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Is Thyroid A Problem In Pregnancy

Unusual Signs Or Symptoms After Delivery May Indicate Thyroid Complications

Can Thyroid Problems Affect Your Pregnancy? Dr. Subramanian Kannan

Some thyroid complications can occur postpartum. People with a history of thyroid problems are at an increased risk of postpartum thyroiditis, a condition that occurs in about 5%-10% of people with ovaries when the thyroid becomes inflamed after having a baby. It may first cause the thyroid to be overactive, but it can eventually lead to an underactive thyroid.

How To Watch For Signs &symptoms Of Hypothyroidism During Pregnancy

Catching hypothyroidism earlier in the pregnancy gives the best chances of effective treatments and a healthy baby.

Signs and symptoms of hypothyroidism in pregnancy include:

  • Weight Gain This is often missed due to pregnancy weight
  • High Cholesterol Levels
  • An Enlarged Thyroid Gland termed Goiter
  • The Dangers of Leaving Hypothyroidism During Pregnancy Untreated

Hypothyroidism during pregnancy can negatively impact both the mother and the vulnerable baby growing in her womb. There are some non-surgical and natural treatments to try that do not include drugs in most cases.

Some women will need to take medication if their doctor recommends this. The worst-case scenarios of untreated hypothyroidism during pregnancy include miscarriage, preterm births, and coma for the mother. In extremely rare cases, the mother and/or baby could die.

Signs And Symptoms Of Hypothyroidism

The signs and symptoms of hypothyroidism are difficult to detect, and they differ from person to person.

However, early warning signs can include fatigue and weight gain. Yet, you may not recognize that these signs are linked to your thyroid until more symptoms arise. These include but are not limited to depression, puffy face, skin breakouts, constipation, decreased heart rate, stiff muscles and joints, dry and diminishing hair, feeling cold, memory loss, and reduced sweating.

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Risks Associated With Thyroid Dysfunction In Pregnancy

  • Overt hypothyroidism and hyperthyroidism are associated with a range of adverse obstetric outcomes and risks to the baby .
  • Studies are now focusing on the potential effect of subclinical thyroid dysfunction and autoimmune disease. A systematic review found that subclinical hypothyroidism in pregnancy is associated with pre-eclampsia and perinatal mortality and the presence of maternal thyroid autoantibodies is associated with miscarriage and preterm birth . A meta-analysis of cohort studies had similar findings for miscarriage and another for preterm birth .

What Are Clinical Trials And Are They Right For You

Thyroid disease in pregnancy

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

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Work With An Integrative Physician To Solve Thyroid Problems

Thyroid issues in women are serious and often complex. An integrative physician or functional medicine doctor will help you figure out the root cause of your thyroid imbalance, and the two of you can work together to come up with a treatment plan.

A lot of mainstream doctors simply respond to thyroid problems by prescribing thyroid hormones, but the effectiveness of the hormones depends on why the imbalance happened in the first place. For example, inflammation can cause a decrease in thyroid receptor sensitivity, which may appear to be hypothyroidism. Where a standard doctor would prescribe T4 or T3 thyroid hormones, an integrative physician can help you address the underlying inflammation, either reducing or eliminating your need for medication.

If your doctor does suggest medication, dont worry. Thyroid medication is safe and usually molecularly identical to the hormones you produce naturally.

Dont try to figure out a thyroid imbalance alone, especially if youre trying to get pregnant. Make it a priority to work with an integrative physician and get a full thyroid exam.

Natural Treatments To Improve Your Thyroid

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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Thyroid Conditions Raise The Risk Of Pregnancy Complications

Thyroid conditions present risks for pregnant women and their babies.

Thyroid conditions can, for the most part, be easily managed in day-to-day life with the right medications and hormone therapy. However, the risks of low or high thyroid hormone levels become much more apparent during pregnancy.

