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Can You Take Thyroid Medicine When Pregnant

Natural Treatments To Improve Your Thyroid

Is it safe to take Thyroid medicine while Pregnant? | Hypothyroidism | Thyroid- Dr. Shefali Tyagi

So what can you do to help optimize your thyroid?

Believe it or not, there are actually many different natural therapies that you can take advantage of right now to help improve your thyroid.

Let me be clear though:

These options are not necessarily a ‘cure’ for your thyroid disease, instead, they should always be combined with thyroid medication if that is something that you need to be on.

These therapies are designed to help eliminate factors and variables which can be blocking your thyroid from functioning at 100%.

Natural treatments that you can use to improve your thyroid include:

Lastly, if necessary make sure that you take your thyroid medication!

You may find that you do better on combination T4 + T3 thyroid medications such as Armour thyroid or NP thyroid .

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When youre pregnant, your baby depends on your body to help her own brain and body develop. Sometimes, its easy to help your baby along, like making sure you eat healthy foods. In other cases, things happen that are beyond your control, and youll need the support of your doctor to keep you and your baby on a healthy course.

Thyroid problems, while rare, are one such example. When youre pregnant, the hormones hCG and estrogen raise the level of thyroid hormones in your body. This ensures that both you and your baby get an adequate supply.

But sometimes, the thyroid levels rise too high or fall too low. If this happens, it can be harmful for both of you. Read on to learn more about thyroid disease during pregnancy and what to do about it.

How Can Hypothyroidism Affect Pregnancy

Untreated hypothyroidism during pregnancy is linked to problems for women and babies during pregnancy and after birth.

Problems for women can include:

  • Anemia. This is when you dont have enough healthy red blood cells to carry oxygen to the rest of your body.
  • Gestational hypertension.This is high blood pressure that starts after 20 weeks of pregnancy and goes away after you give birth.
  • Preeclampsia
  • Placental abruption
  • Postpartum hemorrhage . This when a woman has heavy bleeding after giving birth. Its a serious but rare condition. It usually happens within 1 day of giving birth, but it can happen up to 12 weeks after having a baby.
  • Myxedema, a rare condition caused by severe, untreated hypothyroidism that can cause you to go into a coma and can cause death
  • Heart failure. This is when your heart doesnt pump blood as well as it should. Heart failure cause by hypothyroidism is rare.

Problems for babies can include:

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What Can Cause Hypothyroidism To Appear During Pregnancy

During pregnancy, your body uses more thyroid hormone to keep up with the needs of your growing baby. So pregnancy itself actually makes hypothyroidism more likely, and previous miscarriages or preterm deliveries may be a sign of hypothyroidism. Women who take a thyroid medication may need a new dose that is 25% to 50% higher once they become pregnant. If not, their thyroid hormone levels may drop. If you become pregnant, your provider will check your hormone levels throughout your pregnancy and make adjustments, if needed.

  • Dry skin and hair

  • Constipation

The American College of Obstetricians and Gynecologists guidelines say providers should not routinely test for hypothyroidism in pregnant women. They only recommend testing for women who have related risk factors or symptoms. So always tell your provider how youre feeling and give them a full rundown of your medical history, including medications you take, how your previous pregnancies turned out, and if you have any family members with hypothyroidism. They will follow up and order blood tests, if necessary.

What Should I Eat During Pregnancy To Help Keep My Thyroid And My Babys Thyroid Working Well

Can a woman with thyroid problems get pregnant?

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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How Is Hypothyroidism During Pregnancy Treated

The treatment for hypothyroidism is often referred to as thyroid hormone replacement therapy. It uses the medication levothyroxine to bring your thyroid hormone levels back up to normal. According to the Food and Drug Association , levothyroxine is safe to take in pregnancy. What is unsafe is having hypothyroidism.

Levothyroxine is available in different forms and brands, including:

    As we mentioned, women who take thyroid medications will usually need a higher dose during pregnancy, but hyperthyroidism is also dangerous to an unborn baby. Just remember, never change the dose of your thyroid medication without your provider first.

    If you have a history of thyroid issues, the sooner you see your doctor the better ideally, even before trying to conceive. This way, your doctor can make sure your hormone levels are normal as you prepare for pregnancy.

    The Vague Symptoms Of Thyroid Disorders

    Thyroid hormone regulates metabolism and helps many of our organs to function. Because of this, thyroid problems can cause a wide range of vague symptoms:These symptoms are non-specific and similar to those of a number of other conditions. Some of them also can be related to the rigors of a womans everyday life. Youre busy with family, work, friends, etc. Of course youre tired at times. When theres so much to do that working out or making healthy meals seems impossible, your weight can creep up.I sometimes see patients who when their thyroid hormone test comes back normal admit that they sort of hoped they had a thyroid disorder. It could have been a simple explanation for fatigue and weight gain. Taking a pill may seem easier than making lifestyle changes when theyre so busy already.But, of course, we dont want you to suffer needlessly. Thyroid conditions often can be diagnosed with a blood test to measure thyroid hormone levels. See a doctor if your symptoms:Aside from making you feel sluggish and generally unwell, thyroid disorders can affect family planning as well.

