Your Thyroid While Youre Pregnant
There are a few ways pregnancy can be impacted if thyroid problems arent addressed first.
Increasing demands from a developing baby can occasionally cause new onset or worsening hypothyroidism for pregnant women.
Additionally, impaired thyroid function prior to and during conception can impact healthy brain development in the fetus. That said, T4 therapy through meds like levothyroxine can of babies born with a lower body weight and other complications.
As for pregnancy loss and miscarriage, theres been little evidence found to directly link hyperthyroidism to either. But one study did find that the risk of miscarriage is doubled with hyperthyroid women as compared to women without thyroid issues. In terms of hypothyroidism , there is evidence that suggests that inadequate treatment can lead to infertility, miscarriage, and adverse pregnancy outcomes.
After pregnancy, theres also an increased risk for postpartum thyroiditis, or inflammation of the thyroid this happens to five to ten out of every 100 women within the first year after childbirth. This can lead to temporary hypothyroidism, hyperthyroidism, or hyperthyroidism followed by hypothyroidism.
Thyroid Dysfunction And Reproductive Health
Thyroid function is regulated by the hypothalamus-pituitary axis , an interconnected duo made up of the hypothalamus and the pituitary gland . This pair is as thick as thieves when one of these organs sends a signal, it sets off a chain reaction in the other.
Because the HPA also controls the production of some of the most important hormones related to fertility, thyroid dysfunction can impact how much of those hormones are released. When any of these deviations from the status quo happen, they can disrupt menstrual cycles. Without the complete cycle, including ovulation, fertilization, and implantation, you cant get pregnant naturally.
As a result of these hormone changes, both hyperthyroidism and hypothyroidism have been linked to abnormal menstrual cycles.
All that said, getting a handle on your thyroid through treatment can reduce the chances of related fertility issues down the line. In one study of a group of almost 400 women suffering from infertility, 24% of participants were found to have hypothyroidism but within a year of treatment, 76% were able to conceive.
How Is Graves’ Disease Treated
Treatments for Graves’ disease lower the amount of thyroid hormone in your body or block the action of thyroid hormone. There are three main treatments for Graves’ disease:
- Antithyroid medicine. The Food and Drug Administration has approved two medicines for Graves’ disease: , or MMI and , or PTU. These medicines keep the thyroid gland from making too much thyroid hormone. They are often given to patients before thyroid surgery or radioiodine therapy. You cannot take MMI in the early stages of pregnancy, because it may hurt your developing baby.
- Radioactive iodine . RAI is a type of iodine that damages the thyroid gland by giving it radiation. The RAI destroys thyroid cells so that your thyroid gland cannot make as much thyroid hormone. This cures the overactive thyroid gland, but it can lead to underactive thyroid gland. If this happens, you will need to take thyroid hormone for the rest of your life.
- Surgery to remove all or most of the thyroid. As with RAI, surgery cures overactive thyroid but can lead to underactive thyroid. You will need to take thyroid hormone to replace the needed thyroid hormone that your body can no longer make.
All medicines have risks. You should talk to your doctor about the benefits and risks of all medicines.
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Can Hypothyroidism Impact Your Fertility
An underactive thyroid can affect your ability to conceive. Heres what to do if you have hypothyroidism and are trying to become pregnant.
This means hypothyroidism may make it difficult to conceive if youre planning on having children. A study published in August 2015 in the Journal of Pregnancy found that women with hypothyroidism were less likely to become pregnant and more likely to take longer to become pregnant than women without the condition.
Thats because women with hypothyroidism may not ovulate or ovulate with any regularity, and you have to ovulate to get pregnant, says Ingrid Rodi, MD, a gynecologist and reproductive endocrinologist at UCLA Medical Center in Santa Monica, California.
Hypothyroidism can affect fertility in men as well, according to the Thyroid Foundation of Canada. Although hypothyroidism is less common in men, those who do have an underactive thyroid may have low libido and low sperm count, according to a review of research published in November 2013 in Frontiers in Endocrinology in November 2013.
Trouble Getting Pregnant It Might Be Your Thyroid
Its a little gland in your neck shaped like a butterfly, but the thyroid is powerful. It regulates everything from body temperature to metabolism, but most of us never think about our thyroid until something goes wrong. In some cases, it can be an underactive gland that manifests as hypothyroidism and symptoms like hair loss or weight gain for others, its an overactive gland leading to hyperthyroidism and a rapid heartbeat or insomnia. And for a growing number of people, papillary thyroid cancer is the issue.
But some women have no idea their thyroid isnt working properly until theyre having trouble trying to conceive. Fortunately, with the right kind of diagnosis and thyroid treatment, its still possible for them to become mothers.
How Is Hypothyroidism Tested
The main test used to detect hypothyroidism is measuring blood levels of TSH. An elevated TSH level usually means the thyroid gland is not making enough thyroid hormone, and the pituitary gland has responded by making more TSH to try to get the thyroid hormone levels where they should be.
