Your Thyroid and Your Pregnancy – Be Your Own Advocate
Although only a small gland at the base of the neck, a woman’s thyroid can have a big impact on her ability to conceive, her pregnancy, and her health and the baby’s health post delivery.
Conception
Thyroid disorders can lead to difficulty conceiving. Women experiencing trouble conceiving can easily be screened with a thyroid-stimulating hormone (TSH) blood test.
Pregnancy – An estimated 2.5% of pregnant women have some degree of hypothyroidism (too little hormone). Hypothyroidism in pregnancy can be associated with poor pregnancy outcomes including miscarriage, increased likelihood of C-section, preterm delivery, and if severe, decreased infant IQ.
In addition, iodine supplementation is very important in pregnancy. The American Thyroid Association has recently brought to attention to the importance of adequate iodine in relationship to thyroid function during pregnancy. Pregnant women need extra iodine, and the iodine content of prenatal multivitamins sold in the United States is not mandated. Prenatal vitamins have varying levels of iodine content. Last year the New England Journal of Medicine (NEJM) reported on an evaluation of 127 non-prescription and 96 prescription prenatal multivitamins available in the United States. Approximately one-third of the non-prescription prenatal vitamins contained no iodine whatsoever, and a staggering 72% of the prescription prenatal vitamins studied had no iodine. Talk to your health care provider to make sure you are getting the appropriate amount of iodine.
Postpartum – Too much or too little thyroid hormone is a problem that approximately 5% of new mothers face. It is difficult to diagnose, because one of the symptoms, fatigue, is readily accepted as natural due to caring for a newborn. Postpartum thyroiditis occurs in women after the delivery of a baby. Most women have a postpartum visit to their doctor six weeks after giving birth, but the onset of postpartum thyroiditis usually happens after the 6 week postpartum visit. Most women’s thyroids return to normal after a year, but about 20% of women continue to have ongoing thyroid problems.
Summary-
Megan Haymart, Assistant Professor of Medicine in the Division of Metabolism, Endocrinology, and Diabetes (MEND) and Hematology/Oncology, University of Michigan Health System, wants women to be aware that:
- Hypothyroidism is common. It is important for women to be aware of hypothyroidism, because it can adversely affect maternal and fetal health.
- Women already taking thyroid hormone replacement for known thyroid disorders may need a dose increase when they become pregnant. Since the first prenatal visit typically takes place at 10 weeks gestation, women with thyroid disorders need to let their doctor know they are on thyroid hormone replacement and may need a dose change, as soon as conception occurs (prior to the initial 10 week gestation prenatal visit)
- There is not always universal screening for thyroid disorders during pregnancy. Women should know that if they have increased risk factors for thyroid disease, such as family history of thyroid problems, personal history type 1 diabetes or other autoimmune disorder, previous thyroid problem or thyroid surgery, thyroid enlargement, or symptoms consistent with thyroid dysfunction, then they should inform their health care provider before or during pregnancy. If women are in a high risk group, their health care provider should check their TSH during pregnancy. .
- Haymart says that patient awareness of thyroid disorders and symptoms is very important. Before, during, and after a pregnancy women have multiple health care providers. Women need to be aware so they can make sure their thyroid dysfunction isn’t missed. Haymart encourages women to be their own advocates and pay attention to their symptoms.
Read more about the thyroid-stimulating hormone (TSH) blood test that is used to check for thyroid gland problems.
