditis can recover thyroid function and return to a normal thyroid state in the second year after giving birth. However, the disease can still leave long-term consequences.
Currently, professional recommendations do not support mass thyroid function screening for all postpartum women.
Also according to Dr. Nguyen Van Manh, thyroid function tests in the 3-6th month after birth in the at-risk group can help detect the disease early. Accurate diagnosis is also very important to distinguish postpartum thyroiditis from Basedow's disease or postpartum depression.
Postpartum fatigue is a common condition, but it should not be assumed that all manifestations originate from lack of sleep or pressure to take care of children. When fatigue persists, accompanied by palpitations, rapid heartbeat, weight changes, constipation, reduced concentration, mood disorders or other abnormal symptoms, postpartum women should see a doctor for a comprehensive assessment.
