Thyroid During Pregnancy - Everything You Need To Know

Thyroid During Pregnancy

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Are you are planning to conceive, or have just confirmed a pregnancy? Chances are, one of the first tests that your doctor will ask you to take is a thyroid check.

Thyroid during pregnancy is quite common. Mothers who are affected by thyroid during pregnancy can easily pass it on to their unborn baby. If left untreated, the disease can easily turn into something more serious. Hence it is extremely important that you understand about two specific types of thyroid disorders mainly hyperthyroidism and hypothyroidism in pregnancy clearly.

What Is Thyroid?

The thyroid is the H shaped endocrine gland that is located in your neck below a large cartilage of the larynx. It is 2 inches long and weighs less than an ounce. The thyroid gland produces, stores and releases hormones into the blood stream. These released hormones then direct the functions of the body’s cells.

There are two major hormones of thyroid gland namely, T3 and T4. These hormones help in brain development, breathing, metabolism and other major functions of the body. Increased levels of thyroid hormones in the blood cause Hyperthyroidism and decreased levels of thyroid hormones in the blood causes Hypothyroidism.

Thyroid disorders can be quite different in different people. It can range from simple, harmless goiter that needs no treatment to the abnormal release of thyroid hormones causing various harmful effects on you as well as the growing fetus. This disorder, if not treated in time, can also progress to life threatening cancer.

[ Read: Sinus During Pregnancy ]

Pregnancy Affecting Thyroid Function:

Thyroid during pregnancy can affect the health of you and your baby. Thyroid disorder is common in almost all women in their childbearing age. The impacts and ill effects of thyroid malfunctioning can exceed even after pregnancy. It affects neuron intellectual well-being of your newborn in an early age.

There are two major pregnancy related hormones, namely, Human Chorionic Gonadotropin and Estrogen. These increase Thyroid hormone levels in the blood. During the first trimester you supply thyroid hormones to the fetus through your placenta. However, as pregnancy progresses, at around 12 weeks your baby’s thyroid starts functioning on its own.

Hyperthyroidism In Pregnancy:

Generally, the immune system fights from infection and other foreign guests entering the body. However, in autoimmune diseases like Grave’s disease, the immune system attacks your body’s own cells, thus destroying them. Grave’s disease is an autoimmune disorder that causes Hyperthyroidism during your pregnancy. This makes an antibody with immune system known as Thyroid stimulating immunoglobin. This acts like a Thyroid stimulating hormone, releasing T3 and T4 more than the normal amount of Thyroid hormones. This condition is however rare. During the second half of pregnancy, temporary hyperthyroidism can be observed.

This dysfunction can be caused due to:

  • Grave’s Disease:

    It is an autoimmune disease in which your immune system attacks thyroid glands, causing it to produce T4 (thyroxine). Thyroxine is a hormone that is produced by your thyroid gland.

  • Toxic Adenomas:

    Nodules begin to develop in the thyroid gland and start secreting thyroid hormones, thereby disturbing your body’s chemical balance

  • Sub-Acute Thyroiditis:

    Inflammation of the thyroid causes your gland to leak excess hormones. Pituitary gland malfunctions or growth of cancerous cells in the thyroid region leads to excess secretion.

Symptoms Of Hyperthyroidism:

You can easily detect the disorder by keenly observing the symptoms of hyperthyroidism which are as follows:

  • Increased levels of thyroid hormones
  • Increase in size of thyroid
  • Fatigue
  • Nausea
  • Vomiting
  • Increased heart rate
  • Heat tolerance
  • Changes in appetite
  • Dizziness
  • Increased perspiration
  • Poor eye sight
  • Increase in blood sugar levels
  • Abdominal discomfort

Effects of Hyperthyroidism:

Uncontrolled and undiagnosed hyperthyroidism during your pregnancy shows various malfunctions in you as well as the fetus.

Here is a list of some of the most common ones:

  • Congestive heart failure
  • Severe elevation in blood pressure during your last month of pregnancy
  • Miscarriage
  • Premature birth
  • Low birth weight

If you have any past history of suffering from Grave’s disease, there are chances of TSI antibodies being available in your blood even if your thyroid levels are standard. TSI antibodies produced by expecting mother may travel across the placenta and pass to baby’s blood stream, thus stimulating the fetal thyroid.

However, if you are on anti-thyroid medications, chances of hyperthyroidism in your baby are gradually decreased as these medicines troubles your placenta. Thyroid problem in pregnancy leads to Hyperthyroidism in the newborn which inturn can lead to increased heart rate further leading to heart failure, early closure of soft spot in the skull, poor weight gain, breathing problems, etc.

Diagnosis Of Hyperthyroidism:

The Major basis for diagnosis of Hyperthyroidism in pregnancy is by examining your symptoms and by performing your blood tests to measure T3 and T4 levels in the blood.

