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Hypothyroidism and Pregnancy

Hypothyroidism and Pregnancy

Picture of an expectant mother holding her belly

Facts about hypothyroidism and pregnancy

Hypothyroidism is a condition marked by an underactive thyroid gland and may occur during pregnancy. Unfortunately, many symptoms of hypothyroidism are masked by symptoms of pregnancy, such as fatigue, weight gain, and abnormal menstruation and, as a result, the disease may be left undetected and untreated. In addition, the risk for developing hypothyroidism increases with age, which is significant because more and more women are delaying pregnancy until they are older.

What are the symptoms of hypothyroidism?

Hypothyroidism is a common condition, which can go undetected if symptoms are mild. Hypothyroidism means the thyroid is underactive, producing insufficient amounts of thyroid hormones. Symptoms of hypothyroidism are usually very subtle and gradual and may be mistaken for symptoms of depression. The following are the most common symptoms of hypothyroidism. However, each individual may experience symptoms differently. Symptoms may include:

  • Dull facial expressions

  • Fatigue

  • Cold intolerance

  • Hoarse voice

  • Slow speech

  • Droopy eyelids

  • Puffy and swollen face

  • Weight gain

  • Constipation

  • Sparse, coarse, and dry hair

  • Coarse, dry, and thickened skin

  • Carpal tunnel syndrome (hand tingling or pain)

  • Slow pulse

  • Muscle cramps

  • Sides of eyebrows thin or fall out

  • Confusion

  • Increased or irregular menstrual flow in women

The symptoms of hypothyroidism may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

Very often, hypothyroidism is diagnosed by screening blood tests in a person who otherwise has no symptoms of hypothyroidism.

How does hypothyroidism affect the fetus?

During the first few months of pregnancy, the fetus relies on the mother for thyroid hormones. Thyroid hormones play an essential part in normal brain development and growth of the fetus. Deprivation of the maternal thyroid hormones due to hypothyroidism can have long-lasting effects on the fetus. 

How is the thyroid function screened?

Screening for hypothyroidism involves a blood test that measures thyroid hormone (thyroxine, or T4) and serum TSH (thyroid-stimulating hormone) levels. Hypothyroidism is often suspected when TSH levels are above normal and T4 levels are below normal. Always consult your doctor for a diagnosis.

Who should undergo thyroid function screening?

There is some debate over whether pregnant women should be routinely screened for thyroid disease. Some experts recommend testing only if there is clinical suspicion of abnormal thyroid function and do not recommend thyroid testing as a routine part of prenatal care. Others feel that all women should be screened for thyroid abnormalities within the first nine weeks of pregnancy. The levels of thyroid hormone vary throughout the course of a pregnancy and need to be checked routinely if a person is on thyroid hormone replacement therapy. Women should talk with their doctor about their individual needs.

How is hypothyroidism treated during pregnancy?

Once hypothyroidism is diagnosed, thyroid hormone replacement therapy may be used to treat the mother. Dosage of thyroid hormone replacement therapy is based on the individual's levels of thyroid hormones. The treatment is safe and essential to both mother and fetus. When the fetus is born, routine newborn screening includes a test of thyroid hormone levels.

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