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.
Preparing For A Successful Pregnancy With A Thyroid Condition
Dr Mark Vanderpump2018-01-04 on Thu 4Jan
If you have an undiagnosed thyroid condition it may make it difficult to conceive and can potentially cause some problems during pregnancy. So if there is any family history of thyroid problems or you have an irregular menstrual cycle or it has taken more than 6 months to conceive you may want to check for any potential symptoms on these patient advice sheets and consider getting tested.
If youve already been diagnosed with a thyroid condition, theres no reason why you shouldnt have a healthy pregnancy and baby. However, its important to let your doctor know a few months in advance of trying for a baby so that you can work together to optimise your outcomes before and during pregnancy.
If you think youve conceived before taking the advice of your GP dont panic. Your risk of complications will only be slightly higher than usual. Just let them know as soon as possible.
How Does Graves’ Disease Affect My Chances Of Getting Pregnant
Women with Graves’ disease often have irregular menstrual periods. If your periods are irregular, you may not ovulate each month, which can make it difficult to get pregnant.
In a man, Graves’ disease can harm the sperm, which can make it difficult for you to get pregnant.10
Treatment of Graves’ disease can often make your menstrual periods regular and restore fertility in women and men.11
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Hashimotos Disease Vs Hypothyroidism
Hashimotos is a disease, while hypothyroidism is a thyroid condition that can develop because of it. Not everyone with Hashimotos disease will develop hypothyroidism, but it is the most common cause. If you have an underactive thyroid, or too little thyroid hormone in your blood due to an issue like Hashimotos, the body is unable to function normally. Symptoms of hypothyroidism often include fatigue, weight gain, dry skin, mood swings and irregular periods causing infertility.
What Is The Thyroid
The thyroid is a tiny, butterfly-shaped gland in your neck. A gland is an organ that makes substances that help your body work. The thyroid makes hormones that play a big role in your health. For example, thyroid hormones can affect your heart rate and your metabolism .
Sometimes the thyroid gland makes too much or too little of certain hormones. When this happens, you have a thyroid disorder. Some women have a thyroid disorder that begins before pregnancy . Others may develop thyroid problems for the first time during pregnancy or soon after giving birth.
With treatment, a thyroid condition may not cause any problems during pregnancy. But untreated thyroid conditions can cause problems for you and your baby during pregnancy and after birth.
Work With Your Endocrinologist
Yes, thyroid conditions can complicate fertility, but they absolutely do not make it impossible. First and foremost, properly regulating your thyroid levels will usually solve fertility issues that are linked to your thyroid. Autoimmune conditions can complicate pregnancy, but not always, and there is plenty you can do to make your body a healthier, more balanced system. Remember that each case is individual. Find a thyroid specialist, and then develop an approach that works for you and your individual needs.
Control Hyperthyroidism Before Pregnancy
Your goal before getting pregnant is to stabilize your thyroid and reproductive hormones to regulate your menstruation and increase your chances of getting pregnant.
In most cases, managing hyperthyroidism involves one of the following treatment options:
Antithyroid medications can effectively balance thyroid hormones, but have to be carefully selected as some might be harmful during pregnancy.
Radioactive iodine is used to destroy the thyroid gland so it does not overproduce hormones. After radioactive iodine treatment, pregnancy should be delayed for six to 12 months to prevent serious complications.
Surgical removal of the thyroid gland or its parts leads to hypothyroidism, which is generally easier to manage with medications.
Keep a low iodine diet to provide your body with necessary nutrients, prepare it for pregnancy, and minimize the symptoms of hyperthyroidism. Focus on the following foods:
Avoid soy products, such as soy milk or tofu, as they have been shown to worsen the symptoms of hyperthyroidism and interfere with radioactive iodine treatment.
Vitamins and Supplements
Exercise is beneficial in managing hyperthyroidism and improving fertility as it increases blood flow to key reproductive organs.