    • Abnormal bowel function
    • Changes in mood
    • Occur in combination
    • Have no identifiable cause
    • Are out of proportion to what you think they should be for example, if youre more tired than you normally would be in your daily activities
    • Dont go away

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    Management Of Hyperthyroidism During Pregnancy

    Treatment for hyperthyroidism is very specific for each patient. The goal of treatment is to maintain normal levels of thyroid hormone. Treatment may include:

    • Frequent monitoring of thyroid levels throughout pregnancy
    • Use of anti-thyroid drugs that help lower the level of thyroid hormones in the blood
    • Surgery to remove part of the thyroid

    Portuguese Family Helps Shed Light

    Can thyroid during pregnancy affect baby? | Thyroid Effects on Baby in Pregnancy- Dr. Shefali Tyagi

    In their study, Refetoff and his colleagues focused on a unique family with an inherited syndrome involving thyroid hormone. It’s known as thyroid hormone resistance.

    Those who get this mutation produce more thyroid hormone than normal, he explains. However, the excess is normal for them — so they don’t have increased metabolism, heart rate, and other problems usually caused by excess hormone levels.

    Continued

    For women inheriting this genetic mutation, pregnancy can be problematic. If her baby does not inherit the mutation, her excess thyroid hormones will be excessive for the fetus, Refetoff explains. This group of women “represents a very unique opportunity” to study this problem, he says.

    His research group analyzed medical records for 167 members of this family, including 36 couples. They compared pregnancies of “affected mothers” or “affected fathers” against those without the mutation — looking at miscarriage rates, and at newborns’ birth weights and thyroid hormone levels.

    The couples’ miscarriage rates were as follows:

    His data shows that high levels of this hormone “can exert a direct toxic effect on fetal development,” writes Refetoff. “It is important to recognize that overreplacement appears to be … detrimental.”

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    Managing Pregnancy With An Underactive Thyroid

    If a mother-to-be isn’t producing enough thyroid hormone because of hypothyroidism, her baby’s health is at risk.

    Those raging pregnancy hormones that make you feel moody and have you going to sleep at 8 p.m. every night aren’t the only pregnancy hormones you should be concerned about.

    When you’re pregnant, your growing baby relies on you for everything, including the hormones that your body naturally produces to keep both your bodies healthy and functioning properly. And if you have untreated hypothyroidism, or underactive thyroid, your baby might not be getting what it needs to grow and thrive during your pregnancy.

    Are You At Risk For Having A Thyroid Condition During Pregnancy

    Youre at higher risk for a thyroid condition during pregnancy than other women if you:

    • Are currently being treated for a thyroid condition or you have thyroid nodules or a goiter. A goiter is a swollen thyroid gland that can make your neck look swollen.
    • Have had a thyroid condition in the past , or youve had a baby who had a thyroid condition
    • Have an autoimmune disorder or you have a family history of autoimmune thyroid disease, like Graves disease or Hashimotos disease. Family history means that the condition runs in your family . Use the and share it with your provider. The form helps you keep a record of any health conditions and treatments that you, your partner and everyone in both of your families has had. It can help your provider check for health conditions that may affect your pregnancy. If you have a family history of thyroid or autoimmune conditions, ask your provider about testing.
    • Have type 1 diabetes. Diabetes is a condition in which your body has too much sugar in the blood. Type 1 diabetes is a kind of preexisting diabetes, which means you have it before you get pregnant. If you have type 1 diabetes, your pancreas stops making insulin. Insulin is a hormone that helps keep the right amount of glucose in your body.
    • Have had high-dose neck radiation or treatment for hyperthyroidism. Radiation is a kind of energy. It travels as rays or particles in the air.

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    Facts About Hypothyroidism And Pregnancy

    Hypothyroidism is a condition marked by an underactive thyroid gland and may be present during pregnancy. Many symptoms of hypothyroidism are similar to pregnancy symptoms. For example, fatigue, weight gain, and abnormal menstruation are common to both. Having low thyroid hormone levels may even interfere with becoming pregnant or be a cause of miscarriage.

    How Do Doctors Treat Hypothyroidism During Pregnancy

    How to 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.

