It was January of 2017 and I can’t put into words how incredibly tired I felt every moment of every day! Some people might say being that tired is normal, as my kids were aged two and three, and I myself was turning 38 that December. I worked as a nurse, juggling three casual to part time positions in the public and private sector.
And our family had just lived through an overwhelming renovation of a 1982 home in the perfect neighbourhood – this caused us to move twice in less than three months (four times if you account for our wonderful friends allowing us to store stuff in their garages and basements!).
Between unpacking boxes and settling into new routines, I was also getting up for 6 am yoga and trying to meal plan. It didn’t seem to matter how much water I drank, sleep I got, healthy food I ate, or how active I was, my weight was on a steady climb in the wrong direction! By February of that same year, I had put on over 20 pounds and was feeling as sluggish as ever.
I’ve always been a healthy sized woman, average to most, but gaining so much weight so quickly left me feeling defeated to say the least. My youngest child was nearly two years old, and at this point I was hoping to be losing the baby weight, not continuing to pack it on! I figured I had two options in front of me: either I was pregnant with baby three and needed to start seriously thinking about minivan test driving; or there was something else going on behind the scenes.
Because I was still so tired and didn’t think my 37 year old body could handle another pregnancy, I did what any exhausted mother would do – I ran straight to my doctors office begging for a pregnancy test, full blood work panel, and an answer to my question, “Do I need to find out the black book price on my 2013 Tahoe?!”
To be completely honest, I’d always heard whispers about mysterious weight gain being caused by thyroid dysfunction, but I never thought that would be my answer. Low and behold, we weren’t expanding our family, my thyroid had crapped out, taken it’s foot off the gas so to speak, and the result was a whole pile of symptoms I now had an explanation for!
O Thyroid, Thyroid! Wherefore art thou Thyroid?
My family doctor described the thyroid gland as the foot on the body’s gas pedal, and it’s a key component of your endocrine system. Your body can either be heavy footed, called hyperthyroidism (in pregnancy this is usually caused by Graves’ disease and occurs in ~1/500 women); or light footed, called hypothyroidism (usually this is caused by hashimoto’s disease and occurs in ~3-5 out of every 1000 pregnancies). In both disorders, there is an autoimmune process happening, where the body starts attacking its own cells and organs resulting in a variety of symptoms [National Institutes of Health, 2012].
Symptoms of hyperthyroidism are often very similar to pregnancy and therefore easily go unnoticed; increased heart rate, heat intolerance, and fatigue. Other symptoms to watch for are rapid and irregular heartbeat, slight tremor, unexplained weight loss, failure to gain normal pregnancy weight, and severe nausea and vomiting.
Hypothyroidism, as you’d expect, is on the opposite end of the spectrum, resulting in symptoms such as; extreme fatigue, cold intolerance, muscle cramps, constipation, and problems with memory or concentration. I was experiencing 100% of these symptoms to varying degrees, yet my thyroid stimulating hormone (TSH) was only testing slightly higher than the normal range. I still need to request all my records and find out whether this was a pre-existing condition for me or something brought about by my pregnancies.
What does this mean to the Average Pregnant Woman?
As it turns out, your thyroid is pretty important for your baby during pregnancy, playing a big role in the development of their brain and nervous system. Around ~12 weeks of gestation, your babies thyroid will take over from yours, supplying all the hormone needed to continue functioning and developing in utero.
I found it interesting to note, that even though thyroid disease affects ~5% of U.S. women of reproductive age and has been associated with complications in pregnant women and their children [AACC, 2017], universal screening guidelines for thyroid disease are not standardized and under much debate. The experts do tend to agree that screening is recommended IF women are experiencing symptoms (listed earlier) OR if they have any of the following risk factors:
- Geographic area with iodine insufficiency (not usually an issue in North American diets)
- Personal or family history of thyroid disease
- Positive thyroid antibodies
- Type 1 diabetes and other autoimmune diseases
- History of preterm delivery, miscarriage, infertility
- Two or more previous pregnancies
- Prior or current amiodarone (heart rhythm medication) or lithium (bipolar medication) use
- Head or neck radiation exposure
- Morbid obesity: body mass index > 40
- Age older than 30 yr [CMAJ, 2017]
So where does that leave us – Let’s talk about Treatment
In December 2018, I was officially diagnosed with Hashimoto’s disease, an autoimmune disorder wherein there is chronic inflammation of the thyroid gland. Over time, this inflammation interferes with the thyroid glands ability to produce thyroid hormones. No hormones, means no foot on the gas, and one super tired mama among other things! I’m told that the damage to my thyroid at this point in the game is too significant to make a comeback, and I’ll be on synthetic thyroid hormones for the foreseeable future. If you are put on synthetic hormones, keep in mind that the body is slow to respond, so don’t expect to feel better over night! Check your blood work every 3-4 months until you achieve your “ideal level” and functioning, which will be different for everyone.
If you are diagnosed during pregnancy, be sure to keep taking your prenatal vitamins (they should contain iodine, zinc and selenium), strive to eat a well balanced diet, and follow the treatment plan your health care provider suggests.
Key point, sometimes, women are diagnosed with postpartum blues when it is actually a poorly functioning thyroid gland. If you feel unlike yourself after your baby is born, be sure to talk to your health care provider and ask for appropriate screening. Advocate for yourself, as you know your body best!
I hope you found this article helpful. Please reach out to your local Mama Coach for support with any questions you might have.