So You’re Pregnant With a Thyroid Disorder, Let’s Talk

Did you know that women are 5 to 10 times more likely to have something go wrong with their thyroid than men? In fact, 1 in about every 8 women will have a thyroid disorder over the course of her life – some when pregnant.

Dealing with Thyroid Disorders While Pregnant

Proper and quick treatment and regular monitoring of thyroid disorders can lead you to a healthy pregnancy…and a healthy baby. Lack of treatment, on the other hand, could lead to terrible consequences: from damaging health problems for mother and baby to miscarriage.

So, the good news is: treatment works and can take away your worry. The not-so-good news: about 60% of all people with thyroid problems don’t even know they have them!

Let’s take a moment to understand the thyroid, thyroid disorders, and the effects they have on a pregnant woman and her baby. We will understand why they can often go undiagnosed, what to ask for from your doctor, and how to treat these disorders in case they arise.

A New Relationship Between Your Thyroid and Your Pregnancy

Your thyroid is a very small butterfly-shaped gland found in your neck. Its main job is to both produce and release hormones necessary for your body to function. These hormones are T3 and T4.

T3 and T4 play a vital role in the metabolism process of each and every cell in your body – meaning it affects just about every organ and body system – from your heart to your nervous system. In short, your thyroid is really important. Yet sometimes, it doesn’t work properly.

  • When your thyroid is not producing enough T3 and T4, you have hypothyroidism.
  • When your thyroid is producing too much T3 and T4, you have hyperthyroidism.

Both have their own difficulties, but they do come with a set of unique problems for pregnant women.

It is not until the second trimester that your baby’s own thyroid kicks into gear and creates and releases thyroid hormones. Until then, your thyroid is responsible for providing enough T3 and T4 for both you and the baby. This means your levels of thyroid hormones go up and begin taking care of two different bodies. 

But if your thyroid is not working properly (and you are not properly treated), you both can be harmed.

Do You Have a Thyroid Disorder in Pregnancy?

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If you have been diagnosed with a thyroid disorder before getting pregnant, simply talk to your doctor to see if you need to adjust your current treatment plan. Sometimes you may need to take more mediation; sometimes you may need to switch medications.

If you have not been diagnosed with a thyroid disorder before getting pregnant, it is definitely possible to develop or discover one during pregnancy. However, it isn’t always so easy to find.

Doctors begin thyroid diagnosis with a blood test that looks at your levels of Thyroid Stimulating Hormone (AKA: TSH, the hormone that tells your thyroid what to do), T3, and T4. Along with an understanding of your symptoms, he or she will begin the diagnosis process to see if you have hypothyroidism or hyperthyroidism. 

But we’ve already learned that pregnancy brings about a rise in thyroid hormones. So, a typical blood test showing your T3 or T4 count to diagnose hypo- or hyperthyroidism might not be as cut and dry. 

Similarly, pregnancy often comes with a long list of its own symptoms that happen to be very similar to the symptoms of a thyroid disorder. Things like fatigue, weight gain, muscle weakness/tiredness, and anxiety can potentially signal a thyroid problem in most people – but they are also what just about every pregnant woman experiences.

So how do you know if you have a thyroid condition? 

Pay attention and listen to your body! Nobody feels perfectly healthy and normal during a pregnancy, but if you feel like your symptoms are severe or something doesn’t seem right, speak up! Also, pay attention to these clues:

  • Inability to gain proper weight during your pregnancy
  • Unexplained weight loss 
  • Hoarse voice
  • Irregular or very fast heart beat
  • Shaky hands
  • Severe constipation
  • Sensitivity to heat or cold
  • Muscle cramping

All of this does not mean you doctor cannot find out if you have a thyroid disorder, but it may take a little more time and monitoring than it would if you weren’t pregnant.

Pregnant with Hypothyroidism, Just the Facts

In the United States, about 2 to 3 out of every 100 pregnancies will have hypothyroidism. Chances are, you’ve even known somebody who’s experienced this.

