Everything you need to know about the thyroid in pregnancy

My thyroid hormone levels were normal when I conceived, but now it’s a completely different story.

The thyroid is a small endocrine gland located at the front of your neck. It manages various body functions, from regulating the metabolism to supporting brain and bone growth.

A lot of women face thyroid problems in pregnancy. A study found that the prevalence of hypothyroidism in pregnancy is around 0.3–0.5%. Despite this, the good news is that it responds very well to prompt treatment.

Untreated thyroid during pregnancy may lead to some complications. So, pregnant women should keep an eye on their thyroid hormone levels during pregnancy.

Let's dive in and learn some more about thyroid diseases in pregnancy.

Why are thyroid hormones required in pregnancy?

A baby needs thyroid hormones for the normal development of the brain and nervous system. In the first trimester, the baby cannot make thyroid hormones. The baby's thyroid gland starts working around 12 weeks. But it doesn't make sufficient thyroid hormones until 18 to 20 weeks of pregnancy.

The placenta ensures the constant hormone supply that supports fetal development. It is an organ that grows in the uterus during pregnancy and delivers oxygen, nutrients, and thyroid hormones to the fetus.

What are the causes of thyroid disease during pregnancy?

There can be various triggers for thyroid conditions in pregnancy. Identifying these can help achieve better treatment outcomes.

Causes of hypothyroidism in pregnancy:

• Hashimoto’s disease Hashimoto’s disease is an autoimmune condition. You will be surprised to know that 2% to 3% of pregnant women are diagnosed with it.

  In Hashimoto's disease, the body's defense system attacks the thyroid gland and causes inflammation. Due to this, the thyroid gland cannot make sufficient thyroid hormones.

• Endemic iodine deficiency Iodine is needed to produce thyroid hormones. Low iodine levels can cause hypothyroidism.

Causes of hyperthyroidism in pregnancy:

• Graves' disease: What hit your mind when you heard about Graves' disease?

  Another autoimmune disease!

  According to the Western literature, the prevalence of Graves' disease is 0.1–0.4%. In this disease, the immune system makes antibodies (thyroid stimulating immunoglobulin) that attack and damage the thyroid gland. It leads to overproduction of thyroid hormones.

  High thyroid hormone levels can harm the baby's and mother's health.

• Toxic multinodular goitre Toxic multinodular goitre can also cause excess thyroid hormone production during pregnancy.

  In toxic multinodular goitre nodules develop in the thyroid gland that continuously secrete thyroid hormones. They do not respond to any of the regular signals to control production.

Besides these, other reasons can also lead to hyperthyroidism during pregnancy like:

• Single toxic adenoma (A single nodule that develops on the thyroid gland and starts producing extra thyroid hormones)
• Iodine-induced hyperthyroidism (on unexpected exposure to excess iodine)

Don't get anxious after reading the above content, take a deep breath. Early thyroid diagnosis can help to treat it easily.

What are the symptoms of hyperthyroidism & hypothyroidism in pregnancy?

Diagnosing thyroid disorders in pregnancy is difficult. During pregnancy, it is difficult for doctors to diagnose thyroid conditions because the symptoms are so similar to those of a “normal” pregnancy.

It is crucial to keep an eye on the symptoms of hyperthyroidism & hypothyroidism in pregnancy. It helps in the early detection and treatment of the disorder.

Let's have a look at symptoms of the thyroid during pregnancy:

Symptoms of hypothyroidism in pregnancy

Hypothyroidism symptoms list includes the following:

• Extreme tiredness
• Severe constipation
• Problems with memory or concentration
• Discomfort in cold weather
• Muscle cramps

Most cases of hypothyroidism in pregnancy are mild or may not have symptoms. This is why it is even more important to be cautious.

Symptoms of hyperthyroidism in pregnancy

Hyperthyroidism symptoms list includes:

• Faster heart rate
• Intolerance to heat
• Tiredness
• Shaky hands
• Unusual weight loss or failure to gain regular pregnancy weight

If you notice any of the above symptoms, inform your doctor. They may suggest getting your hormone levels checked.

What complications can thyroid disorders cause in pregnancy?

Treating thyroid disorders during pregnancy is crucial. Untreated thyroid can cause serious health problems in both the mother and child. These include:

• Premature birth
• Miscarriage
• Placental abnormalities
• Hypertension (a dangerous rise in blood pressure)
• Low birth weight
• Anemia
• Congestive heart failure.

To avoid these, make sure you take your thyroid treatment as prescribed.

How to diagnose the thyroid during pregnancy?

Healthcare providers generally don't test for thyroid conditions before or during pregnancy unless you have symptoms of any thyroid condition. They may check your medical history or suggest thyroid function tests that can help detect thyroid conditions.

We all know autoimmune disorders like Graves' and Hashimoto's disease can also cause thyroid conditions. For these, thyroid antibody tests are performed.

How to treat thyroid disorders in pregnancy?

If you have been diagnosed with thyroid conditions, it becomes tricky to manage both thyroid and pregnancy. However, ignoring them can lead to severe consequences.

Treating hypothyroidism:

Thyroid medication: Treatment for hypothyroidism involves thyroid hormone replacement therapy. It is safe for the baby and given until the baby can make its own thyroid hormone.

Nutritional supplements: Several nutrients help to run thyroid function normally. Nutritional supplements also support healthy thyroid function.

Treating hyperthyroidism:

Antithyroid medication: Mild hyperthyroidism may not need any treatment. But in more severe hyperthyroidism, healthcare providers usually prescribe antithyroid medications like propylthiouracil (for the first trimester) and methimazole (second and third trimesters).

These antithyroid medications reduce thyroid hormone production in mothers and prevent the entry of excess thyroid hormone into the baby’s bloodstream. Doctors usually prescribe the lowest dose to treat hyperthyroidism.

Radioactive iodine treatment is not feasible for treating thyroid in pregnancy.

Summing it up:

Undiagnosed and untreated thyroid conditions can result in complications. If you notice any thyroid symptoms in pregnancy, get an appointment with your healthcare provider. Early diagnosis is crucial to managing thyroid and pregnancy effectively.

Want to understand more about thyroid condition management during pregnancy? We can help you.

Reach out to Jeevam Health Team to start root cause-based thyroid treatment.