There are three major tests that are performed. These are:

1. TSH Test:

If you have any symptoms indicating hyperthyroidism, the very first test usually performed is Ultrasensitive TSH test. Levels below normal of TSH are indicative of Hyperthyroidism. However, decreased levels of TSH in the bloodstream also occur in your pregnancy, especially during your first trimester.

2. T3 & T4 Test:

If T3 and T4 levels in the blood are high, it directly confirms the diagnosis.

3. TSI Test:

If you have a history of Grave’s disease, this test is performed to detect any existence of TSI antiseptic.

Treatment Of Hyperthyroidism:

The treatment of hyperthyroidism during pregnancy is limited as the safety of the growing fetus is a must. Sometimes there is a need to put you on medications to slow down your heart rate. However, if your TSH is low, but yourT4 is normal, it needs not to be treated.

What you need to remember?

Major hyperthyroidism is best treated with anti-thyroid medications, which decreases your thyroid hormone production.

  • There are many chances of causing side effects in people who intake anti-thyroid medications.
  • Antithyroid medications should be stopped at once if you start suffering from abdominal pain, fatigue, appetite changes, sore throat, fever or yellowing of skin or rashes.
  • You may also experience itching and rashes and reduced WBC counts in your blood stream. If you require higher doses of anti-thyroid medications to keep your hyperthyroidism in check, it is advisable not to breastfeed your baby.

Hypothyroidism In Pregnancy:

Decreased level of thyroid hormones in the blood causes Hypothyroidism. It is caused by inadequate functioning of the gland itself. Other causes include removal of the thyroid, radiation treatment, medications, pituitary diseases, etc. Endemic goiter and iodine deficiency are found to be the core reason for hypothyroidism.

Hashimoto’s disease, an autoimmune disorder responsible for thyroid in pregnancy, is a chronic inflammation of the thyroid gland. In this disease, immune system attacks thyroid gland, thus interfering with thyroid hormone production causing inflammation.

Symptoms Of Hypothyroidism:

Hypothyroidism is a common condition and may be undetected if the symptoms are mild. Often the symptoms of hypothyroidism are mistaken as symptoms of depression.

The common symptoms noticed in the majority of individuals are as follows:

  • Puffy and swollen face
  • Tightening of skin
  • Extreme fatigue
  • Slow pulse
  • Cold intolerance
  • Weight gain
  • Cramps
  • Abdominal discomfort
  • Lack of concentration
  • Increased level of TSH and decreased level of T4 generally indicates Hypothyroidism.

Effects Of Hypothyroidism:

Hypothyroid usually makes you inactive and you end up sleeping excessively for long periods of time.

Effects of Hypothyroidism are same as Hyperthyroidism including:

  • Anemia
  • Miscarriage
  • Low birth weight
  • Stillbirth

Uncontrolled hypothyroidism can lead to improper development of brain and baby’s growth as thyroid hormones are harmful to fetal brain and nervous system.

Diagnosis Of Hypothyroidism:

It is very important to take a review of signs and symptoms and measure your TSH and T4 levels in your blood.

Treatment Of Hypothyroidism:

Treatment of hypothyroidism is usually done with thyroxin, which is a medication similar to T4. Women with existing Hypothyroidism are required to take doses of iodine to prolong the thyroxin level. You should always keep a check on your thyroid levels.

Postpartum Thyroiditis:

It has been noticed that postpartum thyroiditis follows pregnancy. It usually involves either hyper or hypothyroidism or both sequentially. Postpartum thyroiditis affects almost every woman within a year after delivery. The condition usually starts with hyperthyroidism. Later, thyroid either returns to normal or develops into hypothyroidism.

For those associated with hypothyroidism and postpartum thyroidism, there are more chances of developing permanent hypothyroidism. This requires lifelong treatment.

Symptoms Of Postpartum Thyroiditis:

Following are the most common symptoms:

  • Typical symptoms of postpartum thyroiditis include tiredness, irritability and nervousness.
  • Hormonal changes may occur due to which hyperthyroid phase may go undetected.
  • If a woman tests positive for thyroid antibodies there are increased chances of developing symptoms associated with postpartum depression.
  • Other symptoms include anxiety, tremor, insomnia and other symptoms similar to those of hyperthyroidism.
  • These signs and symptoms typically occur one to four months after delivery and last for about one to three months.
  • This is followed by underactive thyroid i.e. hypothyroidism, including symptoms such as lack of energy, dry skin and symptoms similar to hypothyroidism.
  • Women diagnosed with postpartum thyroiditis develop symptoms of either hyper or hypothyroidism but not both.

Diagnosis Of Postpartum Thyroiditis:

This condition, mostly goes unnoticed by the practitioner. Utmost care should be taken in reviewing the symptoms of both hyper and hypothyroidism. This requires repeat testing of TSH levels.

For a safe and happy thyroid free pregnancy, you can keep a check on your thyroid levels. Consult your doctor if you observe any of these symptoms so that you can nip the problem in the bud.

We wish you a healthy and happy, safe pregnancy!

We would like to know about your experiences, please do share them with us.

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