I’ve always found the topic of autoimmunity very fascinating, probably because it hit very close to home for me. My older sister was diagnosed with psoriatic arthritis a few months after giving birth to her son. She was in so much pain in her knees and elbows, she could barely get up from bed, making it almost impossible for her to hold her infant and care for him. But this was not the first time she had experienced joint pain. In fact, she had been dealing with this “undiagnosed” condition for years, albeit never at this level. She actually felt much better during her pregnancy with no signs of joint discomfort and was puzzled to see that her symptoms returned – with a vengeance- after birth.
Getting a diagnosis
Like most autoimmune diagnosis, it was during a severe postpartum flare-up that my sister was finally able to put a name to her condition. It is not uncommon for an autoimmune diagnosis to follow pregnancy and birth. A New York City survey showed that about half (45%) of women with Graves disease (an autoimmune condition that affects the thyroid), were first diagnosed during the postpartum period [1]. A Danish population study of a million women of childbearing age investigating postpartum autoimmune disease (AID) concluded that women who had been pregnant had a higher incidence of AID than those who had no pregnancy records. It also noted that the risk of AID was significantly higher during the first year after vaginal delivery and cesarean birth (15% to 30% respectively) [2,3].
Given this, you might be thinking that pregnancy causes autoimmune disease, but it’s actually believed that women who had predisposition, or beginning stages of an autoimmune disease, before or during early pregnancy (even if no symptoms were present at the time) are more likely to trigger, worsen or relapse during the postpartum period [4].
What happens during pregnancy
You see, during pregnancy, as early as the 8th day of gestation, a woman’s immune system gets suppressed, in order to promote tolerance towards the fetus. More specifically the Th1 (pro-inflammatory) arm of the immune system gets suppressed while Th2 remains active. This is why most women with autoimmune conditions feel great during pregnancy. After birth, however, starting at 3-6 weeks after delivery, the roles are reversed and the TH-1 arm of the immune system takes charge and kicks into high gear causing inflammatory responses that can worsen autoimmune diseases or cause a relapse.
Thyroid autoimmune diseases
Of the many kinds of autoimmune diseases that exist, the two that are most common in the postpartum period are thyroid-related. Mainly Hashimoto’s (hypothyroidism) and Grave’s disease. Unfortunately, many postpartum women do not realize that they have an autoimmune disease and for many, a proper diagnosis can take a long time to reach because of the complexities of the symptoms.
So what exactly is an autoimmune disease?
An autoimmune disease develops when your body’s immune system starts attacking itself. In a healthy immune system, the exposure to certain toxins, chemicals, infections, and allergens triggers antibodies to attack whatever doesn’t belong, but a compromised immune system can’t make the distinction between what is you and what is an intruder that needs attacking. The result is an immune system that has turned on itself and the body’s tissues.
The thyroid gland is at the center of the issues that develop in hypothyroidism and Hashimoto’s disease. It is the butterfly-shaped, complex, and sensitive hormone-producing gland that plays a role in many of our body’s functions, including body temperature regulation, energy production, and metabolism.
The most common cause for hypothyroidism is Hashimoto’s disease, which is an autoimmune disease that affects 14 million people in the U.S. It causes your body’s antibodies to start attacking your thyroid cells, which can lead to difficulty producing the necessary amounts of thyroid produced hormones [5].
What does Hashimoto’s look like?
Many of the symptoms for Hashimoto’s disease overlap with hypothyroidism:
These symptoms typically appear between 2 weeks and 6 months postpartum, which contributes to the fact that many new moms chalk it up to normal postpartum fatigue and stress and do not get the treatment they need.
Supporting Your Immune System
If you’re experiencing any of the above symptoms, it is important to get the proper testing done in order to determine the health of your thyroid. To rule out Hashimoto’s, a TPO and TBG serum antibody test can be done.
Once you know exactly what type of autoimmune disease you are dealing with, it’ll be possible to craft an individualized treatment plan that includes nutrition and supplementation that can help support your thyroid function.
The following nutrients have been linked to have beneficial effects for autoimmune thyroid conditions:
Selenium – Taking Selenium daily has been shown to help lower the thyroid antibodies. Food sources: Unshelled brazil nuts, tuna, calf liver, swiss chard, pork, brown rice, salmon.