Other blood tests include measuring T4 and thyroid autoantibodies. Antibodies are substances made by your immune system, usually to protect you against bacterial and viral infections. Sometimes, however, the immune system can make antibodies against your own bodysuch as against your thyroid. T4 is a hormone produced directly by the thyroid gland. It is typically low in patients with hypothyroidism. An autoantibody is an antibody that attacks the cells and tissues of the organism that made it. Thyroid autoantibodies are seen in patients with Hashimotos thyroiditis.
What Should I Eat During Pregnancy To Help Keep My Thyroid And My Babys Thyroid Working Well
Because the thyroid uses iodine to make thyroid hormone, iodine is an important mineral for you while youre pregnant. During pregnancy, your baby gets iodine from your diet. Youll need more iodine when youre pregnantabout 250 micrograms a day.1 Good sources of iodine are dairy foods, seafood, eggs, meat, poultry, and iodized saltsalt with added iodine. Experts recommend taking a prenatal vitamin with 150 micrograms of iodine to make sure youre getting enough, especially if you dont use iodized salt.1 You also need more iodine while youre breastfeeding since your baby gets iodine from breast milk. However, too much iodine from supplements such as seaweed can cause thyroid problems. Talk with your doctor about an eating plan thats right for you and what supplements you should take. Learn more about a healthy diet and nutrition during pregnancy.
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Thyroid Disease And Fertility
Whether you suspect a thyroid problem or know you already have a thyroid issue, there are some significant symptoms associated with fertility. Below I have listed those symptoms in relation to fertility only. There are many other signs and symptoms associated with the below thyroid diseases. If you suspect a thyroid issue, please research each pattern of disease more and discuss it with your doctor.
For Patients With A New Diagnosis
Receiving a diagnosis of thyroid cancer may be unsettling, especially for women diagnosed while pregnant. Fortunately, pregnancy does not impact the long-term outcomes of thyroid cancer, and the vast majority face Stage 1 cancer. This kind of thyroid cancer rarely affects life expectancy and does not affect the health of the baby.
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Is It Safe To Get Pregnant If You Have Thyroid Issues
Not only is thyroid function important for getting pregnant it’s also very important for the health of your baby .
When you are pregnant, and your baby is developing, he or she will be dependent upon your thyroid function for a while.
This means that it’s important for you to have a fully functioning thyroid gland in order to prevent developmental issues while your baby is growing.
Babies born to women who do not have optimal thyroid function tend to have problems ranging from birth defects to neurological issues and even a lower than normal IQ after birth .
For these reasons, it’s very important that you optimize your thyroid function before you get pregnant!
So, is it safe to get pregnant if you have thyroid issues?
The answer is yes, but you must be treated appropriately to avoid issues during pregnancy.
Again, don’t let this information scare you but it’s important to have an understanding before you jump in.
Many women, each and every year, get pregnant and have children with thyroid-related issues and their babies are just fine.
But, if you want to give your child the best chance and best health outcomes later in life, then you want to pay close attention to your own thyroid function.
Icipants Of The Study
This study presents an analysis of a part of data gained in an experimental universal screening for AITD performed in years 20062009 . It consisted of measurement of TPOAb, TSH, and free T4 . FT4 was assessed only in women with pathological TSH and/or positive TPOAb. The laboratory assessment was performed in a single center . For the age analysis, we used data of 5223 consecutive pregnant women who were screened between 2006 and 2008. The cohort of screened women consisted of all pregnant women who primarily underwent screening for chromosomal abnormalities in the 912th gestational weeks in the cooperating gynecological centers the screening for chromosomal abnormalities is routinely performed in Czech pregnant women. Women were screened for AITD regardless of their history or symptoms. Ninety-nine percent of the women were of Caucasian origin. All participating women signed an informed consent form. The study was approved by the Ethical Committee of the General University Hospital and the First Medical Faculty of the Charles University in Prague.
How Does Hypothyroidism Affect My Fertility And My Baby If I Become Pregnant
Hypothyroidism can prevent the release of the egg from the ovary . Typically, for women who have periods each month, an egg is released from the ovary each month. But women who have hypothyroidism may release an egg less frequently or not at all.
Hypothyroidism can also interfere with the development of an embryo . This increases the risk of miscarriage. Also, if you are pregnant and your hypothyroidism is not treated, your baby may be born prematurely , weigh less than normal, and have lowered mental capacity.
It is very important for patients to have their thyroid hormones checked and receive appropriate treatment if they wish to have a baby or are already pregnant.
What Eye Problems Are Caused By Graves’ Disease
Graves’ disease can lead to an eye problem called Graves’ . It affects up to half of people with Graves’ disease. The main symptoms of Graves’ ophthalmopathy are eyes that seem to bulge out of their eye sockets, problems seeing, and irritated eyes.
Graves’ ophthalmopathy happens when cells from your body’s immune system attack the tissues around your eyes. The result is inflammation and swelling in the eye socket, causing the eyeball to bulge out. If left untreated, damage to the nerves in the eyes can also lead to blindness.
