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Feeling drained, a bit moody, aching all over, or unable to remember things? Are you noticing an increase in weight, skin changes, and swelling? Naturally, these symptoms are part of the pregnancy package! However, on rare occasions, they may also hint at thyroid disorders, particularly one that is known as hypothyroidism, where the thyroid gland isn't as active as it should be.
Telling apart these normal pregnancy experiences from hypothyroid symptoms can be quite a conundrum due to their striking similarities. Regardless, pinning down the correct diagnosis and initiating suitable treatment are essential steps for both the health of the mother-to-be and her little one. How do doctors manage to distinguish the signs? Let's dig into this and find out how to recognize the signs of hypothyroidism in pregnancy.
Before we delve into the specifics, gaining a sound understanding of the thyroid's role within the body is of great importance. Nested in the front part of your neck, the thyroid gland may be small, but its influence on the body is immense. The thyroid is an essential part of the endocrine system, the body's network of hormone-producing glands. Its primary role is the production of two vital hormones called Triiodothyronine (T3) and Thyroxine (T4). These thyroid hormones are the key controllers of how the body uses energy, influencing your body temperature, heartbeat, and the rate at which you burn calories - essentially, they manage your body's metabolism.
Additionally, thyroid hormones play a crucial role in the normal development of your baby's brain and nervous system. That's why hypothyroidism and pregnancy are closely linked. During the first trimester, the initial three months of pregnancy, your baby relies on your supply of thyroid hormone, which is transported through the placenta. However, roundabout the 12th week, the baby's thyroid begins its own production. Still, it isn't till about the 18th to 20th week of pregnancy that it starts producing enough thyroid hormone. This magnifies the importance of proper thyroid function in expecting mothers, affecting not just their own metabolic rate but also the development of their growing baby.
Hypothyroidism is a condition where the thyroid gland doesn't produce enough thyroid hormone, leading to a slower metabolism. Having low thyroid hormone levels is like trying to drive a car without enough fuel - things slow down and don't function as efficiently as they should.
When a woman becomes pregnant, her body undergoes dramatic changes, one of which is the increase in hormone production to support the growth and development of the baby. During this time, the demand for the thyroid gland increases significantly. Consequently, an already underactive thyroid gland can struggle to meet these increased demands, potentially leading to complications.
It's actually quite common during pregnancy to develop hypothyroidism - when your thyroid gland can't make enough thyroid hormones. In fact, it happens in about 2 to 3 out of every 100 pregnancies. The usual culprit behind this is something called Hashimoto's disease.
So, what's Hashimoto's disease? To put it simply, it's a condition where your immune system, the body's defence against illnesses, gets a bit mixed up. Instead of fighting off infections, it starts attacking your own body. In this case, it targets the thyroid gland, which is the little organ in your neck that makes thyroid hormones.
The problem starts when your immune system creates substances called antibodies that attack this gland. This causes inflammation and damage to the thyroid, a bit like a silent internal battle. Unfortunately, when your thyroid is under attack, it cannot produce enough hormones that your body needs to control how it uses energy.
This faulty immune response can cause the thyroid to become underactive and not produce enough hormones - a condition also known as hypothyroidism. So, in pregnant women, it's common for an overactive immune system to inadvertently slow down their thyroid gland resulting in this condition.
Interestingly, the symptoms of hypothyroidism often mirror those typically experienced during pregnancy. This similarity can make identifying hypothyroidism during pregnancy a challenge, potentially leaving the condition undiagnosed. Here are some of the symptoms of hypothyroidism:
Fatigue: Pregnant or not, fatigue is a common symptom of hypothyroidism. However, if exhaustion persists even after ample rest, it may be time to look further.
Muscle pain or weakness: Should you observe unusual or severe muscle pain and weakness, and it's unrelated to any physical exercise, it may be linked to hypothyroidism.
Memory issues or depression: Having trouble remembering things or feeling uncharacteristically down? While mood swings are part and parcel of pregnancy, persistent forgetfulness or depression might indicate hypothyroidism.
Constipation: Changes in digestion and bowel movements are common in pregnancy, but constant constipation could denote a sluggish thyroid.
Unusual weight gain: Weight gain is inevitable during pregnancy. However, excessive weight gain, despite moderate eating and regular exercise, might be a red flag.
Sensitivity to cold: Feeling overly chilly in a room where others are comfortable might signal that your thyroid is underactive.
Again, many of these symptoms are common in pregnancy—but if their severe, persistent, or multiple symptoms are present, it's worth discussing with a healthcare professional.
More than mere symptom similarities, having insufficient thyroid hormone levels or hypothyroidism can cause various complications during pregnancy if left untreated. Thus, it can pose considerable risks to both women and their babies during pregnancy and post-birth. Here are some of the potential complications:
Anaemia: In this condition, the body doesn't have enough healthy red blood cells to carry sufficient oxygen to the body's tissues. It can cause fatigue and other related symptoms.
Preeclampsia: This is a serious pregnancy complication characterized by high blood pressure and evidence of damage in other organ systems, most often the liver and kidneys. It usually begins after 20 weeks of pregnancy in women whose blood pressure has been normal.
