Hypothyroidism and Pregnancy

 

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Subclinical Hypothyroidism in Pregnancy

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Hypothyroidism in Pregnancy | Famous Gynecologist | Dr Shivani Chandan L Aster RV Hospital

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5 Weeks Pregnant | Early Ultrasound, Hypothyroidism, Early Pregnancy Symptoms

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Facts about hypothyroidism and pregnancy Hypothyroidism is a condition marked by an underactive thyroid gland and may be present during pregnancy. Many symptoms of hypothyroidism are similar to pregnancy symptoms. For example, fatigue, weight gain, and abnormal menstruation are common to both. Hypothyroidism can occur during pregnancy due to the initial presentation of Hashimoto’s thyroiditis, inadequate treatment of a woman already known to have hypothyroidism from a variety of causes, or over-treatment of a hyperthyroid woman with anti-thyroid medications. Hypothyroidism in pregnancy is usually caused by Hashimoto’s disease and occurs in 2 to 3 out of every 100 pregnancies.

1 Hashimoto’s disease is an autoimmune disorder. In Hashimoto’s disease, the immune system makes antibodies that attack the thyroid, causing inflammation and damage that make it less able to make thyroid hormones. If left untreated, maternal hypothyroidism poses a risk for both mother and baby. A pregnant woman’s thyroid hormones are vital not only for her but also for the development of her baby. Pregnant women with uncontrolled hypothyroidism can get high blood pressure, anemia (low red blood cell count), and muscle pain and weakness.

Hypothyroidism is a condition that is caused by an underactive thyroid gland. It may happen during pregnancy. Many symptoms of the condition are similar to pregnancy symptoms.

For example, they can both cause fatigue, weight gain, and changes in menstruation. Hypothyroidism can also cause a shortened second half of the menstrual cycle. This may not allow a fertilized egg enough time to attach to the womb. It can also cause low basal body temperatur.

Hypothyroidism, wherein the thyroid gland produces an inadequate amount of thyroid hormone, is a common disorder, particularly in women of childbearing age. Hypothyroidism of the mother during pregnancy may result in developmental delay in the child. Treatment of hypothyroidism requires thyroid hormone medication. Thyroid function tests change during pregnancy due to the influence of two main hormones: human chorionic gonadotropin (hCG), the hormone that is measured in the pregnancy test and estrogen, the main female hormone.

HCG can weakly turn on the thyroid and the high circulating hCG levels in the first trimester may result in a slightly low TSH. Hypothyroidism, an underactive thyroid, increases the risk of pregnancy complications, such as miscarriage, still birth, infertility, maternal anemia, pre-eclampsia, placental abruption, postpartum hemorrhage, premature delivery, low birth weight and deficits in intellectual development in infants.[2][3] Despite the warnings, not all doctors. Hypothyroidism and pregnancy 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. Deprivation of the maternal thyroid hormone due to hypothyroidism can have irreversible effects on the fetus.

List of related literature:

Hypothyroidism during pregnancy is less frequent because many women with hypothyroidism are anovulatory or have high rates of first-trimester miscarriages.

“Primary Care E-Book: A Collaborative Practice” by Terry Mahan Buttaro, Patricia Polgar-Bailey, Joanne Sandberg-Cook, JoAnn Trybulski
from Primary Care E-Book: A Collaborative Practice
by Terry Mahan Buttaro, Patricia Polgar-Bailey, et. al.
Elsevier Health Sciences, 2019

and T Increased 4 levels while iodine largely demand unchanging during pregnancy free lev­can cause both a 15% increase in sonographic thy­roid size in normal women, and a 25% increase in the pre­pregnancy levothyroxine requirement once a hypo­thyroid woman becomes pregnant.

“Swanson's Family Medicine Review E-Book” by Alfred F. Tallia, Joseph E. Scherger, Nancy Dickey
from Swanson’s Family Medicine Review E-Book
by Alfred F. Tallia, Joseph E. Scherger, Nancy Dickey
Elsevier Health Sciences, 2012

Serious hypothyroidism is rarely encountered during pregnancy.

“Clinical Gynecologic Endocrinology and Infertility” by Leon Speroff, Marc A. Fritz
from Clinical Gynecologic Endocrinology and Infertility
by Leon Speroff, Marc A. Fritz
Lippincott Williams & Wilkins, 2005

Most patients with primary hypothyroidism who are receiving an adequate dosage before pregnancy require an increased dose as the pregnancy progresses (an average dose increase of 25%-50%).

“Mayo Clinic Internal Medicine Board Review” by Amit K. Ghosh
from Mayo Clinic Internal Medicine Board Review
by Amit K. Ghosh
OUP USA, 2010

In most women, the hypothyroidism has already been diagnosed and treated before pregnancy.

