Just about every day in my practice, a new mom breaks down in tears.

“I mean, I’m a new mom, it’s supposed to be hard and I’m supposed to be exhausted, right? I wish I could just toughen up.”

All too often I see these women blaming themselves for their fatigue, their hair loss, their difficulty losing weight, their postpartum depression or anxiety, their missing libidos, or the other new symptoms that appeared since baby’s birth.

But many of these women aren’t just tired because new moms are “supposed” to be tired. They’re exhausted because their immune systems are literally attacking their thyroids. This is a condition known as Hashimotos.

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How does this happen? What causes Hashimotos?

Hashimotos is an autoimmune condition in which a fired up and somewhat confused immune system launches an attack against the body’s own tissues.

Other autoimmune diseases include rheumatoid arthritis, in which the joints suffer; Type I diabetes, where the insulin-producing cells of the pancreas are under duress; Crohns disease, with its damage of the gut; and psoriasis, with its skin anomalies. In the case of Hashimotos, it’s the thyroid that’s under attack.

Many autoimmune diseases are triggered by the hormonal shifts and stressors associated with menarche, pregnancy, and menopause, so it’s fairly common to see Hashimotos present in a woman as she enters motherhood. (As if she didn’t have enough to juggle, right?)

So that’s about where the conventional medical doctor in America would end the explanation.

But it’s not the whole story.

Stress and Fatigue Tank the Thyroid

To better understand the thyroid, let’s take a quick detour and talk about the adrenal glands.

The adrenal glands sit above the kidneys and produce, among other things, a stress hormone known as cortisol. The more demand the body is under, the harder the adrenal glands work, and the more cortisol they produce. When these glands are worked too hard for too long, they become tired and work inefficiently. This state is often referred to as adrenal fatigue.

Conventional medicine does not acknowledge this state, although it’s rather simple and intuitive: if you work a gland too hard, it starts to fatigue and performs insufficiently. I see this in my practice on a regular basis when I check cortisol levels in new moms and see they’re either very elevated (usually in early new-mom-hood, when her body is responding to the high demand) or abysmally low (within a months or two later, once her adrenals start burning out from the stress).

The reason I mention this here is because there is cross-talk between the adrenal glands and the thyroid. The adrenals kick into gear when the body is under stress, or when the brain perceives danger. When this happens, thyroid function goes down, since metabolism isn’t nearly as important as survival. When the adrenals are working hard, the thyroid takes a back seat.

For this reason, it’s basic naturopathic knowledge to always treat the adrenal glands before and during treatment for the thyroid.

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Gluten Exacerbates the Process

It’s clear that gluten exacerbates autoimmune processes. More and more research is coming out explaining the nuances of how this happens.

Because one of the thyroid’s jobs is to controls digestion and metabolism, those with hypothyroidism tend to have compromised digestive integrity (often referred to as intestinal hyperpermeability or leaky gut). A leaky gut is very sensitive to the harmful effects of gluten.

When a person with Hashimotos eats gluten-containing foods like whole wheat bread, pasta, or a cookie, the protein found in gluten (known as gliadin) passes through the gut wall and into the bloodstream. Normally food proteins shouldn’t be passing into the bloodstream, so when this happens the immune system becomes triggered. Once this happens, every time the person eats gluten, their immune system makes antibodies to attack it, causing inflammation and further injury to the gut.

Furthermore, through a process known as molecular mimicry, the gliadin protein can resemble thyroid tissue. That means every time gluten is consumed, the gliadin antibodies become more robust, and attack not only the gluten in the gut, but also the thyroid gland itself.

If you have Hashimotos, eating gluten pulls the trigger on the guns pointed right at your thyroid.

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Signs of Hypothyroidism

Signs of poor thyroid function can include:

• Fatigue, malaise, and lethargy
• Low motivation
• Depression or anxiety (hypothyroidism is the most common organic cause of depression in adults!)
• Difficulty losing weight
• Constipation
• Dry skin or loss of skin luster
• Dry hair, slow hair growth
• Brittle nails, slow growth of nails
• Poor sleep quality
• Poor milk supply
• Fertility issues
• Loss of the lateral edges of the eyebrows
• Thickening of the tongue

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Testing for Hypothyroidism

Most doctors just order a TSH (thyroid-stimulating hormone) test, which is of little to no value by itself. Occasionally a free t4 level is also ordered, which gives more information, but not nearly enough.

The bare minimum testing should include: TSH, free t3, free t4, thyroperoxidase (TPO) antibody, and thyroglobulin (TG) antibody.

Ideally, a reverse T3 would also be drawn, as well as a DHEA-s test and salivary cortisol levels to assess adrenal function. And before I tell anybody to go gluten free, I insist on screening them for celiac disease (read my blog post on why here).

New moms are also at risk for anemia, which is so easy to diagnose and treat, yet so rarely checked for (a CBC and ferritin level are what I order).

I frequently see women with “normal” thyroid labs have very elevated thyroid antibodies and/or low cortisol levels on follow up bloodwork.

These are often the women whose endocrinologists have told them their labs look good and they’re just tired because having a baby is hard.

Nonsense.

These women are at the end of their ropes with an autoimmune disease that’s attacking their thyroids! They need help NOW!

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You Deserve to Feel Better

I’m here to do the testing your endocrinologist doesn’t believe in and treat the abnormal symptoms your OB says are normal. I can help scrape you off the floor.

I’ve salvaged many a new mom from the bottom of many a barrel. If you’re suffering, I hope you find your way to me or to another doctor in your area who understands functional medicine.

You deserve to feel better, and for your problems to be taken seriously.

Sure, you’re a new mom. Maybe you’re supposed to be tired.

…But you’re not supposed to beat yourself up while your immune system goes haywire and your thyroid tanks. Sure, motherhood is hard, and many new moms are tired. But if you’re living with autoimmune endocrine disorder, that’s another matter entirely, and one that requires functional medical care.

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