Placental Abruption: This is a serious condition in which the placenta separates from the uterus before childbirth. It can deprive the baby of oxygen and nutrients, which can lead to heavy bleeding that can harm both mother and baby.
Gestational Hypertension: This form of high blood pressure develops after the 20th week of pregnancy and typically resolves after childbirth. It can have negative effects on the mother's kidneys and other organs, and it can cause low birth weight and early delivery.
Postpartum Hemorrhage (PPH): This condition is when a woman experiences heavy bleeding following childbirth. Often, it happens within a day of childbirth but may occur up to 12 weeks post-delivery. It's considered rare but serious.
Myxedema: This is a rare but extremely serious condition that can result from severe, long-term untreated hypothyroidism. Symptoms include intense cold intolerance and drowsiness followed by profound lethargy and unconsciousness. In the worst cases, it can lead to coma and even prove fatal.
Heart Failure: Another severe but rare complication, heart failure denotes a condition where the heart doesn't pump blood as efficiently as it should. This can be associated with hypothyroidism, as a lack of thyroid hormones can cause a drop in heart rate, degrading the heart's pumping capacity over time.
As explained above, the initial few months of pregnancy are critical for the development of the baby, who relies heavily on the mother for the supply of thyroid hormones during this time. These thyroid hormones are not just significant; they're indispensable for the typical brain development and growth of the fetus. As such, if the mother suffers from a thyroid disease like hypothyroidism, it can potentially have lasting adverse effects on the child. Some complications related to the baby due to the mother's untreated hypothyroidism include:
Infantile Myxedema: This is a condition linked to severe hypothyroidism. Infantile myxedema can cause various problems. These can range from dwarfism, a condition leading to the individual being unusually short in height (typically less than 4 feet 10 inches as an adult), to intellectual disabilities, significantly affecting cognitive capabilities and the acquisition of skills necessary for daily life.
Low Birthweight: Babies born to mothers with untreated hypothyroidism can have a lower-than-normal birth weight, which can invite further health complications.
Delayed Growth and Developmental Issues: Expecting mothers with untreated hypothyroidism can give birth to babies with stunted growth and impaired brain and nervous system development. The nervous system, comprising the brain, spinal cord, and nerves, facilities our ability to think, feel and move. If a mother has hypothyroidism that remains untreated during the first trimester, it could significantly impact a child's IQ.
Thyroid Problems: Though this scenario is less common, babies born to mothers with Hashimoto's disease, an autoimmune disorder causing hypothyroidism, can encounter their own thyroid problems. This can happen because the antibodies causing Hashimoto's disease in the mother can cross the placenta and impact the thyroid gland in the baby.
Miscarriage or Stillbirth: Lastly, untreated hypothyroidism in a pregnant mother may result in miscarriage or stillbirth, causing tremendous emotional distress.
When it comes to the question of whether every woman should undergo thyroid function testing during pregnancy, experts do not yet agree. However, considering the essential role that thyroid hormones play for both the mother and her baby, it's crucial to monitor the risks closely.
The American Thyroid Association (ATA) recommends that as soon as pregnancy is confirmed, women who stand at high risk for thyroid disease should check their Thyroid Stimulating Hormone (TSH) levels. These include factors such as:
Having had thyroid disease in the past or any treatment related to thyroid conditions, either an overactive thyroid (hyperthyroidism - when you have too much thyroid hormone in your body) or underactive thyroid (hypothyroidism), such as radioactive iodine treatment or thyroid hormone replacement therapy.
Testing positive for thyroid antibodies, indicative of potential autoimmune conditions.
Having a visibly swollen neck due to an enlarged thyroid gland (goiter).
Having a family history of thyroid disease
Having a family history of thyroid disease.
Being aged 30 years or above.
Having a Body Mass Index (BMI) of 40 or more.
Having a personal history of autoimmune disorders such as type 1 diabetes.
Having had difficulties while trying to conceive.
Experience of preterm birth.
Having suffered the loss of a baby through miscarriage or stillbirth.
Apart from this, healthcare providers may also recommend a thyroid test if you have witnessed particular conditions or symptoms which may hint at a possible thyroid disease.
In essence, if your healthcare provider feels that you could potentially have thyroid disease, they might recommend you get your thyroid function tested. This is particularly true if you fall into any of the high-risk categories mentioned above.
Diagnosing hypothyroidism during pregnancy involves a series of blood tests to evaluate the level of thyroid hormones and the body's response to them. Here are some of the common tests your doctor might use to diagnose hypothyroidism during pregnancy:
TSH Test: This is often the first step. This blood test measures the amount of Thyroid Stimulating Hormone (TSH) your body is producing. When the level of thyroid hormones (T3 & T4) is low, your pituitary gland produces more TSH in an attempt to stimulate the thyroid to produce more hormones. Hence, a high TSH level often indicates hypothyroidism.
T4 Test: The next step is typically a T4 test. This test measures the level of the thyroid hormone T4 in your body. Low levels can suggest an underactive thyroid.
