Pregnancy And Hypothyroidism: Symptoms, Effects And Treatment

Pregnancy causes significant physiological stress on both the mother and the foetus. When pregnancy is combined with endocrine disorders such as hypothyroidism, the potential for maternal and foetal harm is enormous. Read on for more information.

While quite some attention has been given to the adverse foetal outcomes of hypothyroidism,  attention is gradually shifting to the adverse maternal outcomes of this disorder. The role of antibody positivity in influencing outcomes in a euthyroid woman is also unclear. Therefore, diagnosing and treating hypothyroidism in pregnancy is critical as soon as possible. Subclinical hypothyroidism must also be detected and treated to avoid adverse outcomes, particularly for mothers. A diet plan to manage hypothyroidism or a  power detox  can do wonders.

Table Of Contents

1. Causes And Prevalence Of Hypothyroidism In Pregnancy

2. Symptoms Of Hypothyroidism In Pregnancy

3. Screening And Diagnosis Of Hypothyroidism In Pregnancy

4. Effect Of Hypothyroidism On The Mother And Foetus 

5. Hypothyroidism Caused Complications In Pregnancy

6. Treatment Of Hypothyroidism In Pregnancy

7. Dietitian’s Recommendations

8. The Final Say

9. FAQs

Causes And Prevalence Of Hypothyroidism In Pregnancy

In certain parts of India, iodine deficiency is the most prevalent reason for hypothyroidism during pregnancy. The most common cause in iodine-sufficient areas is autoimmune thyroiditis. Women with subclinical hypothyroidism before pregnancy may develop overt hypothyroidism.

Hashimoto's disease is the most likely reason behind hypothyroidism in pregnancy, affecting 2 to 3 out of every 100 pregnancies. Hashimoto's disease is an autoimmune disorder. The thyroid is attacked by antibodies made by the immune system, which results in inflammation and damage that lowers the thyroid's capacity to make thyroid hormones.

In pregnant women, hypothyroidism is more common than hyperthyroidism. Overt or subclinical hypothyroidism can exist. Overt hypothyroidism is defined as increased TSH and decreased free T4 levels. In contrast, subclinical hypothyroidism is defined as having higher TSH and normal T4 levels. 10% of pregnancies have subclinical hypothyroidism.

Also, see A Guide To Healthy Diet During Pregnancy

Symptoms Of Hypothyroidism In Pregnancy 

Hypothyroidism is a common condition. However, if the symptoms are mild, they may go undetected. Hypothyroidism occurs when the thyroid is underactive and produces insufficient thyroid hormones.

Hypothyroidism symptoms can be soft and appear gradually. The following are the most common hypothyroid symptoms:

• Fatigue
• Intolerance to cold temperatures
• Hoarse voice
• Facial swelling 
• Weight increase
• Constipation
• Changes to the skin and hair, such as dry skin and eyebrow loss
• Carpal tunnel syndrome (hand tingling or pain)
• Sluggish heartbeat
• Muscle pain
• Difficulty concentrating
• Irregular intervals of menstruation

Pregnant women frequently have the same hypothyroidism symptoms as other hypothyroidism patients. Among the symptoms are

• Extreme tiredness
• Trouble dealing with colds
• Muscle cramps
• Severe constipation
• Problems with memory or concentration

Screening And Diagnosis Of Hypothyroidism In Pregnancy 

It is not recommended to screen for hypothyroidism during pregnancy regularly. However, pregnant women with hypothyroidism symptoms, a history of hypothyroidism, or other endocrine system conditions should be screened. Thyroid-stimulating hormone (TSH) and thyroid hormones T4, as well as T3 for hypothyroidism, are used to diagnose Hypothyroidism in pregnancy. In addition, pregnant women who have any of the following symptoms are at risk for hypothyroidism:

• Living in a region with moderate to severe iodine deficiency

• Thyroid disease in the family or personal history

Personal background of

• Antibodies to thyroid peroxidase (TPO)

• Goitre

• Autoimmune disease

• Over 30 years of age

• Diabetes type 1

• Irradiation of the head and neck

• Recurrent miscarriage or premature birth

• Several previous pregnancies (two or more)

• Obesity class 3 (body mass index [BMI] 40 kg/m2)

• Infertility

• Thyroid surgery in the past

Effects Of Hypothyroidism On The Mother And Foetus

The foetus relies on the mother for thyroid hormones during the first few months of pregnancy. Thyroid hormones play an essential role in foetal brain development and growth. The mother's hypothyroidism can have long-term consequences for the foetus. Untreated hypothyroidism in pregnancy can result in

• Preeclampsia (a dangerous rise in blood pressure in late pregnancy)
• Anaemia 
• Miscarriage
• Underweighted birth weight 
• Stillbirth
• Rarely, congestive heart failure

These issues are most common in people who have severe hypothyroidism. 

