Thyroid Levels In Pregnancy
If your practitioner does not routinely check for thyroid disease in pregnancy, ask to be screened.
1. Everyone can have thyroid problems. Even if youve never had thyroid issues prior to pregnancy, you should have your thyroid levels checked in early pregnancy and again in early postpartum. These are very likely times when you may experience difficulties with your thyroid for a variety of reasons.
2. Low thyroid levels can cause intellectual disability;and other problems. Your thyroid hormones are necessary for a healthy baby. It is important that you have the right amount of hormone in your system to ensure a healthy baby.
3. Be checked early in pregnancy if you already take thyroid replacements. Even early on in pregnancy, your thyroid hormone needs can change. You may need to increase or adjust the amount of medication you are taking. You may need to be rechecked frequently throughout your pregnancy to ensure a safe and healthy pregnancy.
4. Dont stop taking your thyroid hormones. If you become pregnant while taking thyroid replacement medications, do not stop taking your medications. Thyroid replacement hormones are a pregnancy Category A drug, meaning they are among the safest drugs available during pregnancy. Talk to your doctor before changing any of your medications.
Hypothyroidism In Pregnancy American Thyroid Associatio
A significant percentage will show mild hypothyroidism. These women should be treated and monitored further during pregnancy where the thyroid hormone levels are known to decrease During pregnancy, the thyroid gland needs to produce about 40 percent more thyroid hormone for both you and your developing baby. Women who don’t receive enough thyroid hormone during pregnancy are at greater risk of complications, including miscarriage , preeclampsia , and preterm delivery Thyroid cancer is the second most common cancer diagnosed during pregnancy after breast cancer. The goal of management is to control malignancy and prevent maternal and fetal complications as a result of maternal hypothyroidism. The role of female sex hormones as an etiologic factor was investigated, with no clear association Two types of thyroid disease are commonly seen in pregnancy: Hyperthyroidism Hypothyroidism Pregnancies complicated by hyper- and hypothyroidism may be complicated by fetal growth delay, preterm birth, preeclampsia, and stillbirth.Blood tests can determine the diagnosis of thyroid disease
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.
- 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 Is The Interaction Between The Thyroid Function Of The Mother And The Baby
For the first 18-20 weeks of pregnancy, the baby is completely dependent on the mother for the production of thyroid hormone. By mid-pregnancy, the babys thyroid begins to produce thyroid hormone on its own. The baby, however, remains dependent on the mother for ingestion of adequate amounts of iodine, which is essential to make the thyroid hormones. The World Health Organization recommends iodine intake of 250 micrograms/day during pregnancy to maintain adequate thyroid hormone production. Because iodine intakes in pregnancy are currently low in the United States, the ATA recommends that US women who are planning pregnancy, pregnant, or breastfeeding should take a daily supplement containing 150 mcg of iodine.
How To Control Thyroid During Pregnancy
Thyroxine, a synthetic thyroid hormone is used to treat Hypothyroidism. This medicine is identical to T4, a hormone which is secreted by the gland. Your doctor may ask to increase your dose of thyroxine of you are suffering from pre-existing hypothyroidism, this will help maintain normal thyroid function. The intake of synthetic thyroxine is found to be safe and necessary for the well-being of the fetus if the mother has hypothyroidism. A regular test of TSH levels every 6-8 week should be done during pregnancy.
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Diet To Follow During Pregnancy For Thyroid Control:
For pregnant mothers, there is a specific regulatory diet to be followed in order to control and balance the thyroid hormones. It is essential to avoid and intake certain foods and diet accordingly for the best of the health both for the mother and the unborn baby . The advised thyroid diet for pregnancy is,
- A healthy diet is crucial. It is good to have a satisfactory intake of fruits and vegetables, including whole grains.
- Healthy oils such as olive oil is recommended during the cooking process
- Proteins are good for health. Lean source protein such as from fish is highly recommended
- High iodine content should always be avoided
- Avoid high amounts of soy and related proteins
- Cut down on bad carbs and fats. While nuts, seeds, legumes, cheese, milk, and other trans fats are good to go, it is advised to minimize soft drinks, alcohol, refined sugary drinks, sugar substances, chips, packaged foods, candy, and more junk foods.
- A high intake of dietary fiber is always a plus.