“Endocrinology: Adult and Pediatric E-Book” by J. Larry Jameson, Leslie J. De Groot
from Endocrinology: Adult and Pediatric E-Book
by J. Larry Jameson, Leslie J. De Groot
Elsevier Health Sciences, 2015

If untreated during pregnancy, hypothyroidism increases the risk for miscarriage, premature delivery, and preeclampsia.

“Linne & Ringsrud's Clinical Laboratory Science E-Book: Concepts, Procedures, and Clinical Applications” by Mary Louise Turgeon
from Linne & Ringsrud’s Clinical Laboratory Science E-Book: Concepts, Procedures, and Clinical Applications
by Mary Louise Turgeon
Elsevier Health Sciences, 2018

If you were treated in the past for hypothyroidism and then become pregnant, you should have your OB doctor or an endocrinologist monitor your thyroid medicine carefully, because you will often need higher doses to keep within the optimal range as the ovarian hormones change rapidly during pregnancy.

“It's My Ovaries, Stupid!” by Elizabeth Lee Vliet
from It’s My Ovaries, Stupid!
by Elizabeth Lee Vliet
Scribner, 2003

Ideally, hypothyroid women should be made euthyroid before pregnancy (normal FT4 and a TSH below 2.5 µIU/mL) and the treatment readjusted whenever needed, because up to 60–70% of patients may require higher replacement doses during pregnancy.

“Management of Common Problems in Obstetrics and Gynecology” by T. Murphy Goodwin, Martin N. Montoro, Laila Muderspach, Richard Paulson, Subir Roy
from Management of Common Problems in Obstetrics and Gynecology
by T. Murphy Goodwin, Martin N. Montoro, et. al.
Wiley, 2010

Pregnancy does not change the symptoms of hypothyroidism or hyperthyroidism or the normal values and ranges of free serum thyroxine (T4) and thyroid-stimulating hormone (TSH).

“Master the Boards USMLE Step 3” by Conrad Fischer
from Master the Boards USMLE Step 3
by Conrad Fischer
Kaplan Publishing, 2015

A recent study of more than 700 patients with recurrent pregnancy loss identified 7.6% with hypothyroidism.35 Hypothyroidism is easily diagnosed with a sensitive thyrotropin test, and patients should be treated to become euthyroid before attempting a next pregnancy.

“Clinical Reproductive Medicine and Surgery” by Tommaso Falcone, William W. Hurd
from Clinical Reproductive Medicine and Surgery
by Tommaso Falcone, William W. Hurd
Mosby/Elsevier, 2007

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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28 comments

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  • Susan do u have estrogen or testosterone dominance with Hashimoto? I have Hashimoto and hormonal imbalance ( high androgens ; male hormones > than female). Which one do I have to focus on for the other symptom to get better? Does hormonal imbalance come from Hashimoto or is Hashimoto the result of hormonal imbalance?��

  • I have hashimotos and PCOS, i just started taking levothyroxine a week ago…i started 500mg 2 weeks ago and still no pregnancy. Im moderately active, ive tried vitex, i eat healthy and don’t eat diary.. i dont know what to do…

  • I found out I have hypothyroidism about 2 weeks ago. I go tomorrow to get more info on some more bloodwork done to see how bad it is. I have three healthy kids, 6, 4, and 6 months. I’ve also had 2 miscarriages. I’m really thankful that I was able to have kids despite having this condition. Thank you Jesus!!!

  • I have had hypothyroidism since 13 or so. then found out I had goiters and Hashimotos about 16, 17. I’ve had 3 pregnancies but 2 babies. and with each pregnancy my thyroid got worse and was having heart palpations. now at 31 I’m on 200mg synthriod I had a partial thyroid-ectomy. they found a bit of cancer and now a year later I’m getting the rest of my thyroid and goiters removed. ��. I just can’t wait to feel normal again!

  • Thank you for this video. I have Hashimotos and had a miscarriage last year. Finally have the courage to try again. Keeping fingers crossed!

  • This is not meant to disrespect your life and video. I apologize in advance if it makes you uncomfortable… I have Hashimoto’s disease and I haven’t had ANY of the symptoms that you have. Nor was I checked every month to make sure everything was ok. I just called the doctor when I felt that my Thyroid was starting to swell, and they would get me in for an appointment as soon as possible. That only happened once out of my pregnancy so far. I am 25 weeks currently. Nor did I see a doctor before I got pregnant. Mainly because I wasn’t planning on having a baby, but life happens. I also didn’t get the medication I needed until I was 3.5 months pregnant, And everything is fine with baby. I wanted to emphasize that every woman, pregnancy, baby, illness/disease is different. Yesssss what your saying is helpful. But also scary. I didn’t bleed one time. I just don’t want other woman to watch this and think DISASTER is going to strike them because of Hashimoto’s disease. But Someone will benefit from your story, and for that thank you for sharing.

