Thyroid Problems/Postpartum Imbalance
QUESTION: I just had my son via c-section 6 weeks ago and haven't felt the same since! The first 2 days after he was born I felt great, then on the 3rd I was released from the hospital and my milk came in. I started to get weak and dizzy and felt pressure in my head, I almost passed out so my husband called an ambulance. When they got there they checked my blood sugar and it was in the 50s (I found out I had hypoglycemia in high school but it rarely bothers me because I eat well.) My blood pressure was also 140/93, which is high for me. Everyday since then I have felt terrible with new symptoms. My first few days home I was tired, weak, nauseous, and lightheaded. I also had occasional headaches and pressure in my head and sometimes face. I was REALLY thirsty all the time and my eyes were really dry. I also had occasional ear pain or felt like my hearing was more sensitive than usual. I would wake up in the middle of the night covered in sweat and was having hot flashes. I went to the doctor and they did an EKG on my heart, that was fine. She also drew some blood checking my thyroid and other functions. Everything looked fine except I was borderline anemic and my liver enzymes were a little elevated. She told me to continue the prenatal vitamins. I started to think that maybe some of my symptoms were hormone related since it all started the day my milk came in. I was also eating like crazy, but could not get my hypoglycemia under control. I decided to stop breastfeeding my son and we started him on formula. Over the weeks since my son was born I have started to feel better, but I still do not feel like myself. I still have occasional headaches or pressure feeling in my head and sometimes face also. I sometimes feel like I have brain fog and can't focus or concentrate. I also still have dizzy spells, I don't feel like I am going to pass out anymore but sometimes feel off balance. I also occasionally have jumpy vision and it is hard to focus or read. I noticed that when I look in the mirror sometimes my pupils are actually pulsating and I feel like this is what is messing with my vision. I have an appointment with an Opthamologist in a few weeks to check. I went back to the doctor and she told me that I had allergies and that I could have Labyrinthitis. She started me on singulair, flonase, and high doses of Valtrex. I have noticed that since having my son I also seem to be more sensitive to medication because I have taken all of those medications before, however when I took them this time they made my heart race and I just felt funny the first few hours after taking each medication. I felt like the singulair and flonase were actually making the pressure in my head and face worse so I quit taking them. A new symptom that just started about a week and a half ago is that the top of my forehead to the middle of my scalp feels tight, like I am wearing a hat or something but I am not, sometimes it almost has a burning sensation as well. I recently had my 6 week check up and decided to go back on a low dose birth control pill to see if it would help the hormone imbalance. I took one pill on Sunday night and didn't really feel any different on Monday. Then, I took the pill Monday night and woke up in the middle of the night and could not go back to sleep. I felt funny, and was having chest pain, no trouble breathing, just a dull ache. I think I was having a little bit of an anxiety attack (another symptom that I occasionally get since having my son.) I was up for a few hours and finally fell to sleep only to wake up feeling nauseous and having abdominal pain. I went to my doctor and told her I really felt like something is off-balance inside of me, being that this all happened 2-3 days after my son was born. I am having all these random symptoms and am all of a sudden sensitive to medicine I have taken before. She agreed with me and decided to send me to an Endocrinologist for further testing. My appointment is next week. Until then she recommended that I continue the birth control, take zyrtec for my allergies and she prescribed me a low dose muscle relaxer to help with the scalp/forehead sensitivity and tightness ( which I am scared to take given how I am reacting to medication right now.) I also had blood work done again and am no longer anemic, and everything looked good except my liver enzymes were still slightly elevated. She said that could be due to the pregnancy. Could I have something wrong with my thyroid even though the blood test came back normal? My mom has always had issues with her thyroid and her tests always came back normal but they found a growth on hers and removed it, now she is hypothyroid. Is it normal to be more sensitive to medicine after having a baby, can hormones cause this? Can hormones cause all the symptoms above, even the head pressure and scalp/forehead feeling? I am desperate to get better and am trying my best to not lose hope. Thank you for any information you can provide!
ANSWER: Hi Mary,
Initial history of your case is suggesting postpartum pitutary necrosis. i.e. suffering of pitutary gland due to lack of blood supply after child birth. For confirmation I will need your blood reports. So do send Thyroid function test, Hb, Liver Function Tests any other test reports you have. Also because of pitutary necrosis there is possibility of adreanl glands getting over used quickly and getting exhausted causing hypoglycemia. Please tell how are your Menstrual cycles now? For how many days you could breast feed your baby? Did lactation stop? By the way your opthalmologist has rightly diagnosed it as labyrinthitis. Normally in labyrinthitis, there is vasovagal/parasympathetic response is seen from your body which might have made you sensitive to medicines. So did you get cured of labyrinthitis completely?
After going through info you provided, first impression i get is labyrinthitis was not managed properly and might have spread. Otherwise I dont see any reason for you having thyroid problems. Since you have familial history of thyroid, let us give a glance to thyroid also. Dont worry you will be alright soon :) Do send the info I have requested.
---------- FOLLOW-UP ----------
QUESTION: Thank you for responding These are the results of my blood work:
White Blood Cells 6.73K/uL
Red Blood Cells 4.33M/uL
Sodium 140 mmol/L
Potassium 4.1 mmol/L
Chloride 105 mmol/L
Carbon Dioxide 28 mmol/L
Calcium 9.5 mg/dl
Total Protein 7.0 g/dl
Albumin 4.6 g/dl
Total Bilirubin 0.4 mg/dl
Alkaline Phosphatase, S 148 H (H) U/L
Triiodothyronine, Free, Serum 3.1pg/mL
Free T4 1.23ng/dL
My breastmilk came 3 days after my son was born. I produced a good amount of milk and breastfed him exclusively for 3 weeks. I quit breastfeeding him because I was hoping that since this all started the day my milk came in I was hoping that if I quit all my symptoms would go away as well. I had my son 6 weeks ago and haven't started my period yet. I started birth control pills two days ago but they were giving me insomnia and making me feel very sick, so I don't think I am going to take them anymore. If I do have pituitary necrosis, what is the treatment for it? Will it go away on it's own? Will my hormones balance out on their own? Can this be what is causing all my symptoms including the pulsating pupils? Can this also cause my scalp/top of forehead to feel sensitive or like I have pressure/ tightness/almost a burning sensation at times?
From what my doctor told me about labyrinthitis it is viral and would have to run it's course. She did give a prescription of valtrex for a week. How could it have spread? What would the effects/symptoms of it spreading mean? How do I treat it?
I want so desperately to feel like myself again! I was fine the first 2 days after the birth of my son, I don't understand how my health could take such a turn so quickly. :( Thanks again for your help!
As you had told all your Lab results are within range except for Alkaline Phosphatase and blood sugar (hypo). The initial dizziness on third day can be attributed to blood loss during C section and you becoming anemic. Also several women experience the vertigo while or after lactation due to anemia and deficiency of nutrients. Did you have gestational Hypertension? or this was the first time you faced hypertension?
I had doubted pitutary necrosis but after seeing TSH value definitely that is out of question. I dont see any thyroid related hormonal imbalance either.
And labyrinthitis means infection of the inner ear. Since its close to meninges and brain, it sometimes can spread to meninges through auditory canal.
Please tell me are you working woman? when do you get headache? how frequent? time of the day you get it (any specificity? what part of head (only top of forehead)? is it associated with vomiting and nausea?
The most important question is are you sure you are experiencing pulsating pupils? does your physician know this?
How are you feeling today?