What Are The Treatment Options For A Pregnant Woman With Graves’ Disease/ Hyperthyroidism
Mild hyperthyroidism often is monitored closely without therapy as long as both the mother and the baby are doing well. When hyperthyroidism is severe enough to require therapy, anti-thyroid medications are the treatment of choice, with PTU being preferred in the first trimester. The goal of therapy is to keep the mothers free T4 in the high-normal to mildly elevated range on the lowest dose of antithyroid medication. Addition of levothyroxine to ATDs is not recommended. Targeting this range of free hormone levels will minimize the risk to the baby of developing hypothyroidism or goiter. Maternal hypothyroidism should be avoided. Therapy should be closely monitored during pregnancy. This is typically done by following thyroid function tests monthly.
In patients who cannot be adequately treated with anti-thyroid medications , surgery is an acceptable alternative. Surgical removal of the thyroid gland is safest in the second trimester.
Radioiodine is contraindicated to treat hyperthyroidism during pregnancy since it readily crosses the placenta and is taken up by the babys thyroid gland. This can cause destruction of the gland and result in permanent hypothyroidism.
Thyroid During Pregnancy: 3 Things You Need To Know
Theres a common perception that thyroid during pregnancy is a huge problem says Dr. Priti Arora Dhamija. But this is nothing to be afraid of. With the right treatment, thyroid problems during pregnancy can easily be brought under control.
Eat Healthy And On Time:
Eat natural, home-cooked food. Avoid eating out. Stay away from prepackaged and processed foods. Try to eat as much organic food as possible. Wash your fruits and vegetables in vinegar bath before consumption. You need to eat on time, whether you have hypothyroidism or not and whether you are pregnant or not. But you absolutely need to eat on time to regulate your metabolism if you are both hypothyroid and pregnant. On the whole, eat fresh, clean and healthy food every day
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What Are The Risks Of Hypothyroidism To The Mother
Untreated, or inadequately treated, hypothyroidism has increased risk of miscarriage, and has been associated with maternal anemia, myopathy , congestive heart failure, pre-eclampsia, placental abnormalities, and postpartum hemorrhage . These complications are more likely to occur in women with severe hypothyroidism. Some risks also appear to be higher in women with antibodies against thyroid peroxidase . Women with mild hypothyroidism may have no symptoms or attribute symptoms they have to the pregnancy.
What Is Thyroid Disorder
The thyroid gland, located at the front of the neck just below the voice box, is part of the endocrine system, which produces all of the hormones in your body. The hormones your thyroid creates play a key role in regulating your metabolism the way your body uses energy along with your temperature, weight, cholesterol levels and other key body functions.
Production of thyroid hormones, in turn, is regulated by levels of thyroid-stimulating hormone , generated by your pituitary gland . The levels of thyroid hormones in your blood naturally fluctuate throughout the day; usually, the pituitary gland responds by creating more or less TSH.
Hypothyroidism , can cause many of the bodys functions to slow down, or hyperthyroidism , can cause many of the bodys functions to speed up.
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How Can You Avoid The Complications Of Hypothyroidism In Pregnancy
A number of medical associations and organizations have made recommendations on screening for thyroid disease. Some of the recommendations are:
The management of each woman’s situation is considered individually after consultation with her physician. The benefits of treatment extend not only to pregnant women with hypothyroidism, but also to their children.
What Is The Natural History Of Graves’ Disease After Delivery
Graves disease typically worsens in the postpartum period or may occur then for the first time. When new hyperthyroidism occurs in the first months after delivery, the cause may be either Graves disease or postpartum thyroiditis and testing with careful follow-up is needed to distinguish between the two. Higher doses of anti-thyroid medications may be required during this time. As usual, close monitoring of thyroid function tests is necessary.
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What Is Postpartum Thyroiditis
Postpartum thyroiditis is an inflammation of the thyroid that affects about 1 in 20 women during the first year after giving birth1 and is more common in women with type 1 diabetes. The inflammation causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage raises the hormone levels in your blood, leading to hyperthyroidism. The hyperthyroidism may last up to 3 months. After that, some damage to your thyroid may cause it to become underactive. Your hypothyroidism may last up to a year after your baby is born. However, in some women, hypothyroidism doesnt go away.
Not all women who have postpartum thyroiditis go through both phases. Some only go through the hyperthyroid phase, and some only the hypothyroid phase.
What Is The Link Between Iodine Deficiency And Thyroid Function In Pregnancy
Having too little iodine in your body is a common cause of low thyroid hormone levels. A study found that, on average, Australian women consume 100 micrograms of iodine a day. However, the World Health Organization recommends a daily intake of least 250 micrograms of iodine during pregnancy and breastfeeding.
Australian guidelines recommend that pregnant and breastfeeding women take a supplement containing 150 micrograms of iodine each day .
