So, we’ve gone through the basics of Thyroid as well as the Diet to be maintained when you have a Thyroid imbalance. Today we’ll be talking about another sensitive topic pertaining to Thyroid and Pregnancy. As we know, the Thyroid is a key gland and the imbalance in this hormone causes havoc on our bodies. So its evident that during pregnancy, the situation needs to be well in control to avoid any mishaps like miscarriage or developmental issues of the fetus.
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I wanted to dedicate this post to my niece ( through marriage). Her mom had a thyroid imbalance (didn’t know it then) but she visited a Government hospital during her pregnancy (Don’t ask me why) and the doctor didn’t even bother with thyroid tests. The delivery was a hard one since the baby was quite large and after such a hard delivery they had a beautiful baby girl in their arms and nothing seemed to matter….until she turned 1yr and they realized she still couldn’t crawl and her baby babble was quite different. On visiting a child specialist, they came to know that this beautiful child was retarded. And apparently, this was all because the mother’s thyroid imbalance wasn’t detected and hence was left untreated for the duration of her pregnancy. Everytime I see that beautiful child with that bright smile of hers, it breaks my heart to know how tough life is for her and how much tougher it will be in times to come. Her mother just gave birth a second time last year and thanks to the medication which was carefully monitored throughout her pregnancy, the baby is normal and healthy. Moral of the story is….Ladies, pls don’t take your pregnancy or your health too lightly. Visit the proper doctor and don’t skip any tests even if you feel you’re as healthy as a horse.
Now let’s proceed to the post Right here, let me tell you that those with Hypothyroidism will still have an easier pregnancy than those with Hyperthyroidism. Want to to why? Read on to find out.
The most common thyroid disorder occurring around or during pregnancy is thyroid hormone deficiency, or hypothyroidism. Hypothyroidism can cause a variety of changes in a woman’s menstrual periods: irregularity, heavy periods, or loss of periods. When hypothyroidism is severe, it can reduce a woman’s chances of becoming pregnant. Checking thyroid gland function with a simple blood test is an important part of evaluating a woman who has trouble becoming pregnant. If detected, an underactive thyroid gland can be easily treated with thyroid hormone replacement therapy. If thyroid blood tests are normal, however, treating an infertile woman with thyroid hormones will not help at all, and may cause other problems.
Hypothyroidism and Pregnancy
Because some symptoms of hypothyroidism (tiredness and weight gain) are already quite common during pregnancy, it’s easy to overlook them. Blood tests, particularly measuring the TSH level, can determine whether a pregnant woman’s problems are due to hypothyroidism or not. So please don’t skip on this test.
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Since thyroid medications (particularly levothyroxine) are essentially identical to the thyroid hormone made by the normal thyroid gland, a woman with an underactive thyroid gland can feel confident that it is perfectly safe to take thyroid hormone medication during pregnancy. Don’t worry, it won’t harm your baby.
There are no side effects for the mother or the baby as long as the proper dose is used. In the case where hypothyroidism in the mother is NOT detected, the thyroid will still develop normally in the baby.
Women with previously treated hypothyroidism should be aware that their dose of medication may have to be increased during pregnancy. They should contact their doctor, who should check their blood level of TSH periodically throughout pregnancy to see if their medication dose needs adjustment. Typically, the Thyroid tests are repeated every 2 months of the pregnancy in case the imbalance has been detected just during pregnancy or if the levels seem to be fluctuating too much. If you already have been on medication and your Thyroid levels are relatively steady, then the tests may be done every trimester.
Post delivery, the medication dosage should be returned to the pre-pregnancy dose and thyroid function tests reviewed two months later.
Hyperthyroidism and Pregnancy
Hyperthyroidism refers to the signs and symptoms which are due to the production of too much thyroid hormone.
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An overactive thyroid gland (hyperthyroidism) often has its onset in younger women. Because a woman may think that feeling warm(akin to hot flushes), rapid heartbeat, nervousness, sleeplessness, or nausea with weight loss are just parts of being pregnant, the symptoms and signs of this condition may be overlooked during pregnancy.
In women who are not pregnant, hyperthyroidism can affect menstrual periods, making them irregular, lighter, or disappear altogether. It may be harder for hyperthyroid women to conceive, and they are more likely to have miscarriages. If a woman with infertility or repeated miscarriages has symptoms of hyperthyroidism, it is important to take the tests (T3,T4,TSH) to be sure. It is very important that hyperthyroidism be controlled in pregnant women since the risks of miscarriage or birth defects are much higher without therapy.
Fortunately, there are a lot of effective treatments available. Antithyroid medications cut down the thyroid gland’s overproduction of hormones. When taken regularly, they control hyperthyroidism within a few weeks. In pregnant women, thyroid experts consider propylthiouracil (PTU) the safest drug.
Because PTU can also affect the baby’s thyroid gland, it is very important that pregnant women be monitored closely with examinations and blood tests so that the PTU dose can be adjusted. In rare cases when a pregnant woman cannot take PTU for some reason (allergy or other side effects), surgery to remove the thyroid gland is the only alternative and should be undertaken prior to or even during the pregnancy if necessary.
Although radioactive iodine is a very effective treatment for other patients with hyperthyroidism, it should never be given during pregnancy because the baby’s thyroid gland could be damaged. So pls make an informed decision should you doctor make a similar suggestion.
Because treating hyperthyroidism during pregnancy can be a bit tricky, it is usually best for women who plan to have children in the near future to have their thyroid condition permanently cured. Antithyroid medications alone may not be the best approach in these cases because hyperthyroidism often returns when medications is stopped. So if you have Hyperthyroid, pls visit your doctor before you plan for a child. Remember, this is to ensure a healthy pregnancy and a healthy child.
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Radioactive iodine is the most widely recommended permanent treatment with surgical removal being the second (but widely used) choice. It is concentrated by thyroid cells and damages them with little radiation to the rest of the body. This is why it cannot be given to a pregnant woman, since the radioactive iodine could cross the placenta and destroy normal thyroid cells in the baby. There is no evidence that radioactive iodine treatment of hyperthyroidism interferes with a woman’s future chances of becoming pregnant and delivering a healthy baby. Hence, if the doctor recommends this treatment before you plan, be aware that it will not affect your chances of conceiving and will not effect your future child negatively.
I hope this has been a good read for all of you. Those with Hyperthyroidism should definitely take more care of themselves and prefer a planned pregnancy. Those with HypoT should also be extra careful especially since its easy to chalk your tiredness and sleeplessness as an effect of your pregnancy whereas it might actually be your thyroid levels giving you a warning.
Another major pressing point is to tell your doctor right away that you have a thyroid imbalance. Don’t hide it or keep it under wraps. Remember that this is extremely important and ommission of this info may be detrimental to your child’s development.
And lastly, if you’re having difficulty conceiving, don’t lose hope. It may take a bit longer to conceive than your friends, but it will happen. Just believe….
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Sources: 1, 2, 3,4, 5