T3 Test: Although not always necessary for diagnosing hypothyroidism, in some cases, your doctor might order a T3 test to get a better understanding of thyroid function.
TPO Antibody Test: Hashimoto's disease, an autoimmune disorder, is the most common cause of hypothyroidism, and it's often implicated in cases of hypothyroidism in pregnancy. This test looks for the presence of TPO (Thyroid Peroxidase) antibodies in your blood - key markers for Hashimoto's disease.
In some cases, your healthcare provider may suggest imaging tests like an ultrasound or a scan to check the size of your thyroid gland and assess its ability to take up iodine (used to make thyroid hormones).
It's crucial to note that diagnosing hypothyroidism during pregnancy is a delicate process, as reference ranges for hormonal levels often need to be adjusted. Pregnant women usually have lower TSH and higher T4 levels than non-pregnant individuals. Your doctor will take this into account, as well as your symptoms and medical history, to make an accurate diagnosis.
The question of who should receive treatment for hypothyroidism in pregnancy is an important one.
According to the ATA, any woman who is found to have a TSH level higher than 10 mIU/L during the first trimester should receive treatment for hypothyroidism. On the other hand, women with a TSH level of 2.5 or less do not require thyroid hormone replacement.
The recommendations become a bit more nuanced for women falling in between those numbers - that is, with a TSH level between 2.5 and 10. Treatment decisions might hinge on whether the mother's thyroid is producing too many TPO antibodies or not.
In cases where TPO antibodies are present, indicating an autoimmune response, the ATA advises treatment when the TSH level is above 4. They also state that treatment should be considered if TSH levels are between 2.5 and 4. In contrast, if there are no TPO antibodies, meaning the antibodies testing comes out negative, the ATA's recommendations are slightly less definitive. They suggest that treatment 'might be considered' for women with a TSH level between 2.5 and 10 mIU/L.
These treatment guidelines aim to address the different complexities that can arise with hypothyroidism during pregnancy. They're based on the level of evidence currently available showing that levothyroxine treatment can be beneficial in these cases. Ultimately, the aim is to ensure the best health outcomes for both mother and baby.
To address hypothyroidism during pregnancy, doctors usually replace the hormone that the mother's thyroid gland is unable to produce in sufficient quantities. This treatment involves the use of thyroid hormone replacement medications targeting the need of the mother. The dosage of thyroid hormone replacement therapy is customized based on the individual's thyroid hormone levels. It's crucial to remember these levels and the corresponding dosage required may change during pregnancy. For the most accurate monitoring, thyroid hormone levels should ideally be checked every four weeks during the first half of pregnancy.
There are different types of thyroid hormone replacement medications, but the main ones are as follows:
One of the most widely used treatments for hypothyroidism during pregnancy is levothyroxine, a synthetic form of the T4 hormone. Produced in a lab, levothyroxine precisely mimics the T4 hormone naturally created by your thyroid gland. When ingested, your body metabolizes levothyroxine into T3, the active form of thyroid hormone your body uses.
An alternative to synthetic options like levothyroxine is Natural Desiccated Thyroid (NDT). Extracted from the thyroid gland of pigs, NDT encompasses both T3 and T4 hormones. Since this form of treatment contains both types of thyroid hormones in ratios comparable to the human thyroid gland, it can sometimes prove to be more beneficial.
In contrast to synthetic replacements that only consist of T4, facilitating all necessary hormones in case of conversion issues between T4 to T3 in some patients is where NDT stands apart. As every individual is different, some pregnant women might find NDT to be a more effective treatment option that matches their personal health profile and helps maintain a healthy thyroid hormone balance during pregnancy.
If you're looking for the most common Natural Desiccated Thyroid (NDT) medications in the United States, Armour Thyroid and NP Thyroid top the list. Want some more options? You can also buy desiccated thyroid online in supplement form, like VitaliThy; no doctor's prescription is needed! Just like Armour Thyroid and NP Thyroid, VitaliThy contains both T4 and T3. As a bonus, it's free from common allergens like lactose, gluten, fish, shellfish, and eggs. You also won't find any artificial colors or flavors in it. It's a great choice if you're after a more natural option for thyroid hormone replacement.
Absolutely, yes. Having hypothyroidism doesn't rule out the possibility of a successful pregnancy. However, it does mean that a bit of extra care and management is required.
Today, hypothyroidism can be effectively managed with appropriate medication such as levothyroxine or natural desiccated thyroid, enabling a balance in thyroid hormone levels and significantly reducing the potential risks associated with hypothyroidism during pregnancy. A great option is the supplement VitaliThy, a natural desiccated thyroid you can buy online.
Regular check-ups and monitoring are essential, allowing any needed adjustments to your treatment plan as your pregnancy progress. A healthy lifestyle - including a balanced diet, moderate exercise, and plenty of rest - is also highly beneficial.
The key takeaway is this - do not let hypothyroidism diminish the joyous journey of pregnancy. With the right treatment, routine care, and a supportive healthcare team, like the experts at Vitality, you can navigate this special time confidently, ensuring the health and well-being of both you and your little one.
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