Is thyroid important in pregnancy?
Yes, it is. A normal thyroid balance is very important for conception and for continuation of pregnancy.
Hypothyroidism can affect pregnancy in several ways:
- In women
- It can cause infertility in women because it can prevent the production of eggs.
- A pregnant woman with hypothyroidism is at higher risk for miscarriage.
- Women with untreated hypothyroidism near the time of delivery are in danger of developing high blood pressure and premature delivery.
- In men
- Can affect sperm production
- Hence thyroid tests are included in infertility workup.
I came to know I am pregnant! I was diagnosed hypothyroidism last year. What can I do to ensure my health & my baby’s health? Do I need to take another TSH test?
The key in dealing with thyroid condition during pregnancy is close monitoring of TSH and Free T4 levels and compliance with the treatment regimen.
In particular, it’s known that the thyroid hormone dosage requirement can increase in pregnancy. Thyroid hormone replacement should be taken throughout the pregnancy.
How do we treat under active thyroid in pregnancy?
Treatment is actually very simple. If you have been diagnosed with under-active thyroid, treatment should be started immediately.
Mother’s under-active thyroid may affect the baby in the tummy in different ways. This is a sort of natural treatment, replacing the deficient hormone.
We now prepare in the laboratory thyroid hormone (same chemical nature) that is produced by our thyroid gland, so the chance of reaction or not tolerating is not there. You need to take the tablet regularly in empty stomach and in the correct dose.
Remember iron and calcium tablet do not allow thyroid tablet to get absorbed from the stomach. You will be taking are iron and calcium tablet in pregnancy normally. Please make sure of the gap of four hours between thyroid and iron/calcium tablet.
What is the correct dose?
There is no correct dose; we need to give you the dose your body needs. Remember, your dose of thyroid medicine will go up in pregnancy, with the growing baby the demand increases. So, we need blood check in pregnancy a bit more frequently.
Is the baby at an increased risk of developmental abnormalities if the mother is hypothyroid?
The thyroid balance in the pregnant women has to be maintained at the right level for the proper development of the baby. Developmental abnormalities in babies are related to mother’s iodine deficiency, good news is that our water and salt are now iodised.
If the thyroid balance is fine we do not expect harmful effect to the baby.
What is the treatment of Overactive Thyroid in pregnancy?
Treatment of overactive thyroid is always with tablet that suppresses the thyroid gland (Carbimazole and Propylthiouracil). Radioiodine is NOT to be given in pregnancy.
If we can not manage with tablets, we might have to proceed to surgery that is taking the thyroid gland out. This is rarely needed now-a-days.
Can I plan pregnancy when I am on Thyroxine tablet?
Safely you can. As we have told, the structure of the thyroid hormone in our body and that of the thyroid tablet is same, so there is no chance of baby getting problem of any sort.
Commonly, pregnant ladies stop treatment because of the fear that any medicine in pregnancy is harmful but stopping can be harmful for the pregnancy. A fine tuning of the dose is required in pregnancy for normal growth of the baby.
Can I plan pregnancy with overactive thyroid?
You can safely plan for pregnancy if you have overactive thyroid but it is best to sort out thyroid problem before conception if possible. If you have received radioiodine, you should not conceive within four months of treatment.
We start medical treatment with tablet if you have been diagnosed to have overactive thyroid for the first time in pregnancy and control the thyroid function.
This time you may require frequent testing of the blood, may be once a month. Also we monitor baby’s growth carefully by ultrasound. Baby getting a problem of thyroid if mother has overactive thyroid is very rare. So it is better not get worried for this.
Can hypothyroidism develop after Pregnancy?
One in every 20 women will develop hypothyroidism after pregnancy. This happens because they developed antibodies to their own thyroid prior to the pregnancy, and this causes inflammation of the thyroid after delivery.
This condition most often develops between four months to a year after delivery and can resolve on its own. If it is long-lasting or permanent, it is easily treated with replacing thyroid hormone.