10. Tender, swollen breasts 9. Fatigue 8. Implantation bleeding 7. Nausea or vomiting 6. Increased sensitivity to odors 5. Abdominal bloating 4. Frequent urination 3. A missed period 2. Your basal body temperature stays high 1. The proof: A positive home pregnancy test
Follow us on: Twitter: twitter.com MySpace: www.myspace.com Facebook: www.facebook.comDISCLAIMER The participants in 5WaitingWombs are not medical professionals and do not take legal responsibility for any information or advice that is shared via videos, emails, comments. The information and facts we share are for educational purposes only and cannot substitute for a conversation with your doctor or pharmacist. We strongly encourage you to discuss with and obtain permission from your doctor before making any medical decision or beginning any over-the-counter or doctor prescribed drug(s) / herb(s).
Here is week 26 and 27. Going over new things and all that good stuff. Check out part II for a belly shot.
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Have a wonderful holiday, or evening!
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www.DrAieta.com Dr. Frank Aieta is a Naturopathic Physician with a private practice in West Hartford Connecticut. He is an expert in the treatment of chronic disease through the use of natural medicine. Dr. Aieta specializes in acupuncture, clinical nutrition, physical medicine, botanical medicine, homeopathic medicine and the use of bio-identical hormones.
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fluoridation hard to swallow. www.youtube.com Fluoride – It’s toxic! www.youtube.com CNN: Most Bottled Water is Tap www.youtube.com MSNBC: Pharmaceuticals in US Water Supply www.youtube.com New Fluoride News www.youtube.com Should Infants Drink Fluoridated Water? www.youtube.com Fluoridation Advocate Admits Poisoning Babies www.youtube.com Fluorosis www.youtube.com The same fluoride added to tap water and toothpaste is used to kill rats, roaches and termites and is used as a pesticide, because it kills bugs on contact.Fluoride is what makes sarin nerve gas poisonous – a chemical weapon that was used in Iraq.Fluoride is more poisonous than lead and just slightly less poisonous than arsenic (1984 issue of Clinical Toxicology of Commercial Products).Most fluoride added to tap water contains lead, arsenic and cadmium.If you have white or brown stains on your teeth, this is a sign of fluoride poisoning.Fluoride has been proven since the 1920′s to lower IQ at least 10-15 points.Fluoride causes bone cancer, hypothyroidism, osteoporosis and hip fractures.Fluoride causes the body to store aluminum in high quantities, which is associated with Alzheimer’s.It also induces depression, early puberty and causes many other diseases: www.slweb.org fluoride does not prevent cavities; it is the number one cause of tooth loss and makes teeth brittle, causing them to break.Fluoride is the main ingredient in most psychiatric medications, such as Prozac, and these meds are affiliated with …
www.DrAieta.com Dr. Frank Aieta is a Naturopathic Physician with a private practice in West Hartford Connecticut. He is an expert in the treatment of chronic disease through the use of natural medicine. Dr. Aieta specializes in acupuncture, clinical nutrition, physical medicine, botanical medicine, homeopathic medicine and the use of bio-identical hormones.
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www.DrAieta.com Dr. Frank Aieta is a Naturopathic Physician with a private practice in West Hartford Connecticut. He is an expert in the treatment of chronic disease through the use of natural medicine. Dr. Aieta specializes in acupuncture, clinical nutrition, physical medicine, botanical medicine, homeopathic medicine and the use of bio-identical hormones.
Done dieting? Want to learn about eating “raw”, Wilson’s Syndrome and hypothryroidism, and running/walking for weight loss? Come along with me as I record my journey into wellness.
Amy takes a viewer question from Amy (lovecanbemagic)DISCLAIMER The participants in 5WaitingWombs are not medical professionals and do not take legal responsibility for any information or advice that is shared via videos, emails, comments. The information and facts we share are for educational purposes only and cannot substitute for a conversation with your doctor or pharmacist. We strongly encourage you to discuss with and obtain permission from your doctor before making any medical decision or beginning any over-the-counter or doctor prescribed drug(s) / herb(s).
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How To Loose Weight With Hypothyroidism – How Long Does It Take To Loose Pregnancy Weight – Reduce Weight
How To Loose Weight With Hypothyroidism
Finding enough motivation to get your body back after pregnancy can be challenging enough. After 9 months of growing and stretching it definitely won’t be easy. I hope this article can help you achieve your goal and find personal happiness again.
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You do not have to spend your entire life in an overweight body. There are many things that you can do to get your weight under control and get your life moving in the direction that you deserve.
The article lists the factors causing over-weight and explains the components that must exist in a successful weight reduction plan.
Are you looking for some easy ways to lose weight fast? Losing weight can be difficult for many people but it does not have to be. Weight loss can actually turn into a fun hobby you just have to know how to get started and not overdo it. Take a quick look at these options of losing weight and you will see it doesn’t have to be as bad as some make it out to be.
In today’s world every body is living a very busy life. The adverse effect of busy lifestyle is that we don’t have time for proper exercise and also this routine disturbs our food. Many of us take food in irrespective way and also the food we intake is not always hygienic.
If you’re at all serious about weight loss you want to make sure you know how to choose the right weight loss plan for you. Once you have that down the rest is just following instructions but how do you know which weight loss products and diets are right for you? If you don’t know what you’re doing you can seriously and permanently hurt your body with the wrong weight loss program.
Diet is important and safe weight loss too. Looking good is important. And hence losing weight is important. But it is also important to take care of ones health. To lose weight does not mean that one should starve and discard all food.
