Managing any chronic illness can be quite difficult. Especially if that illness is hypothyroidism, a disorder with fluctuating hormones and regular medication adjustment. Women with hypothyroidism who become pregnant often deal with a myriad of concerns beyond morning sickness and smell aversions.
It is well known that before trying for a baby you should make lifestyle choices that promote a healthy pregnancy, including scheduling a physical with your doctor. If you have hypothyroidism, you should probably schedule an appointment with your endocrinologist as well.
Your endocrinologist will need to know, almost as soon as you know, that you are expecting. The task of managing your thyroid levels with appropriate doses of your medication only increases in difficulty and necessity when you are with child.
If you are having difficulty becoming pregnant, your thyroid levels may be playing a role. The body needs adequate levels of thyroid hormone to carry out a variety of functions in women, one of these functions includes the release of an egg. If your hypothyroidism is not well managed it could delay or prohibit ovulation.
If you are hoping to become pregnant, you should work closely with your doctor and thyroid specialist. If necessary, they may refer you to a fertility specialist.
A severe and untreated hypothyroidism condition during pregnancy may lead to miscarriage or developmental delays in the baby. To minimize risk of complications, you, your OB, and your endocrinologist will likely work together closely.
Some other complications of hypothyroidism and pregnancy include:
Your thyroid levels should be monitored through frequent blood tests over the course of your pregnancy. In most cases, your thyroid levels will be kept in the normal to high range. This usually means your doctor will increase your typical medication dosage. In some cases, your dose may increase by up to 50%.
If your hypothyroidism is the result of an autoimmune disease, such as Hashimoto’s or Grave’s disease resulting in a thyroidectomy, there is a higher risk of your antibodies crossing the placenta. Your doctor will check for any antibodies present that may pose a risk to your baby.
During the first trimester or the first few months, your growing baby depends on you for thyroid hormone. These hormones are essential for healthy brain development. This is why it is important that your doctor monitors your levels closely and maintains your hormones within the standard range for pregnancy.
Though joyful and beautiful, pregnancy can be a challenging and worrisome time. It is perfectly normal to feel concerned for your unborn baby and worry about the effects of your thyroid disorder on your little one. It can be helpful to share any fears or concerns with your doctor so they can reassure you and provide any testing or treatment deemed necessary.
Most women with a known thyroid condition are managed quite well throughout their pregnancy by a team of doctors and go on to deliver a healthy baby. Even if you did not have a preexisting thyroid condition, doctors are beginning to include thyroid screening in maternal blood work panels to help catch the condition early.
Some women who did not have a pre-existing thyroid condition, but one that was triggered by pregnancy, will return to normal function after the birth of their baby. For those that had a thyroid condition prior to pregnancy, you will likely be able to quickly return to your normal medication dosage.
Certain thyroid disorders, namely Graves’ disease, can be passed to the infant resulting in neonatal Graves’ disease in which the baby experiences the symptoms of the disorder. If severe enough, intensive care and support may be necessary. However, this condition is quite rare and the effects are typically not long-lasting.
As your hormones return to normal levels and your body adjusts to motherhood, you should begin to feel like your “old” self once again. Most physicians will decrease your thyroid medication dosage almost immediately after birth.
As you resume daily activities it is important to self-monitor your symptoms and share any concerns with your doctor. Your doctor will likely want to check your blood levels within the first few postpartum weeks to make sure that your thyroid is back on track.
The most important factor concerning thyroid disorders and pregnancy is working closely with your doctor. If you are being treated for a condition currently, you should notify your physician about your plans to become pregnant so that they can maintain optimal thyroid levels to support your fertility. You should also contact them as soon as you find out that you are expecting.
Once pregnant you should be monitored frequently by your OB and your endocrinologist. They will work together to ensure that both your thyroid and your baby’s thyroid are functioning well, and that your little one’s development is on track. It is very likely that once you give birth your thyroid will return to its pre-pregnancy state with no lasting effects on you or your bundle of joy.
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