  • Please tell me when will be ultrasonograpghy test confirms pregnancy?
    I mean at after how many days of intercourse we can go for it and confirm?
    Please tell me asap you read this.
    Thank you.

  • Gd afternoon mam, I am 2 months 4 days pregnant. Today i got my thyroid results T3 0.99ng/ml, T4-8. 04ug/dl, tsh-4. 09Ul/ml.mam pls tell me this result is normal or not

  • Congratulations on your pregnancy! You are not alone in your journey. It’s so great that you are sharing your experience with others so they can be aware of challenges and tips! Wishing you a healthy and happy pregnancy.

  • Hello I have hypothyroid Ian try to conseve last 5year my THS is 3.I am taking thyronom 88mcq last 3.5year but not sucesswhat I should to conseve

  • Hi man I want know I missed my period iam having thyroid iam taking 75 mg tablet I think iam pregnant also now this lockdown is there so I can’t go to hospital also for check up
    Now how can I do at home plz help

  • This was such a great video! I have had hypothyroidism since I was 18 and I’m now 23. When I first went to my endocrinologist my levels were in the 400s!! I don’t have family or friends with this same issue and it was so helpful to hear your story. I never hear about anyone’s experiences with this!

  • Not certain about the points made but,if anyone else wants to uncover what is positive mindset try Bablim Money Magnet Booster (should be on google have a look )? Ive heard some super things about it and my mate got great results with it.

  • I lost my baby at 12 weeks, I was given medication but might be pregnant again, is it safer for me to continue the medication or go without?

  • I’m 9 weeks pregnant my tsh is 2.05 t4 15 if this rises will my baby die emidiatly. My question is how long does it take for fetus to die if thyroid levels are abnormal

  • Helllow mam Meri 9month chalraha hey Meri tsh 3.7 during my 7month my tsh level was 3.37meri doctor ne mujhe thyronm 25 tablet suggest diyethey.mam after delivery Kya me thyroid medicine chodsakthi hoon

  • How did you get pregnant? What did you take to increase to get pregnant? I have been trying for 2 years to get pregnant but be having miscarriage. ��

  • Hello Dr. My wife is primi with 2 month of pregnancy, but her tsh is 15.8, is it effects the fetal growth, what can we do to get a healthy baby

  • Really enjoyed this segment on hashimoto’s and pregnancy! I would’ve never come across this if it wasn’t for my friend Elaine but so thankful she shared this with me. There’s so much I still feel I don’t know much about this auto immune disease and I’ve had one miscarriage so far. I’ve also been so afraid and reluctant to start hormone therapy but hearing both your stories, make me feel more at ease.

  • Hi mam I have an thyroid problem tsh level is 13 I m into my first timister of pregnancy
    Doctor gave me medicine thyroxine 75 mg
    Is there would be any future side effects

  • We just stumbled across this video and want to say a huge thank you! There is such little good quality information out there about Hashimotos and pregnancy, so much so that we decided to set up our own channel to chart our journey too. Thank you for leading the way!

  • Madam Main Maharashtra se Ek Constable bol raha hu aur meri Family 6 weak pregnancy hai
    Or abhi hum TSH check Kiya usme 100 se jada bataya hai
    TSH k wjhase baacche par effect ho sakta hai kya
    Plzzzz Madam Muje Bataye ������
    Apka contact number bhi nahi hai

  • Omg thank you so much for this video! I have had 2 miscarriages now. I just had my blood work done and found out I have Hashimoto’s. I’m just starting medication and this gives me sooooo much hope that the next time will work out.

  • Hi mam thank you so much making this vidio���� I have hypothairaid and my blood is B=negetive My 1st baby is 10 year old for normal dilivary blood negtive hone per jo injection lagta hai vo bhi baby born ke baad lagvaya tha i want 2nd baby but i am sucses please help aap kae hospital ka branch mumbai me hai to please rply����

  • Thank you for posting this video and congratulations on welcoming your baby boy.
    I have hashimotos and endometriosis. There was a surgery for endometriosis beginning of the year and I was gluten/dairy free 6 mo prior to the surgery and after.
    Could you please let me know if you followed gluten/dairy free diet throughout your pregnancy?
    Thank you!:)

  • Hi mam. Mere period miss hoke 15 days ho gaye. Symptoms he toh test kiya maine. But ve aya. Thyroid test kiya toh tsh value 1.7 aya. Kya hypothyroid ki wajah se urin me hcg leval kam ata he? Mai kya karu?

  • Many thanks, I have been researching “hormonal imbalance symptoms thyroid” for a while now, and I think this has helped. Have you ever come across Yannabarn Vanish Thyroid (search on google )? Ive heard some pretty good things about it and my neighbour got great results with it.

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