Research published in the Endocrine Societys Journal of Clinical Endocrinology & Metabolism shows that the risk of complications increases for both women with underactive thyroid glands, or hypothyroidism, and those with overactive thyroid glands, or hyperthyroidism. Using data from the Consortium on Safe Labor on 223,512 single-child pregnancies, researchers found that these conditions can increase the risk of obstetrical, labor, and delivery issues.

Women need appropriate thyroid hormone levels to support a healthy pregnancy, so it is very important to carefully monitor expecting mothers who have thyroid diseases, said Dr. Pauline Mendola of the National Institute of Healths Eunice Kennedy Shriver National Institute of Child Health and Development in a press release.

With up to four percent of pregnancies involving thyroid disorders, understanding how to keep the conditions in check is crucial for both mother and child.

What Has Been Your Experience Of Pregnancy And Hypothyroidism Were You Considered High Risk

Pregnancy and Autoimmune Thyroid Disease

You can click on the hyperlinks in the above post to learn more and see references to information given.

See also:

You, Me and Hypothyroidism: When Someone You Love Has Hypothyroidisma book for those who know someone with hypothyroidism. It looks at how pregnancy, fertility, parenting, home life and more can all be affected by hypothyroidism, and what you can do about it.

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Improve Your Gut Health To Reduce Thyroid Issues In Women

A lot of thyroid issues in women are the result of autoimmune disorders your immune system gets out of control and starts attacking your thyroid as if it were a foreign invader. Gut issues and thyroid imbalances are also very common together, and each seems to worsen the others symptoms . That makes sense, considering 70% of your immune system is in your gut . Improving your gut health can relieve thyroid imbalances and increase your chances of getting pregnant.

You can improve your gut health a few ways:

  • Get more probiotics. Eat lots of yogurt, kefir, kimchi, sauerkraut, kombucha, and other fermented foods. They all contain healthy probiotic bacteria that can strengthen your gut microbiome. You can also take a good probiotic supplement. Elixa is an excellent option.
  • Cut out sugar. Sugar feeds bad gut bacteria and can cause intestinal inflammation, making your gut health worse. Minimize sugar and refined carbs to improve your gut health.
  • Eat lots of fiber. Veggies and complex carbs are packed with gut-strengthening fiber that feeds good gut bacteria, decreases inflammation, and helps keep your gut lining strong.

Improving your gut health may decrease your thyroid problems and help balance your hormones.

Should You Be Tested For Hypothyroidism

Mild hypothyroidism that doesnt cause symptoms may not pose a pregnancy danger, and so there’s some disagreement about whether doctors should routinely screen all pregnant women. The American College of Obstetricians and Gynecologists does not call for hypothyroidism screening.

But hypothyroidism testing is important for pregnant women with certain risk factors, says Serena H. Chen, MD, the director of reproductive medicine at the Institute for Reproductive Medicine and Science at the Saint Barnabas Medical Center in Livingston, New Jersey. These risk factors include:

  • Family or personal history of thyroid disease
  • Radiation exposure to the head or neck
  • Multiple miscarriages

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Problems With Brain And Nervous System Development

During hypothyroidism, a mother’s body produces very little thyroid hormone. Consequently, the lack of thyroid hormone as the baby develops causes irreversible mental and motor development delays

Babies born to women with severe hypothyroidism that is either undetected or untreated during gestation may score lower in IQ tests.

What Does The Thyroid Gland Do

Thyroid Disease and Getting Pregnant

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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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.  

Are You At Risk For Hypothyroidism

Although any person can develop hypothyroidism, you are at a greater risk than others primarily if you are a woman and above the age of 60.

The more the body ages, the more susceptible people become to certain health issues. Hypothyroidism is more common in women. Scientists have not been able to find out why, but they suspect that thyroidism and its causes are connected to autoimmunity which is widely seen in women compared to men.

Besides sex and age, your risk for hypothyroidism is high if you are currently being treated for thyroid issues and are taking anti-thyroid medicine. Also, you are at risk if you been affected by hypothyroidism in the past, including after giving birth, or have had a baby who had a thyroid condition

As well, if you have a family history of thyroid disease and autoimmune disorders like Hashimoto’s disease or Graves’ disease you have high chances of developing hypothyroidism.

