Hypothyroidism During Pregnancy : All That You Need To Know

 

The thyroid is a vital gland, located in front of the neck and its hormones are crucial for all the cells in the body to work routinely. Moreover, it has an indispensable role in assuring healthy fetal development, particularly the brain and nervous system during the first three months of your pregnancy as the baby depends on your hormones exclusively then.

Maternal thyroid disease is known to affect up to 5 % of pregnancies. It requires appropriate treatment as it has adverse effects on both the mother and child before and after delivery.

Does pregnancy affect your thyroid?

Well, there are certain reversible physiological and hormonal fluctuations in thyroid during pregnancy. These mainly include

  • Increase in gland size
  • Alteration of thyroid hormones

Keeping this in mind is essential during the identification and management of any underlying thyroid disease during pregnancy.

 So, why hypothyroidism matter during pregnancy?

  • Fetal growth during the first trimester is totally dependent on your thyroid hormones for development of his/her neural and various vital systems.
  • Children born to hypothyroid mothers have lower IQ scores and impaired psychomotor (mental and motor) development.
  • Risk of complications for you and your baby.

What are the causes of maternal hypothyroidism??

  • Endemic iodine deficiency
  • Autoimmune thyroid disorders or Hashimoto’s thyroiditis
  • A family history of thyroid disorders
  • Increased exposure to radiation
  • Thyroidectomy
  • Pituitary tumors (Secondary effect on Thyroid gland)

What are the clinical symptoms of hypothyroidism?

Few signs and symptoms are similar to what you see in a normal pregnancy. But you should be aware of the following signs:

  • Extreme tiredness
  • Weight gain
  • Dry skin and hair
  • Constipation
  • Intolerance to heat
  • Memory problems
  • Muscle cramps

So, how can you diagnose hypothyroidism?

Iodine (mostly added to your common salt) is needed for normal thyroid functioning, hence iodine deficiency can manifest as a visible or palpable thyroid gland in the front of the neck known as ” goiter “. In most instances it is associated with hypothyroidism. However, some patients exhibiting goiter, the thyroid gland may function normally, thus needing no treatment.

High levels of thyroid stimulating hormones (TSH) and low levels of thyroid hormones T4 (active form) & T3 indicate that your thyroid gland is under active and you are suffering from hypothyroidism.

American Thyroid Association’s (ATA) recommendations of TSH values during trimesters are:

  TSH level (ml U/L)
First trimester 0.1-2.5
Second trimester 0.2-3
Third trimester 0.3-3

 

  • Based on your physical examination, clinical signs and symptoms, and lab investigation report of the hormonal levels, diagnosis of an underactive thyroid can be confirmed.

So, how is hypothyroidism treated?

Finding out the underlying cause of hypothyroidism is a must. In conjunction with that, both medical and overall health management is must if you choose to combat hypothyroidism.

Medical management:

  • Thyroid hormone replacement drug Levothyroxine which is similar to T4 made by the gland.
  • Always follow your doctors advise for the drug dosage based on your hormonal levels
  • Get your hormonal levels checked every 4-6 weeks as per doctors advise.

Overall health management:

  • Healthy lifestyle
  • Regular exercise
  • Thyroid friendly diet

Hypothyroidism is more common than people know, with 1 in 3 Indians suffering from this disease (and affects around 11-15% worldwide). So by knowing about the progression, outcome, and management of the disease, you are in a better position in managing the situation. In case of any doubt, the assessment of the gland function is always advisable to rule out the condition.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Aishwarya

Dr. Aishwarya Rajeev has completed her MDS degree and is currently pursuing her PhD. She is an avid reader and loves to teach and write!

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