Typically, these hypothyroidism cases are related to Hashimoto’s disease (it’s the most common cause of hypothyroidism in general). In this immune system disorder, your thyroid is attacked by antibodies. This attack causes inflammation and damage that leads to lowered production of thyroid hormones. Hashimoto’s will be mostly problematic in the first trimester, when your baby requires all that extra T3 and T4 from you for their development. 

If you have had thyroid surgery or radiation therapy in the past, the chances of developing hypothyroidism also go up. Some medications (like lithium) can lead to this condition as well. Be specific with your doctor about any medical procedure you have had or medication you have taken – they will know if a thyroid disorder is possible for you.

Reading about the facts of hypothyroidism and pregnancy can be helpful, but it might be even more helpful to hear about real life experience. In this video, you will hear one woman’s conceiving and pregnancy story while having hypothyroidism due to Hashimoto’s disease:

What to Expect When Treating Thyroid Disorders in Pregnancy

First off, expect to be monitored regularly. These frequent checkups will tell your doctors if your treatment plan needs to change throughout your pregnancy and will help prevent any real harm to you or your baby.

While some women with minimal thyroid problems may not need treatment during their pregnancy, most women will need to take treatment seriously. It is possible for untreated thyroid disorders to cause serious harm to both you and your baby, including the following:

  • Miscarriage
  • Premature birth
  • Anemia
  • Low birthweight
  • Preeclampsia
  • Congestive heart failure
  • Stillbirth

Fortunately, treatment should make these problems a non-issue for you! Your specific treatment will vary depending upon the severity of your condition and other factors. But here’s a general idea of what you can expect if your thyroid disorder does indeed need intervention.

  • Hypothyroidism Treatment: Fortunately, taking the synthetic thyroid hormone Levothyroxine is considered safe during pregnancy. This medication acts like T4 in your body and helps you achieve proper thyroid function. Thyroid desiccated (thyroid hormones from pigs!) is considered acceptable too. Some other hypothyroid mediations can be harmful to brain development and should not be used while pregnant. Talk to your doctor about any concerns.
  • Hyperthyroidism Treatment: Sometimes a woman may receive an antithyroid medication. Often specialists need to be monitoring this treatment closely to make sure it is only helping the thyroid levels, not causing birth defects. In more extreme cases, part of your thyroid may need to be removed.

Anytime you are feeling worse in any way when taking your thyroid treatment, be sure to call your doctor immediately. If you do not get an answer, head to your nearest emergency room.

Thyroid Diet and Supplements While Pregnant Are an Important Part of the Plan

Both hypothyroidism and hyperthyroidism can be aided by proper diet and supplementation. For example, the thyroid uses iodine to create thyroid hormones. Somebody with hypothyroidism can benefit from upping their iron intake, while somebody with hyperthyroidism can benefit from lowering it. Getting the right amount of zinc and selenium is important too.

Luckily, a good prenatal should have a general boost of these nutrients. If you are interested in adding any supplements to your prenatal vitamin, do so only after a consultation.

In terms of diet, lowering both your soy intake and gluten intake may prove helpful to managing your thyroid.

Pregnancy, Thyroid Disorders, and You

Here’s your thyroid and pregnancy plan:

  • If you already know you have a thyroid disorder, talk to your doctor before you become pregnant or immediately after finding out you are pregnant to discuss if any changes need to be made to your thyroid treatment plan. You will also begin the frequent monitoring of your thyroid and your baby’s thyroid.
  • If you have not been diagnosed with a thyroid disorder, it is never a bad idea to have your doctor run blood tests to check your levels from the beginning. Your doctor may do this on his/her own, but if not, ask!
  • If you have not been diagnosed with a thyroid disorder and have experienced some severe symptoms or any of those thyroid disorder “clue symptoms” we mentioned earlier, see your doctor immediately to check your thyroid.

Rest assured that proper treatment means you and your baby can have a smooth and healthy pregnancy process. As one scientific review states: “timely detection and treatment of the disorder could reduce the burden of adverse fetal and maternal outcomes.”

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