Smoking is the leading risk factor for Graves’ ophthalmopathy. Quitting smoking lowers your risk for developing Graves’ ophthalmopathy. If you already have Graves’ ophthalmopathy, quitting smoking can help your treatment work better.
Graves’ ophthalmopathy is treated with eye drops and eyeglasses, radiation therapy, or eye surgery. Your treatment will depend on how serious your eye problems are.
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What Tests Are Used To Check Thyroid Function
- with symptoms of thyroid dysfunction
- with their own or family history of thyroid disease
- with previous thyroid surgery
- who are severely overweight or obese
- who are aged 30 or older
If you feel you fit into one or more of the above categories, ask your doctor or midwife if your thyroid function should be checked.
What Does The Thyroid Gland Do
The thyroid gland produces two hormones: triiodothyronine and thyroxine . These hormones play an important role in metabolism. Metabolism is the bodys ability to transform food into energy. The thyroid gland is controlled by thyroid-stimulating hormone . TSH is produced by the pituitary gland, which is located in the brain.
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What Are Common Symptoms For Thyroid Problems
Common symptoms of thyroid problems can vary widely. People can experience weight loss or gain, fatigue, tremors, palpitations, abnormal heart rhythm , anxiety, depression, shortness of breath, heat intolerance, muscle pain, change in mood, eye symptoms and anemia, among other symptoms.
All of these can also be symptoms of other things, which is why bloodwork is the primary method for diagnosing thyroid conditions. If you’re experiencing these symptoms, be sure to mention them to your healthcare provider who can run diagnostic tests.
What Are Thyroid Nodules
A thyroid is a swelling in one section of the thyroid gland. The nodule may be solid or filled with fluid or blood. You may have just one thyroid nodule or many.
Thyroid nodules are common and affect four times as many women as men. Researchers do not know why nodules form in otherwise normal thyroids.
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How Is Graves’ Disease Treated During Pregnancy
During pregnancy, you may need to see an , a doctor who treats people with hormone problems. Your doctors will check your thyroid levels during pregnancy.
You cannot get radioiodine therapy during pregnancy. It can cause problems with your pregnancy and to your unborn baby. Your doctor may give you anti-thyroid medicine instead. Propylthiouracil is safe to take throughout pregnancy.
Also, your treatment may change during your pregnancy. For some women with Graves’ disease, symptoms are worse in the first trimester and then get better for the rest of the pregnancy as thyroid hormone levels change. Some women can stop taking anti-thyroid medicines in the last four to eight weeks of pregnancy if their thyroid activity becomes normal. Your doctor will check your thyroid hormone levels again after childbirth.
Can Thyroid Disease Cause Problems Getting Pregnant
Both hyperthyroidism and hypothyroidism can make it harder for you to get . This is because problems with the thyroid hormone can upset the balance of the hormones that cause ovulation. Hypothyroidism can also cause your body to make more prolactin, the hormone that tells your body to make breastmilk. Too much prolactin can prevent .
Thyroid problems can also affect the . Your periods may be heavier or irregular, or you may not have any periods at all for several months or longer .
How Do Doctors Treat Hypothyroidism During Pregnancy
Treatment for hypothyroidism involves replacing the hormone that your own thyroid can no longer make. Your doctor will most likely prescribe levothyroxine, a thyroid hormone medicine that is the same as T4, one of the hormones the thyroid normally makes. Levothyroxine is safe for your baby and especially important until your baby can make his or her own thyroid hormone.
Your thyroid makes a second type of hormone, T3. Early in pregnancy, T3 cant enter your babys brain like T4 can. Instead, any T3 that your babys brain needs is made from T4. T3 is included in a lot of thyroid medicines made with animal thyroid, such as Armour Thyroid, but is not useful for your babys brain development. These medicines contain too much T3 and not enough T4, and should not be used during pregnancy. Experts recommend only using levothyroxine while youre pregnant.
Some women with subclinical hypothyroidisma mild form of the disease with no clear symptomsmay not need treatment.
If you had hypothyroidism before you became pregnant and are taking levothyroxine, you will probably need to increase your dose. Most thyroid specialists recommend taking two extra doses of thyroid medicine per week, starting right away. Contact your doctor as soon as you know youre pregnant.
Your doctor will most likely test your thyroid hormone levels every 4 to 6 weeks for the first half of your pregnancy, and at least once after 30 weeks.1 You may need to adjust your dose a few times.
Graves Disease And Pregnancy
Men are advised to wait for 4 months before fathering a child if they have had radioiodine treatment. Women are advised to wait for 6 months before becoming pregnant after radioiodine treatment.
Although your thyroid function may be normal on Levothyroxine after being successfully treated by surgery or radioiodine, there may still be Graves disease antibodies in the blood even if your condition is well under control.
These antibodies can cross the placenta and cause temporary symptoms of Graves disease in the baby during the second half of pregnancy and for up to 2-3 months after delivery.
I hope you found this helpful. Please read my next post about morning sickness and pregnancy – you might be surprised to learn that this is endocrine related.
Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.
As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link
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