08December2019

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Thyroid Functioning – Things to do During Pregnancy

Dr. Nupur Gupta, Gynecologist& Director, Well Woman Clinic, Gurguram

The thyroid is a key link to whole body wellness. The butterfly shaped small size thyroid gland can have a dramatic impact on most of the metabolic processes in your body. The disorders associated with thyroid can range from a small, harmless goiter to weight gain, graves diseases, weight loss and to thyroid cancer in extreme cases. The most common thyroid problems involve abnormal production of thyroid hormones. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to hypothyroidism. Although the effects can be unpleasant or uncomfortable, most thyroid problems can be managed well if properly diagnosed and treated.

What happens during hypothyroidism?

Low thyroid functioning may be directly linked to negative impact on women’s reproductive health. Hypothyroidism is more common a cause for infertility and miscarriage in women than most of them realize.

When thyroid gland does not produce enough hormones; it interferes with the release of egg from ovaries during ovulation and impairs fertility. Common symptom that indicates you may have hypothyroidism are Fatigue or lack of energy, Dry, coarse skin and hair, Sensitivity to cold temperatures, Heavy and/or irregular periods. Puffy tissues, Unexplained weight gain, Depression, Muscle cramps, muscle pain and tenderness, Slower than normal heart rate, Constipation, Infertility, Mental lethargy Goiter (swelling of the thyroid, located just below the Adam's apple) and Decreased libido.

Things to do during pregnancy

Thyroid disorders are very common during pregnancy. Over 25 % women develop hypothyroidism during the 6th week. Secretion of thyroid hormone is important for both placental and fetal development and the level needs to increase by 50% during pregnancy to accommodate the increased metabolic needs of both mother and fetus. And when a mother’s body fails to secrete enough of it against the demand, the risk of miscarriage, preterm birth, low birth weight, and postnatal developmental issues becomes higher

A negative feedback loop exists between the ovarian and the thyroid hormones which are needed for egg follicle maturation and ovarian production of estrogen and progesterone. Hypothalamus, pituitary, thyroid, ovaries, and adrenals – all these glands are interconnected like a spider web. Hence imbalance in one part of the web will influence the other glands and hormones in the system.

It is really important for a woman to keep a check on her hypothyroidism to become pregnant. Conception is more difficult for hypothyroid women due to associated ovarian dysfunction. Women with thyroid disorders often have menstrual cycle abnormalities such as flooding, scanty periods or irregular cycles. Close monitoring of the thyroid hormone level during pregnancy is essential to promote normal fetal development and reduce the chances of miscarriage.

What causes hypothyroidism?

The most common cause of hypothyroid is autoimmune disease or improper medications and use of lithium. Family history of thyroid disease, RA can be a reason for risk. After developing hypothyroidism, women has reduced libido, menstrual abnormalities and may have difficulty in conceiving. During pregnancy, fetal growth and development is controlled by maternal thyroid hormone, with help from fetal thyroid hormone later in pregnancy. Growth and development continue to be regulated by the thyroid postpartum.

How to prevent hypothyroidism and thus infertility?

- Stop smoking - Smoking can damage the thyroid, and may worsen some existing thyroid conditions leading to prevention of hormone secretion. This is a contributing factor for infertility.

- Drink bottled water - Fluoride and perchlorate content in water are those substances which trigger hypothyroidism or lead to risk of other thyroid problems.

- Consume Moderate Iodine - When it comes to iodine, think moderation. Too little or too much iodine -- including taken as kelp or bladderwrack -- can increase your risk of hypothyroidism or goiter.

- Reduce your stress - Reducing stress using effective mind-body techniques can play a part in preventing thyroid disease.

 - Be careful about too much soy - Excessive soy isoflavones may trigger or worsen hypothyroidism, goiter or nodules. Some doctors advise avoiding soy supplements and powders and eating no more than one small serving of soy foods daily.

- Don't feed infants soy-based formulas - There's evidence that this can contribute to later risk of thyroid disease.

For women, treating hypothyroidism is an important part of any effort to correct infertility. If infertility remains after hypothyroidism has been corrected, other interventions to treat infertility may be needed.

Early diagnosis and control is mandatory in pregnant women. Getting a blood test on time can indicate timely treatment measures.

  • Written by Denis Giles
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