Hypothyroidism Caused Complications In Pregnancies

During the first trimester, the foetus cannot manufacture thyroid hormones, so it relies on maternal thyroid hormones for neurodevelopment. Hypothyroidism is dangerous in pregnant women; untreated hypothyroidism can result in maternal and foetal complications.

• Maternal complications include hypertension, diabetes, abruption placenta, and postpartum haemorrhage.
• Low birth weight, stillbirths, early birth, and abortions are all foetal complications.
• Overt hypothyroidism also hurts foetal neurocognitive development.
• Subclinical hypothyroidism may also have negative consequences. For example, children born to mothers with untreated hypothyroidism are likelier to have low IQs and learning disabilities.

Treatment Of Hypothyroidism During Pregnancies

When treating hypothyroidism during pregnancy, levothyroxine should be administered with a serum TSH target of less than 2.5 mIU per L. At 4 to 6 weeks of pregnancy, then every 4 to 6 weeks until 20 weeks of pregnancy and on a stable medication dosage, then once more at 24 to 28 weeks gestation and once more at 32 to 34 weeks gestation, serum TSH should be tested in pregnant women who are being treated for hypothyroidism.

Levothyroxine supplements are used in treatment. In a trial of 131 women with positive TPO antibodies (euthyroidism or subclinical hypothyroidism) who were randomised to receive levothyroxine medication or no treatment, levothyroxine treatment dramatically decreased the rate of premature delivery.

Dietitian’s Recommendations

Hypothyroidism in pregnancy is a prevalent health problem these days. Although the doctor consistently gives necessary medical assistance, you can easily maintain your thyroid levels by following a healthy diet and maintaining a good workout routine. In addition, you can consult a nearby dietician to help you with the same.

-Dietician Lavina Chauhan

The Final Say

Suppose you are trying to conceive, have an underlying thyroid or autoimmune disease, or have had previous pregnancy complications. In that case, your doctor can order the necessary tests and help you plan a healthy pregnancy. The sooner you start planning, the better your chances of success. Also, do not underestimate the value of regular exercise, healthy eating and stress reduction.  

Because women with hypothyroidism during pregnancy, particularly those with autoimmune hypothyroidism, may experience a relapse or require thyroxine replacement after delivery, adequate follow-up is essential. Finally, routine screening, early diagnosis, and prompt treatment are recommended. In addition, to ensure favourable maternal and foetal outcomes, regular post-partum follow-up is required.

FAQs

1. Does hypothyroidism affect the baby during pregnancy?

The foetus may suffer irreparable harm if the mother's thyroid hormone is withheld owing to hypothyroidism. Early research revealed decreased IQ and worse psychomotor (mental and motor) development in children born to moms with hypothyroidism during pregnancy.

2. Is pregnancy safe with hypothyroidism?

Additionally, hypothyroidism might hinder embryonic growth (fertilised egg). This makes miscarriage more likely. Further, suppose you have hypothyroidism while pregnant and do not receive treatment. In that case, your unborn child could be minor than average and have impaired mental development.

3. Can pregnancy damage your thyroid?

After having a baby, a woman can get postpartum thyroiditis, a thyroid gland inflammation. About 3 in 100 to 2 in 25 pregnant women, or a small fraction, are affected by this illness. The thyroid is a tiny gland near your throat that produces thyroid hormones.

4. Do thyroid tablets affect pregnancy?

Thyroid hormone replacement therapy is a common name for hypothyroidism treatment. Your thyroid hormone levels are returned to normal using the drug levothyroxine. The Food and Drug Association (FDA) states that levothyroxine use during pregnancy is safe.

5. Can thyroid transfer from mother to baby?

Thyroid hormones transfer from mother to embryo by the placental cord that has deiodinase enzyme for transformation T4 to T3. But in the second and third trimesters, the embryo can produce thyroid hormones in addition to the mother.

6. What is the average TSH level for a pregnant woman?

The Endocrine Society advises keeping TSH levels between 0.2 and 2.5 Mu/L in the first trimester and between 0.3 and 3 mU/L in the subsequent trimesters.

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