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Take Charge Of Your Care
Dont assume that your fertility doctor will be on top of your thyroid issues. Surprisingly, some fertility doctors and clinics dont pay much attention to thyroid testing or the management of thyroid disease during preconception, assisted reproduction , or early pregnancy. Choose a fertility doctor who is thyroid-savvy and develop a plan to ensure that your thyroid disease doesn’t interfere with a healthy pregnancy.
How Is Hypothyroidism Treated During Pregnancy
Thyroid hormone replacement is used to treat the mother. Dosage of thyroid hormone replacement therapy is based on the individual’s levels of thyroid hormones. Thyroid hormone levels may change during pregnancy. And, the thyroid replacement dosing may also change. Thyroid hormone levels need to be checked every 4 weeks during the first half of pregnancy. The treatment is safe and essential to both mother and fetus. Routine screening for all newborns includes a test of thyroid hormone levels.
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The Importance Of Treatment
You should begin treatment right away when you’re pregnant and you become hyperthyroid due to Graves disease or thyroid nodules. Leaving hyperthyroidism untreated can result in high blood pressure, thyroid storm, congestive heart failure, miscarriage, premature birth, low birth weight, or even stillbirth. For pregnant and non-pregnant patients, treatment typically begins with taking antithyroid medications.
In cases where you’re already being treated with a low dose of antithyroid medication and your thyroid function is normal, your healthcare provider may take you off your medication, at least during your first trimester when your baby is most susceptible. You’ll need to be monitored closely, having your TSH and FT4 or TT4 checked every one to two weeks during the first trimester and every two to four weeks during the second and third trimesters, as long as your thyroid function remains normal.
Otherwise, if you’ve been newly diagnosed, you haven’t been taking antithyroid medication for very long, or you’re at a high risk of developing thyrotoxicosis , your dosage will likely be adjusted so that you’re on the lowest possible dose of antithyroid medication while still keeping your free T4 at the top end of the normal range or just above it. This protects your baby from overexposure since these medications are more potent for him or her than they are for you.
Too Much Thyroid Hormone Can Harm Fetus
< P> Miscarriage Risk May Be Higher, but Don’t Panic — It’s Manageable< /P>
Aug. 10, 2004 — High levels of thyroid hormones can have a direct toxic effect on fetal development, a new study shows. Women with thyroid problems should see their doctors — and get a blood test — right away, researchers say.
“Our data show a threefold to fourfold increase in the rate of miscarriage” in mothers with excess thyroid hormones, writes researcher Samuel Refetoff, MD, with the genetics and molecular medicine department at University of Chicago.
His paper appears in this week’s issue of the Journal of the American Medical Association . It comes on the heels of evidence published just a few weeks ago — showing that women with thyroid deficiency should increase their dosage each week when they learn they are pregnant until tests can be done to determine their exact needs.
There’s much at stake: During those early weeks, the developing fetus is totally dependent on the mother’s supply of thyroid hormone. Too little, and the risks to the baby include impaired mental development and even death. Because the impact on babies is so serious, newborns are routinely screened for this deficiency.
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Do I Need To Continue To Monitor My Thyroid Levels
It is important to have blood levels checked regularly even after the correct dose is found. Hypothyroidism is often a lifelong and progressive disease and the dose of thyroid hormone replacement may need adjustment.
Frequent monitoring is important if the dose of thyroid replacement hormone is too high, women may develop treatment-induced hyperthyroidism. This could cause heart palpitations, nervousness, and osteoporosis .
If you become pregnant, your doctor will need to monitor your blood every trimester as your levothyroxine dose needs may change due to pregnancy.
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.
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What Are The Common Signs Of A Thyroid Problem
Hypothyroidism, , is the most common thyroid disorder. Some of the common symptoms of hypothyroidism include:
Puffiness, especially around the eyes
On the other hand, hyperthyroidism, although less common, can still affect a variety of patients. Some of the common symptoms associated with hyperthyroidism include:
What Should My Thyroid Levels Be To Get Pregnant
When it comes to optimal thyroid levels during preconception, this is unfortunately a topic that has been long debated. If you recently had your thyroid labs completed and you are not pregnant, you may notice that the normal range is anywhere from 0.4-4.5 milli-international units per liter. The problem with this range, especially during preconception, is that your thyroid is extremely important during the first few weeks of pregnancy. In fact, during the first 10 weeks of pregnancy your babys brain development relies solely on your thyroid function. This is why it is actually NORMAL for your thyroid function to increase during pregnancy. Once the baby reaches 10 weeks gestation, the babys thyroid gland is developed enough to begin to produce its own thyroid hormones.
