When it comes to the thyroid, everything gets confusing and complicated. Who hasn’t heard about thyroid imbalance, which causes discomforts like swelling, difficulty losing weight, and even sweating? There are two types of alterations: hypothyroidism and hyperthyroidism. The basic difference between them is that hypothyroidism causes a reduction in hormone production, while hyperthyroidism causes an increase in hormonal function.
However, if an imbalance in thyroid hormones is already concerning for women who are not pregnant, the situation becomes even more complicated during pregnancy. Did you know that gland issues can bring serious consequences? That is why doctors advise: if you have a problem with hypothyroidism1 or hyperthyroidism2, it’s better to treat it before trying to get pregnant.
But what is the thyroid, what does it do, and why is it so dangerous to get pregnant with imbalance issues? The thyroid is a gland located in the neck. It is responsible for producing two essential hormones for metabolism, T3 (triiodothyronine) and T4 (tetraiodothyronine). These two hormones determine how cells expend energy and to which part of the body most of the hormones go. That is why women who want to get pregnant must keep the thyroid under constant watch. Hypothyroidism or hyperthyroidism can cause:
- Weight gain or difficulty losing weight
- Hair loss
- Dry skin
- Loss of muscle tone and muscle stiffness
- Increased cholesterol
- Swelling
- Changed heart rhythm
The most evident signs are those mentioned above. However, other symptoms may appear, such as depression, swelling of the face, hands, legs, and feet, cholesterol changes, intolerance to cold, tingling, and skin with different texture and color, yellow and dry. Obviously, all these symptoms may occur due to other health issues, but by checking the signs and performing the requested tests, it may be found that there is a thyroid alteration. The doctor responsible for diagnosis and treatment is the endocrinologist. 
Hypothyroidism can be an autoimmune disease, meaning the body attacks the thyroid, possibly causing issues like Hashimoto’s thyroiditis. Hypothyroidism is more common than hyperthyroidism, which is an increase of hormones. It can directly affect female fertility and also that of men. A woman who wants to get pregnant may have her fertility compromised by the increase in all functions of the T3 and T4 hormones. This is because TSH, important for the proper functioning of all the body’s other hormones, can change and modify body hormones, including fertility hormones. It’s common to find cases of women with hyperthyroidism who cannot get pregnant simply because they do not ovulate due to this increase in hormones.
The blockage or drastic reduction of fertility hormones can delay ovulation or, in some cases, prevent it from happening at all. Therefore, diagnosis and treatment of the problem is fundamental. If you’ve been trying to get pregnant for a long time and haven’t succeeded yet, it’s worth talking to your doctor to check your hormone levels with a simple blood test. In fact, the diagnosis of hypothyroidism or hyperthyroidism is very simple. Just a laboratory test to determine TSH, T3, and T4 levels.
The treatment for hypothyroidism is simple: just replace the missing hormone with medication. However, the dosage changes from case to case, and only a doctor can guide its use. Self-medicating can cause problems and unwanted effects. In the case of hyperthyroidism, the treatment is different. The disease is controlled with antithyroid drugs such as levothyroxine, for example. The most common thyroid issue is hypothyroidism, which requires controlled medication replacement not indicated during pregnancy, since they can cross the placental barrier. For those planning pregnancy, once the disease is controlled, the menstrual cycle returns to its normal function and, on average after three months, you will be ready to get pregnant.
And what about hypothyroidism during pregnancy?
Hypothyroidism during pregnancy must be closely monitored by a doctor. As soon as a woman with hypothyroidism becomes pregnant, she must adjust the dosage of her medication upwards. In fact, ideally one should treat the issue before even getting pregnant. If pregnancy occurs during treatment, the doctor will advise how to proceed with the ongoing hormone replacement. It is important to treat it to avoid problems in the fetus3.
It is important to remember that, in very advanced cases of gland imbalance, hypothyroidism during pregnancy may cause malformations in the baby. It is also possible that untreated issues lead to heart problems and neurological and emotional development problems in the baby. Premature birth is also a possibility in women with hypothyroidism, as well as an acceleration of fetal heartbeats.
IMPORTANT: Did you know that thyroid issues can be passed on from mother to baby? When the mother has high levels of antiperoxidase antibodies, the baby has a high chance of inheriting thyroid disease. Through the enhanced heel-prick test, performed shortly after birth, it is possible to observe thyroid hormone levels and diagnose early.
Most gynecologists do not know exactly how important it is to control thyroid hormone levels during pregnancy. The correct approach is to monitor the pregnant woman’s hormones at least every two months to make sure everything is fine. In fact, a woman who did not have hypothyroidism before pregnancy may develop it after giving birth! That is why it’s important to have a doctor well-informed on the subject. Do not be afraid, hypothyroidism in pregnancy is a manageable problem. To be at ease, it is good to have a good endocrinologist working alongside your obstetrician. Working together greatly helps in controlling the disease and using the right medication.
In addition to medication for controlling hypothyroidism, a healthy diet together with exercise recommended during pregnancy, such as water aerobics, walking, yoga, swimming, and stationary cycling, also help ensure a smoother pregnancy. But do not exercise without a specialist’s guidance and your doctor’s approval. It’s also important to point out that teachers need special training to work with pregnant women. Also see: What is Prolactin – Hormones and Pregnancy
Photo: mrtopp