Lastly, if you have undergone thyroid surgery to have your thyroid taken out or as a treatment for thyroid cancer, you are at risk. This also applies to cases where your upper chest or neck has been exposed to radiation through therapy.

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What Are The Symptoms Of Postpartum Thyroiditis

The hyperthyroid phase often has no symptomsor only mild ones. Symptoms may include irritability, trouble dealing with heat, tiredness, trouble sleeping, and fast heartbeat.

Symptoms of the hypothyroid phase may be mistaken for the baby bluesthe tiredness and moodiness that sometimes occur after the baby is born. Symptoms of hypothyroidism may also include trouble dealing with cold; dry skin; trouble concentrating; and tingling in your hands, arms, feet, or legs. If these symptoms occur in the first few months after your baby is born or you develop postpartum depression, talk with your doctor as soon as possible.

Your Thyroid Function May Be Altered After Having A Baby

Thyroid Disease in Pregnancy Video Brigham and Womens Hospital

It’s common for women to feel tired, experience mood swings, and have a variety of other symptoms in the months after childbirth. But for some women, symptoms can become troublesome and may point to a thyroid problem known as postpartum thyroiditis an inflammation of the thyroid that initially occurs in the first year after childbirth, miscarriage, or induced abortion. It’s considered a variation of autoimmune thyroiditis, also known as Hashimoto’s thyroiditis.

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Treating Thyroid Disorders In Pregnancy

Because untreated thyroid disorders can be harmful to both mother and baby, all conditions require prompt treatment in pregnancy.

Hypothyroidism: Babies of women with untreated hypothyroidism have a higher risk of neurological or developmental problems, including mental retardation. You’ll be given hormone replacement pills to boost the level of thyroid hormone in your blood.

Hyperthyroidism: If you have hyperthyroidism, you’re more likely to develop a type of pregnancy-related high blood pressure called preeclampsia, and you’ll need medication to reduce the amount of thyroid hormone your body makes. However, you should not be given radioactive iodine during pregnancy because it can damage your unborn baby’s thyroid gland.

The good news is that most medications used to treat thyroid disorders are considered safe in pregnancy. If you take medication for your condition, your healthcare provider will regularly measure the amount of thyroid hormone in your blood and make adjustments as the pregnancy progresses.

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. 

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If You Have Graves’ Disease Your Newborn May Be Evaluated For Thyroid Dysfunction And Treated

This is because the thyroid receptor antibodies that cross the placenta during pregnancy can affect the fetus. The recommendation is to test the birthing parents’ antibody levels at 22 weeks gestation if you have current or past Graves’ disease. After delivery, testing the infant for thyroid disease is recommended.

Thyroid Disease + Pregnancy

Thyroid disease in pregnancy

Pregnancy can be such a wonderful and joyful time, even though it has its struggles.

But theres another side of pregnancy that can be heartbreaking and devastatingand that is infertility and loss. I recently shared a post about thyroid disease and the autoimmune condition often responsible for causing hypothyroidism, called Hashimotos thyroiditis. Not only can it cause debilitating fatigue, anxiety, hair loss, inability to lose weight, and so much more it can also cause infertility and problematic pregnancies.

This is something that the conventional medical community acknowledges, but there dont seem to be many good resources for pregnant women with thyroid disease. During pregnancy and postpartum, our hormones go through the ringer. This isnt a bad thing by any means, but because of the overwhelming amounts of hormonal changes, it can trigger an adverse thyroid reaction.

An undiagnosed or not properly managed thyroid problem can also lead to various complications with pregnancy and birth. In fact, untreated thyroid disease increases the chances of premature birth, preeclampsia, miscarriage, low birth weight, anemia, and even stillbirth.