That being said, the minute you are pregnant, your doctor will want to make sure your TSH stays between 0.5-2.5, NOT 0.4-4.0 as it was previously when you were not pregnant. So how come two weeks before you get pregnant a TSH of 3.5 is totally normal but then, the minute you get pregnant your doctor will likely give you a thyroid medication to get you to the optimal 2.5 range? This is where there is still much debate however, for my patients who come to see me during preconception, I generally aim for their TSH to be 0.5-2.5 so that we know that their thyroid is well supported and ready for a health pregnancy.
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Will Thyroid Disease Affect My Baby
Learn about the treatment options for thyroid disorders while pregnant, and whether the condition will affect your pregnancy or baby.
If you suffer from a persistent thyroid problem, you may be wondering if you can have a successful pregnancy or if the medicine used to treat your condition will harm your unborn baby. Fortunately, most thyroid problems can treated safely, resulting in both a healthy mom and baby. Heres what you need to know about dealing with thyroid disorders during pregnancy.
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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Other Medications And Herbs
Some herbal supplements and medications can have an impact on thyroid hormone levels. They may affect your hormones by:
- Competing with the body’s thyroid hormone activity
- Increasing the effects of thyroid hormones
- Altering medication absorption and activity
Add A Comment12 Comments
hi i have just found out im pregnant..and i have an underactive thyroid…im on medication tyroxine 150mg to treat it but i went for a blood test and my doctor said the upper lim it of normal is 20. but mine is 22.something which he said is slighty over verging onto overactive and now im really worried what do you girls think any input would be great thanks
Congratulations on your pregnancy!
I am not sure what your question is, but whether you have hypothyroidism or hyperthyroidism, or some other thyroid condition, these can all be safely treated during pregnancy.
In fact, pregnancy can actually affect normal thyroid function .
Do you currently have any symptoms that are causing problems?What has your doctor recommended for treatment?
Please know that each lab is different, regarding what they use as their “normal” ranges. I am not sure what the blood test was checking for, and if you are at a “22” for TSH, T3, T4 or something else , but please know there are treatments available , and blood test results can be more difficult to read when you are pregnant, due to the “pregnancy hormones” .
You can read more about pregnancy and thyroid conditions at: National Endocrine Association
Please let us know what specific questions you have!
How Low Hypothyroidism Affects Ovulation
Though it is the most common type of thyroid disorder, hyperthyroidism isn’t the only problem a woman could have. Her levels could swing the other way in a condition called hypothyroidism.
With hypothyroidism, the thyroid gland doesn’t produce enough T3 and T4 hormones, which can affect a person’s metabolism in a completely different way than over-production. Some symptoms of the condition include weakness and fatigue, depression, brittle hair or fingernails and unintentional weight gain .
The most common cause of low thyroid production is a condition called Hashimoto’s disease, similar to Graves’ disease in that it’s an autoimmune disorder. With Hashimoto’s disease, the body’s immune system mistakenly attacks the thyroid itself, damaging the gland’s cells and reducing the amount of hormone it can produce .
With cases of hypothyroidism that are less severe, ovulation can occur normally, much like with hyperthyroidism. However, the condition has to be closely monitored and possibly treated if a woman becomes pregnant.
In addition, there is one type of hypothyroidism that is extremely dangerous both to women trying to get pregnant and those already carrying a child. Though rare, a condition known as myxedema coma can occur in women with hypothyroidism.
In a fetus, thyroid hormones are essential to brain and nervous system development. Left unchecked, the mother’s hypothyroidism could negatively affect the baby’s growth .