Check with your antenatal health provider if you are concerned about your iodine levels, particularly if you are taking supplements such as pregnancy or pre-natal vitamins and minerals.
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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.
The Debate Over Universal Thyroid Screening
In the United States, doctors tend only to screen women at high risk for thyroid dysfunction or those who have a history of autoimmune diseases or preterm deliveries.
Doctors tend to debate the screening based on cases when a women has no symptoms or abnormal or borderline thyroid tests. Treating borderline cases detected via a universal screening could risk patient anxiety and puts pressure on clinicians. Most noted is that evidence is lacking when it comes to the benefits of treating women with abnormal and borderline test results.
On the flip side, Taylor said that universal thyroid screening in early pregnancy could improve child IQ and reduce complications of pregnancy.
However, a consensus is unlikely to be reached without further controlled trials which recruit women pre-conception or as early as possible in pregnancy, he added.
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What Are The Risks Of Graves’ Disease/ Hyperthyroidism To The Baby
The risks to the baby from Graves disease are due to one of three possible mechanisms:
Is It Safe To Breastfeed While Im Taking Beta
Certain beta-blockers are safe to use while youre breastfeeding because only a small amount shows up in breast milk. The lowest possible dose to relieve your symptoms is best. Only a small amount of thyroid hormone medicine reaches your baby through breast milk, so its safe to take while youre breastfeeding. However, in the case of antithyroid drugs, your doctor will most likely limit your dose to no more than 20 milligrams of methimazole or, less commonly, 400 mg of PTU.
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Thyroid Hormones Are Necessary For Normal Fetal Development During The First 3 Months Because Hypothyroidism And Hyperthyroidism Are Possible Thyroid Levels Should Be Monitored Before And Throughout Your Pregnancy
The thyroid diseaseshyperthyroidism and hypothyroidismare relatively common in pregnancy and important to treat. The thyroid is an organ located in the front of your neck that releases hormones that regulate your metabolism , heart and nervous system, weight, body temperature, and many other processes in the body.
Thyroid hormones are particularly necessary to assure healthy fetal development of the brain and nervous system during the first three months of your pregnancy since the baby depends on your hormones, which are delivered through the placenta. At around 12 weeks, the thyroid gland in the fetus will begin to produce its own thyroid hormones.
If you have Grave’s disease while pregnant, you will likely have your thyroid levels checked monthly.
There are 2 pregnancy-related hormones: estrogen and human chorionic gonadotropin ; that may cause your thyroid levels to rise. This may make it a bit harder to diagnose thyroid diseases that develop during pregnancy. However, your doctor will be on the look-out for symptoms that suggest the need for additional testing.
Untreated thyroid diseases during pregnancy may lead to premature birth, preeclampsia , miscarriage, and low birth weight among other problems. Therefore, it is important to talk to your doctor if you have had a history of hypothyroidism or hyperthyroidism so you can be monitored before and during your pregnancy, and to be sure that your medication is properly adjusted, if necessary. ;
How Is Thyroid Dysfunction In Pregnancy Managed
If you have hypothyroidism, your doctor may prescribe thyroxine tablets before and after conception to optimise your thyroid hormone levels. This treatment is usually accompanied by regular thyroid function tests to ensure your thyroid level is in the recommended range. If left untreated, low levels of thyroid hormone can cause complications in pregnancy, such as premature birth, low birth weight and miscarriage. It may also affect the intellectual development of your baby.
If you have hyperthyroidism, your doctor or specialist may prescribe medication to block thyroid hormone production . The most common medicine used for this is called propylthiouracil. Uncontrolled overactive thyroid during pregnancy has been associated with complications such as a higher fetal heart rate , small gestational size, premature birth or stillbirth.
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How Are Thyroid Conditions During Pregnancy Diagnosed
Health care providers dont usually test your thyroid before or during pregnancy unless youre at high risk of having a thyroid condition or you have signs or symptoms of one. If you have signs or symptoms of a thyroid condition, especially during pregnancy, tell your provider. Signs of a condition are things someone else can see or know about you, like that you have a rash or youre coughing. Symptoms are things you feel yourself that others cant see, like having a sore throat or feeling dizzy. Signs and symptoms of thyroid conditions may appear slowly over time. Many are signs and symptoms of other health conditions, so having one doesnt always mean you have a thyroid problem.
Your provider gives you a physical exam and a blood test to check for thyroid conditions. The blood test measures the levels of thyroid hormones and thyroid stimulating hormone in your body. TSH is a hormone that tells your thyroid gland to make thyroid hormones. If you think you may have a thyroid condition, ask your provider about testing.