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What Is The Difference Between An Overactive And An Underactive Thyroid

During pregnancy, some women may experience thyroid dysfunction where their thyroid becomes:

  • An underactive thyroid , which can be due to having too little iodine in their body, a pre-existing immune disorder, or previous damage to the thyroid gland; or
  • An overactive thyroid , which is usually a result of a condition that stimulates the thyroid gland too much, such as Graves disease.

Thyroid dysfunction affects 2 to 3 in every 100 pregnant women. Either an overactive or underactive thyroid dysfunction should be monitored and treated if necessary.

Screening For Thyroid Problems While Pregnant

Though most healthcare providers don’t routinely screen pregnant women for thyroid disorders, your doctor may recommend testing if you have a family history or another autoimmune disorder , or if you experience any symptoms. Most conditions can be easily diagnosed with a simple blood test and can be treated safely, enabling you to have a healthy baby.

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    What Current Medical Research Says

    More research needs to be done to improve thyroid disorder treatment, but researchers know in which direction they need to move.

    Although we lacked information on treatment during pregnancy, these nationwide data suggest either a need for better thyroid disease management during pregnancy or that there may be an intrinsic aspect of thyroid disease that causes poor pregnancy outcomes, the study authors wrote. Future research is still needed to distinguish if women with adequately treated thyroid disease have higher risk of pregnancy complications due to the disease itself or if treatment can truly prevent adverse outcomes.

    Monitor Your Iodine Nutrition Before And During Pregnancy

    Can You Get Pregnant with Thyroid Problems?

    Iodine is a key nutrient for thyroid hormones and thyroid health.* During pregnancy and lactation , iodine requirements from the US Food and Drug Administration increase from 150 for nonpregnant people micrograms to 290 mcg.

    That said, supplemental iodine which is a common component of prenatal vitamins may not be recommended if you’re taking levothyroxine , also known as L-thyroxine, a manufactured form of the thyroid hormone thyroxine . Since prenatal vitamins are an essential part of preconception and pregnancy nutrition, it’s important to talk to your healthcare provider about whether or not a prenatal vitamin with iodine is right for you.

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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.

    Overview Of Tests & Screening To Spot Low Thyroid Problems During Pregnancy

    There should be thyroid screening and tests for pregnant women especially if they have certain risk factors for the development of a thyroid disorder.

    These risk factors include:

    • ver 30 Years of Age
    • Family History of Thyroid Issues and/or Autoimmune Diseases
    • History of Radiation to Neck Area
    • Personal or Family History of Thyroid Cancer
    • Past Problems Getting Pregnant or Staying Pregnant Until Full-Term
    • History of Past Miscarriages or Preterm Births
    • History of Thyroid Surgery

    All the above risk factors should be conveyed to your medical treatment team.

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    Analysis Of Risk Factors For Hypothyroidism

    Data on risk factors for hypothyroidism in pregnancy were available in 132 women screened hypothyroid in pregnancy; 78 women filled in the questionnaire, and in 54 women, we used data extracted from the hospital database. Fifteen women were treated by levothyroxine before pregnancy, none by antithyroid drugs. Thyroid disease in a first-degree relative was reported in 47 women . Goiter was reported by nine women , and one had had a total thyroidectomy before the pregnancy. One woman had diabetes type 1, and seven suffered from other autoimmune disease. Eleven women were treated for infertility, and 21 had a spontaneous abortion in history. All women lived in an iodine-sufficient area. There were no cases of head/neck irradiation, history of lithium or amiodarone treatment, or morbid obesity. Commonly, several individual risk factors occurred in combination. There were five twin pregnancies in this group.

    Overall, 73 hypothyroid pregnant women had at least one risk factor except age of 30 or older. Of the 59 women without any risk factor excluding age, 40 were at least 30 yr old. Thus, from the 132 hypothyroid pregnant women analyzed, 113 had at least one risk factor according to the new guidelines of the ATA.

    Always Be Your Own Advocate

    Thyroid Disease in Pregnancy

    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.

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    Participants 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.

    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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