Thyroid Disorders in Pregnancy
What is a thyroid disorder?
Thyroid disease is a group of disorders that affects the thyroid gland. The thyroid is a small, butterfly-shaped gland in the front of the neck that makes thyroid hormones. Thyroid hormone (T3 and T4) affects every cell and all the organs in your body by: Regulating the rate at which your body uses calories (energy). This affects weight loss or weight gain and is called the metabolic rate even slowing down or speeding up your heart rate.
Sometimes these hormones are secreted in too less or too much levels which might lead to
- Hypothyroidism (underactive thyroid).
- Hashimoto’s disease (an autoimmune condition that causes hypothyroidism).
- Hyperthyroidism (overactive thyroid).
- Graves’ disease (an autoimmune condition that causes hyperthyroidism).
What happens to thyroid hormones in pregnancy?
Pregnancy is a time of complex hormonal changes. The body normally undergoes rapid changes during pregnancy for the development of the child. However, endocrine problems sometimes occur during pregnancy as part of a preexisting or new condition. Thyroid disease is second only to diabetes mellitus as the most common endocrinopathy that occurs in women during their reproductive years.
In women with normal thyroid function, there is an increase in thyroxine (T4) and triiodothyronine (T3) production, which results in inhibition of thyroid-stimulating hormone (TSH) in the first trimester of pregnancy, due to a high human chorionic gonadotropin (hCG) level that stimulates the TSH receptor because of partial structural similarity.
Normal thyroid function is essential for fetal development. A deficiency or an excess of thyroid hormone can occur in pregnancy. Thyroid dysfunction can cause problems for both the mother and baby. Symptoms of thyroid disease often mimic common symptoms of pregnancy, making it challenging to identify. Poorly controlled thyroid disease is associated with adverse outcomes during pregnancy, and treatment is an essential part of prenatal care to ensure maternal and fetal well-being.
Hyperthyroidism in Pregnancy
Hyperthyroidism in pregnancy is usually caused by Graves’ disease. Graves’ disease is an autoimmune disorder where the immune system makes antibodies that cause the thyroid to make too much thyroid hormone. This antibody is called thyroid stimulating immunoglobulin, or TSI.
Symptoms of hyperthyroidism in pregnancy?
Some signs and symptoms of hyperthyroidism often occur in normal pregnancies, including faster heart rate, trouble dealing with heat, and tiredness, fast and irregular heartbeat, shaky hands, unexplained weight loss or failure to have normal pregnancy weight gain.
Untreated hyperthyroidism during pregnancy can lead to
- Miscarriage
- Premature birth
- Low birthweight
- Preeclampsia—a dangerous rise in blood pressure in late pregnancy
- Thyroid storm—a sudden, severe worsening of symptoms
- Congestive heart failure
An overactive thyroid in a newborn can lead to
- A fast heart rate, which can lead to heart failure
- Early closing of the soft spot in the baby’s skull
- Poor weight gain
- Irritability
How is hyperthyroidism diagnosed and treated in Jaipur?
Diagnosis is done by blood tests for thyroid levels and antibodies to check for graves’ disease.
Mild hyperthyroidism usually doesn’t require treatment, in severe cases antithyroid medicine propylthiouracil or methimazole are prescribed by the doctor.
Hypothyroidism in Pregnancy
Hypothyroidism in pregnancy is usually caused by Hashimoto’s disease and occurs in 2 to 3 out of every 100 pregnancies. Hashimoto’s disease is an autoimmune disorder. In Hashimoto’s disease, the immune system makes antibodies that attack the thyroid, causing inflammation and damage that make it less able to make thyroid hormones.
Symptoms of hypothyroidism in pregnancy
Most cases of hypothyroidism in pregnancy are mild and may not have symptoms. Symptoms of an underactive thyroid are often the same for pregnant women as for other people with hypothyroidism. Symptoms include
- Extreme tiredness
- Trouble dealing with cold
- Muscle cramps
- Severe constipation
- Problems with memory or concentration
Untreated hypothyroidism during pregnancy can lead to
- Preeclampsia—a dangerous rise in blood pressure in late pregnancy
- Anemia
- Miscarriage
- Low birthweight
- Stillbirth
- Congestive heart failure, rarely
These problems occur most often with severe hypothyroidism.
How is hypothyroidism diagnosed and treated in Jaipur?
Diagnosis is done by blood tests for thyroid levels and antibodies to check for hashimotos disease.
Treatment for hypothyroidism in Jaipur 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.
Dr. Mayuri Kothiwala
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