Signs and Symptoms Beyond “Postpartum Changes” by Cynthia Li, MD

Being a doctor, I thought I knew a lot about health and disease. Until I got sick myself.

I remember vividly the day I was walking home from Dolores Park, my babe strapped into the carrier on my chest. There was an intermittent flutter in my chest. Later that night, there was a soreness in my throat. Over the next few weeks, I lost weight. My muscles vanished. My face erupted with pimples, and hot flashes surged throughout my body. It felt as though puberty and menopause were hitting me at once.

Postpartum changes? Everyone I asked said so. Friends, family, even doctor friends. So I told myself, Sure, postpartum changes. I had nothing else to compare it to. My medical textbooks didn’t directly translate into lived experience.

This turned out to be the onset of postpartum thyroiditis, an autoimmune condition that occurs in 5-10% of mothers. Though most cases resolve in a year’s time-as mine did about 20-40% of women will go on to have chronic hypothyroidism, or an under-active thyroid gland-as I did, and then some. I was exhausted, dizzy, sleepless, and depressed. I felt like my body had betrayed me.

It Doesn’t Happen Overnight. I learned that chronic diseases, including any of the 80+ autoimmune conditions, usually start years, sometimes decades, before a diagnosis can be made. Sure, the enormous fluctuations in hormones during and after pregnancy can indeed trigger the immune system. But the hormones seem to be merely the trigger, so to speak, for a gun that was already loaded.

In hindsight, I see that I had symptoms of subtle imbalances during my medical training, college, and even as far back as adolescence, that might have increased the chances of autoimmunity. What are symptoms, but our bodies’ ways of communicating that something needs to change? So perhaps it was the other way around: by ignoring my body, I’d unknowingly been betraying myself.

Pay Attention. Some of the earliest signs of potential autoimmune disease: fatigue beyond the usual post-exertion tiredness. Joint stiffness, especially upon waking. Muscle soreness. Brain fog. Swollen glands. Swollen fingers. Excessive hair loss. All of these symptoms are common, in fact, with “normal” postpartum physiology. But regardless of a potential diagnosis lurking in the shadows, they can represent inflammation.

  1. See your doctor. Request a full thyroid panel (not just the TSH screening test), including thyroid antibodies.
  2. Try a 30-day elimination of gluten and dairy, which are two of the most common culprits for autoimmunity, as well as generalized inflammation due to “leaky gut.”
  3. Take care of yourself as you take care of your babe. Take a nap. Take a bath. Eat whole, nutrient-dense foods. Make yourself a green smoothie.
  4. Practice pleasure. Laughter and joy trigger our bodies’ own feel-good chemicals and relaxation hormones. In this state, healing happens as a side-effect.
  5. Inhabit your body. It’s easy to detach from our bodies when we’re not feeling well. But to heal, we need to ground in ourselves. Integrate yoga into your daily schedule, even if it’s 15 minutes twice a day. Be present. Don’t multi-task. Breathe through the challenge areas. If you’re too tired to do the poses, visualize yourself doing them. Healing is about flow and balance between mind, body, and spirit.

About the Author : Cynthia Li, MD, is board-certified in internal medicine and has worked in settings as diverse as Kaiser Permanente Medical Center, San Francisco General Hospital, and St. Anthony’s Medical Clinic for the homeless. She also volunteered with Doctors Without Borders in rural China, focusing on HIV/AIDS care. Her personal health challenges led her to integrative and functional medicine, and besides having a private practice in Berkeley, CA, she serves as faculty for the Healer’s Art program at the University of California San Francisco Medical School.

She is a contributor to Thrive Global and Psychology Today, and the author of a new book, “Brave New Medicine: A Doctor’s Unconventional Path to Healing Her Autoimmune Illness.” Learn more at or buy a copy of “Brave New Medicine”.

Jane Austin Yogi IconJane Austin is an internationally recognized Prenatal and Postnatal Yoga Teacher and Teacher trainer empowering women and pregnant people to trust their bodies as they transition into parenthood and beyond.

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