Supplementation: Taking 200 mcg of Selenium daily is recommended (5).
Zinc – studies have indicated that supplementing with Zinc can improve thyroid hormone production. Food sources: seafood (especially oysters), beef, chicken, liver, cooked spinach, nuts, and seeds.
Supplementation: 25 mg once daily if testing shows a deficiency. The RDA is 12 mg for women (7).
Vitamin A – Vitamin A plays a role in manufacturing thyroid hormones, and any deficiency can lead to the reduction of active hormones. Food sources: The most concentrated sources of retinol are liver (beef, calf, chicken), pastured dairy, cod liver oil and eggs. Beta-carotene rich foods include lightly cooked spinach, kale, collard greens, winter squash, carrots, red bell peppers, sweet potatoes, and cantaloupes.
Supplementation: The RDA is 800 RE or 2,000-5,000 IU for women.
Other supportive foods, herbs, and nutrients:
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Vitamin D is especially helpful for Hashimoto’s because of its ability to restore healthy immune function and to suppress autoimmune activity. Food sources: fatty fish, liver, organ meats, lard, other seafood, butter, and egg yolks. Supplementation: The vitamin D council recommends a serum 25 hydroxyvitamin D level between 50-80ng/mL, and supplementing with 4,000 to 5,000 IU a day of cholecalciferol (D3).
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Essential Fatty Acids are essential for healthy hormone production and help to reduce inflammation in your body. Food sources: cold-water fish, fish oil, flax seeds, evening primrose oil, borage oil, and black currant seed oil. Supplementation: DHA + EPA. Try our Omega-3 DHA & EPA
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B-vitamins are necessary for hormone synthesis Food Sources: beef, chicken, fish, pork, organ meats, nutritional yeast. Our multivitamin includes absorbable forms of B vitamins [6,8].
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Ashwagandha is an adaptogenic herb that can increase thyroid hormone levels and protect the thyroid from cortisol-induced imbalances.
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Turmeric is an anti-inflammatory antioxidant with the potential to increase thyroid function. Try our Golden Collagen powder that contains a highly absorbable form of turmeric, curcumin (and it's delicious!)
Mother Nutrient offers a line of superfoods, probiotics, and nutraceutical supplements that can support and nourish your body with the necessary building blocks to feel better in the postnatal period. Take our 3-minute Wellness Quiz to find out which products you can benefit from, and explore our products page!
Recognizing symptoms and reaching out for help is the first step in improving your thyroid health. Talk to your doctor about your symptoms. If you want to learn more about ways to improve your postnatal experience, Mother Nutrient can help!
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How did pregnancy and birth affect your autoimmune conditions? Tell me in the comments!
Content found on this website is not considered medical advice. Please consult with a physician before making any medical or lifestyle changes.
1. Rochester D, Davies T. Increased Risk of Graves' Disease After Pregnancy. Thyroid. 2005;15:1287-1290.
2. Khashan A, Kenny L, Laursen T, Mahmood U, Mortensen P, Henriksen T, O'Donoghue K. Pregnancy and the Risk of Autoimmune Disease. PLoS ONE. 2011;6:e19658.
3. Andersen SL, et al. Hypothyroidism incidence in and around pregnancy: a Danish nationwide study, 2016
4. Singh N, Perfect J. Immune Reconstitution Syndrome and Exacerbation of Infections after Pregnancy. Clinical Infectious Diseases. 2007;45:1192-1199.
5.Bonnie Juettner. Diseases & Disorders Detroit: Lucent Books, 2010. COPYRIGHT 2010 Gale, Cengage Learning
6.Bauman, E., Friedlander, J. Therapeutic Nutrition. Penngrove, CA. Bauman College, 2015.
7. Murray, M., Pizzorno, J., Pizzorno, L. The Encyclopedia of Healing Foods. New York. Atria Books, 2005.
8.Pizzorno, J., Murray, M., Joiner-Bey, H. The Clinician’s Handbook of Natural Medicine. St. Louis, MO.
Fatigue