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    Be Prepared For Your Current Medication Regime To Change

    Once someone with a pre-existing thyroid condition becomes pregnant, the Endocrine Society has guidelines for doctors to follow when it comes to adjustments in thyroid medication during pregnancy:

    • If you had hyperthyroidism before getting pregnant, your healthcare provider may prescribe antithyroid medicines called propylthiouracil in the first trimester and change to medications called methimazole in the second and third trimesters. The timing of these medications is important to reduce the risk of liver problems and birth defects.
    • If you had hypothyroidism before getting pregnant, you may need to increase your medication dosage and/or change to a new medication. Levothyroxine is the most common medicine used to treat hypothyroidism during pregnancy. Its safe to take this medicine during pregnancy.

    If all of these changes seem a little overwhelming, specialists like Dr. Chaudhary are here to support you by helping you do the following things:

    • Obtain insurance approval for your new medications.
    • Enroll in financial assistance programs.
    • Coordinate delivery of your medications.
    • Get counsel on your new medication regimen.

    Thyroid Disease In Pregnancy

    LEO A. CARNEY, DO, Naval Hospital Pensacola Family Medicine Residency Program, Pensacola, Florida

    JEFF D. QUINLAN, MD, Uniformed Services University of the Health Sciences, Bethesda, Maryland

    Am Fam Physician. 2014 Feb 15 89:273-278.

    Thyroid disease is the second most common endocrine disorder affecting women of reproductive age, and when untreated during pregnancy is associated with an increased risk of miscarriage, placental abruption, hypertensive disorders, and growth restriction. Current guidelines recommend targeted screening of women at high risk, including those with a history of thyroid disease, type 1 diabetes mellitus, or other autoimmune disease current or past use of thyroid therapy or a family history of autoimmune thyroid disease. Appropriate management results in improved outcomes, demonstrating the importance of proper diagnosis and treatment. In women with hypothyroidism, levothyroxine is titrated to achieve a goal serum thyroid-stimulating hormone level less than 2.5 mIU per L. The preferred treatment for hyperthyroidism is antithyroid medications, with a goal of maintaining a serum free thyroxine level in the upper one-third of the normal range. Postpartum thyroiditis is the most common form of postpartum thyroid dysfunction and may present as hyper- or hypothyroidism. Symptomatic treatment is recommended for the former levothyroxine is indicated for the latter in women who are symptomatic, breastfeeding, or who wish to become pregnant.

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    Always Be Your Own Advocate

    Because providers may differ in their screening practices, its important to be your own advocate on this from the very beginning. Always share your thyroid health history at your very first prenatal appointment. Experts say testing for serum TSH abnormalities should be done by your ninth week of pregnancy or at the time of your first visit.

    How To Tell If You Have A Thyroid Problem

    Can You Get Pregnant with Thyroid Problems?

    It’s fairly easy to diagnose thyroid-related issues, as long as you have a little bit of knowledge.

    Because of the important role that your thyroid plays in many systems in the body, it’s often difficult to miss the diagnosis.

    The symptoms associated with hypothyroidism are relatively easy to diagnose and hard to miss.

    The more nuanced cases, such as those who only have minor thyroid dysfunction can be more difficult to spot, but the more obvious cases are rarely missed.

    The symptoms of hypothyroidism include:

    • Fatigue
    • Weight gain
    • Hair loss

    It’s important to understand, though, that there is a difference between optimal and ‘normal’ thyroid function.

    The way that your regular primary care physician looks at your thyroid and the way that your reproductive endocrinologist look at the thyroid are completely different.

    Reproductive endocrinologists often realize that even slight changes to thyroid function can impact your ability to get pregnant.

    Because of this, these physicians tend to use tighter reference ranges as opposed to the more general and large reference ranges that regular Doctors may look at.

    Understanding how pregnancy impacts thyroid function is also very important.

    Once you are pregnant, the demand for thyroid hormone production increases immediately in your body.

    Your body has to produce enough thyroid hormone for both you and your baby .

    But what if you are already taking thyroid medication and you become pregnant?

    It can’t.

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    How Does Hyperthyroidism Affect Pregnancy

    Uncontrolled hyperthyroidism has many effects. It may lead to preterm birth and low birth weight for the baby. Some studies have shown an increase in pregnancy-induced hypertension in women with hyperthyroidism.

    A severe, life-threatening form of hyperthyroidism, called thyroid storm, may complicate pregnancy. This is a condition in which there are extremely high levels of thyroid hormone that can cause high fever, dehydration, diarrhea, rapid and irregular heart rate, shock and death, if not treated.

    It is always best to plan for pregnancy and to consult with your physician to ensure your thyroid status and treatment are optimized prior to becoming pregnant and monitored throughout your pregnancy. However, if this does not happen and you find out you are pregnant, you should contact your physician immediately to arrange for increased testing of your thyroid functions and a potential change in your medication.

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