Here's why pregnant women should have their thyroid function monitored carefully

As if there weren’t enough things to worry about during pregnancy, here’s another one you might want to keep in mind. If you’re familiar with hypo or hyperthyroid disorders, you know that while inconvenient, they can be managed with the right medication and lifestyle changes. But abnormal thyroid function can be much more detrimental for expecting mothers as well as their babies. Many pregnant women do not know the importance of optimum availability of the thyroid hormone for maintaining pregnancy and a healthy baby. Similarly, a large number of people who have a history of successful pregnancies have no clue about thyroid being the reason behind it. [caption id=“attachment_7477531” align=“alignleft” width=“380”]  Representational image. Image by u_96tmu9c4 from Pixabay[/caption]

What is thyroid and why is it important?

The thyroid is a small, butterfly-shaped gland in the front of your neck that produces thyroid hormone. Thyroid hormone controls and checks how your body uses energy, so it affects the way nearly every organ in your body works - even the way your heartbeats. Sometimes the thyroid makes too much or too little of this hormone. Too much thyroid hormone is called hyperthyroidism and can cause many of your body’s functions to speed up. “Hyper” means the thyroid is overactive. Similarly, too little thyroid hormone is called hypothyroidism and can cause many of your body’s functions to slow down. “Hypo” means the thyroid is underactive.

What happens to the thyroid during pregnancy?

Normal pregnancy entails substantial changes in thyroid function in all animals, including humans. “During pregnancy, there is an overall increase in thyroid activity, which allows the healthy individual to remain in a net euthyroid state - with normal thyroid gland function. Both hyper and hypothyroidism can occur in pregnant women, although hypothyroidism is much more common,” said Dr Archana Nirula, a gynaecologist associated with myUpchar.com. “Undiagnosed or underlying hypothyroidism can even prevent pregnancy in some cases. Even if the woman becomes pregnant, inadequate amounts of thyroid hormone in the body can lead to miscarriage or a premature baby,” Dr Nirula added. “An expecting mother should get a Thyroid-Stimulating Hormone (TSH) test every two months to avoid any possible complications.” As for women who were already taking medicine for hypothyroidism before pregnancy, Dr Nirula advised consulting their doctor to revise their dosage. “After getting pregnant, they may need twice or thrice the amount. But if they continue to take the same dose of medication, they may give birth to a baby with congenital hypothyroidism - a condition that can lead to slow development or intellectual disability.”

What is Congenital Hypothyroidism?

Congenital hypothyroidism is a severe deficiency of thyroid hormone in newly born babies. This can cause physical deformities, stunted growth, and intellectual disability. Congenital Hypothyroidism can be caused by iodine deficiency or deficiency of thyroid hormones during early pregnancy. On the other hand, gestational hyperthyroidism — or an excess of thyroid hormone during pregnancy — is associated with increased risk of preeclampsia, premature labour, fetal or perinatal death, and low birth weight, among other problems. In humans, hyperthyroidism usually is the result of Graves’ disease, which involves the development of autoantibodies against the TSH receptor that stimulates the thyroid gland.

How to treat hypo and hyperthyroidism?

In an article published on “Thyroid function in pregnancy” in British Medical Bulletin, a peer-reviewed journal, researcher John H. Lazarus mentioned that thionamides anti-thyroid drug therapy (propylthiouracil in the first trimester and then carbimazole) is the treatment of choice for hyperthyroidism due to Graves’ disease. Doctors may prescribe L-thyroxine to treat hypothyroidism to reduce obstetric and fetal complications. Women already receiving thyroxine must increase their dose during gestation after consultation with their doctor. Other than the management of thyroid dysfunction through medicines, closely and regularly monitor thyroid gland activity. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, please read our articles on   Hypothyroidism  and the   TSH Test_._