Being a mother encompasses many different responsibilities - including your child’s development. This responsibility starts from an early stage - when your child begins developing inside your womb.
Unfortunately, sometimes, our bodies do not cooperate with our wishes and during pregnancy, unexpected situations derail our plans. One of the most notable threats to pregnant women, would be thyroid dysfunctionalities - its prevalence makes thyroid conditions potent. In fact, the National Institute of Diabetes and Digestive Kidney diseases has reported that in every 100 pregnant women, 3-4 suffer from thyroid diseases.
What exactly is the thyroid, you may ask, and what preventive measures should be taken to ensure that my child will not be affected? Read on to find out what the most commonly asked questions about mothers with thyroid conditions.
The thyroid is a gland which produces thyroid hormones, which controls how your body uses energy and thus affects the way nearly every organ in your body works. Additionally, it is crucial for the normal development of your baby’s brain and nervous system. In fact, during the first trimester, your baby depends on your supply of thyroid hormone, which comes through the placenta. At around 12 weeks, your baby’s thyroid will start to work on its own, however, it will not produce enough thyroid hormone until 18-20 weeks of pregnancy.
Thyroid disease cannot be taken lightly, as they could have severe implications on you and your baby.
Untreated hyperthyroidism during pregnancy can lead to miscarriage, premature birth, low birth weight, affecting your baby’s development. For mothers, possible implications include a dangerous rise in blood pressure in late pregnancy, a sudden severe worsening of symptoms and congestive heart failure.
Similarly, an overactive thyroid in a newborn can lead to a fast heart rate, which in time leads to heart failure, early closing of the soft spot in the baby’s skull, irritability and poor weight gain.
As such, to maintain you and your child’s good health, it is crucial that you keep thyroid hormone levels within a healthy range.
Hypothyroidism and hyperthyroidism have different causes and effects.
Pertaining to hypothyroidism, the most common cause would be the autoimmune disorder known as Hashimoto’s thyroiditis. Hypothyroidism can occur during pregnancy due to the initial presentation of a chronically inflamed thyroid gland, or the inadequate treatment of a woman already known to have hypothyroidism from a variety of causes.
Approximately 2.5% of women will have a thyroid-stimulating hormone level of greater than 6mIU/L (slightly elevated) and 0/4% will have a thyroid-stimulating hormone level of greater than 10mIU/L during pregnancy, according to the American Thyroid Association.
Overall, the most common cause of hyperthyroidism in pregnant women is Grave’s disease, which occurs in 0.2% of pregnant patients. This occurs when there is an overproduction of thyroid hormone by the entire thyroid gland. In addition to other usual causes of hyperthyroidism, another condition of hyperthyroidism is characterised by one or more nodules in the thyroid that may gradually grow and increase activity, so that the total output of thyroid hormone into the blood is greater than normal. This is also known as toxic nodular goiter.
Hypo- and hyperthyroidism have symptoms that take different forms.
Symptoms of an underactive thyroid (hypothyroidism) during pregnancy include:
Being sensitive to cold
Slow movements and thoughts
Muscle aches and weakness
Dry and scaly skin
Brittle hair and nails
Loss of libido (sex drive)
Pain, numbness and a tingling sensation in the hand and fingers (carpal tunnel syndrome)
Irregular periods or heavy periods
Symptoms of an overactive thyroid (hyperthyroidism) during pregnancy include:
Severe nausea or vomiting
Shaking hands (slight tremor)
Weight loss or low weight gain beyond that expected of a typical pregnancy
If you have any symptoms of hypo- or hyperthyroidism, it is best to consult a physician immediately.
If the physician suspects that you have a thyroid disorder, a simple physical examination will be carried out to detect tell-tale signs.
The warning signs of hyperthyroidism detected through a physical examination include an enlarged thyroid gland and a rapid pulse. The physician will also look for moist, smooth skin and a tremor of your fingers. This diagnosis will be confirmed by laboratory tests that measure the amount of thyroid hormones in your blood. A high level of thyroxine and a low level of thyroid-stimulating hormone indicates an overactive thyroid. Your doctor may also want to obtain a picture of your thyroid through imaging for further analysis.
To diagnose hypothyroidism, the doctor will review your medical history and symptoms. After which, a blood test that measures the level of thyroid-stimulating hormone, and sometimes the level of the thyroid hormone thyroxine will be taken. A low level of thyroxine and high level of thyroid-stimulating hormone indicates an underactive thyroid.
Certain beta-blockers are safe to use during breastfeeding as only small amounts show up in breast milk. Nonetheless, taking the smallest dose to relieve symptoms is best.
Negligible thyroid medication will reach your baby through breast milk, thus the above medications are relatively safe to take while breastfeeding.
However, it is safest to converse with your doctor and obtain their recommendation with regards to how you should go about breastfeeding while on the above medications.
In general, eating a healthy and nutritious diet during pregnancy is important, because a good diet is linked to good brain development and a healthy birth weight.
However, specific to thyroid functionality, research has found that certain foods are closely linked to a healthy thyroid.
The thyroid uses iodine to make thyroid hormones, thus iodine is an important mineral for you while you’re pregnant. During pregnancy, your baby also gets iodine from your diet - you will need more iodine while you’re pregnant.
Iodine rich foods include dairy foods, seafood, eggs, meat, poultry and iodised salt. Experts also recommend taking iodine tablets with 150mg of iodine to make sure that you are getting sufficient levels of iodine.
If you are breastfeeding, you will also need more iodine, as your baby will get his/her iodine content from breast milk.
Conversely, do note that taking too much iodine rich supplements can also cause thyroid problems. Thus, it is advisable that you talk to your doctor to discuss the eating plan that is right for you and the supplements that you should take.
Postpartum thyroiditis is an inflammation of the thyroid that affects about 1 in 20 women during the first year after giving birth, as reported by the National Immune and Kidney Disease Association. The inflammation causes stored thyroid hormones to leak out of your thyroid gland. Initially, the leakage raises the hormone levels in your blood, following which the damage to your thyroid may cause it to become under-active.
Symptoms include irritability, trouble dealing with heat and sleeping, a fast heartbeat and tiredness.
Your health journey doesn't end after giving birth to your child. It is important to look after your health as well. If these symptoms present themselves in the first few months after your baby is born, talk with your doctor as soon as possible.
At Speedoc, we provide services to help you monitor and manage your thyroid conditions, so download our app today to book your thyroid chronic disease management package.
In conclusion, while thyroid problems can be hard to diagnose in pregnancy due to higher levels of thyroid hormones and other symptoms that occur both in pregnancy and thyroid disorders, keeping an eye out for symptoms and diagnosing early can allow you to have a healthy pregnancy and protect your baby’s health. As a continuation of diagnosis, you should have regular thyroid function tests and take the prescribed medication to maintain your thyroid levels.
At Speedoc, we provide services to help you monitor and manage your thyroid conditions with our Chronic Disease Home Management (CDHM)™ programme.