Find More Hypothyroidism Articles
Does Hypothyroid Cause Heartburn – Pregnancy And Symptoms Early Heartburn – Doctors Treat Gerd
Does Hypothyroid Cause Heartburn
Heartburn pain can be mistaken for the pain associated with heart disease or a heart attack but there are specific differences. This article discusses the differences and outlines how Natural Solutions can be used for Heartburn and Acid Reflux.
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If you are a constant heartburn sufferer then you don’t need to be told how uncomfortable distressing or acutely painful your problem can be. I know it can affect your whole life…
Before you decide listen to this: keeping a diary can be a good way to have a picture of your heartburn symptoms. I say this because heartburn can be a complex problem and identifying the symptoms an important element. Of course it could be something as simple as too much salsa on a taco or perhaps something at bit stranger like roasted green bell peppers.
How to cure insomnia is an ever present question for a lot of people. It is estimated that at least half the population in the western world suffers from sleeping problems at one time or another. This article gives you the basic facts about insomnia.
Learn more about the different methods and foods you can use to help fight off heartburn. These could just be the best remedies for heartburn that you have ever found.
Is there a cure for Acid Reflux Disease? Learn all you need to know about this digestive disorder (also known as Gastro-Esophageal Reflux) a chronic condition in which stomach acid backs up into the esophagus causing persistent heartburn symptoms and / or serious damage in the lining of the esophagus.
If you have IBS and traditional treatments haven’t relieved your symptoms don’t give up hope. There are many lifestyle changes along with natural remedies that have given my patients a new lease on life. How is that possible? Let’s first take a look at what IBS is.
Part 2 of the video series dealing with thyroid disease in pregnancy. This video is about hypothyroidism in pregnancy.
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Hypothyroid is a self-protective mechanism. Visit healthbyyourself.net for more information. Learn to trust the designer.
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Pregnancy and Hypothyroidism
There are several issues with pregnancy and hypothyroidism. It is important that you discuss testing with your doctor if you are pregnant or plan to become pregnant. Hypothyroidism can be managed during pregnancy but there are some risks to the fetus. For example, during gestation the baby depends on the mother’s thyroid hormone. If the mother has a thyroid disorder the baby is more likely to physically develop at a slower rate.
Pregnant women with hypothyroidism are more likely to have children with a slightly lower IQ than women without hypothyroidism. On a related note, children born of mothers with the disorder are more likely to repeat grades and have trouble in school. In other words, mothers with untreated hypothyroidism have children with lifelong problems.
The best way to avoid these consequences is to get screened. Women who are pregnant or who are planning to become pregnant should get screened. If a woman is pregnant with hypothyroidism, she can take a low dose of the thyroid hormone to reduce negative side effects. If a woman is pregnant and taking thyroid hormone, her doctor will have to monitor her closely because of natural fluctuations of hormones during pregnancy.
It is very important to discuss testing with your doctor. You should make sure that you have a strong partnership with your doctor so that both of you can decide on the best course of action for you and your baby. Early action on the part of you and your doctor is critical. If you have already been diagnosed with hypothyroidism, you must let your Obstetrician know as soon as you find out that you are pregnant. This is important because it is critical that your thyroid hormone is kept in check during pregnancy in order to avoid side effects for the baby.
Many women are concerned about having a difficult pregnancy with hypothyroidism. Fortunately, most women with the disorder feel better during pregnancy. They do not feel as bone tired as they did before becoming pregnant. There is also less brain fog. Unfortunately, it is possible that a pregnant woman will develop gestational diabetes because of the hypothyroidism. It is also possible that the baby will have the disease, but it is rare.
The key points to remember for pregnant women with hypothyroidism are:
Get screened as soon as you know you are pregnant.
1.It is important to continue taking your medication even while pregnant.
2.it is important to have a good relationship with your doctor so the two of you can monitor your hormone levels.
3.Be vigilant about all of the above
Remember that there are risks involved with being pregnant and having hypothyroidism. If you pay attention and keep in front of the disease, it is likely that the baby will be fine. Stay vigilant. Take your medicine and communicate with your doctor.
It can be scary but at least it is manageable with early detection and carefully monitored medicine. Many OB/GYNs do not know much about hypothyroidism. Therefore it is important to tell your doctor if you have hypothyroidism.
At hypothyroidism diet you can learn more about hypothyroidism and its causes, cures, symptoms and what is the optimal thyroid diet. Also go to: Hypothyroidism Pregnancy to learn more about hypothyroidism and pregnancy.
Subclinical Hypothyroidism and Its Adverse Pregnancy Outcomes
Subclinical Hypothyroidism
Subclinical hypothyroidism, also known as mild hypothyroidism, is usually asymptomatic or if it does manifest itself, it may present with vague symptoms that could be attributed to other causes. Patients with subclinical hypothyroidism have elevated serum levels of the thyroid-stimulating hormone while maintaining normal levels of thyroxine and triiodothyronine and may occur in the presence or absence of thyroid antibodies.
A common cause for subclinical hypothyroidism in areas with sufficient iodine sources is Hashimoto’s disease. In Hashimoto’s disease, a person’s own immune system generates antibodies, now called autoantibodies, that target the thyroid gland and impair its function. Patients with subclinical hypothyroidism also run the risk of developing overt hypothyroidism.
Several signs of subclinical hypothyroidism include fatigue, constipation, weight gain, intolerance to cold, dry skin, menometorrhagia and infertility, decreased concentration and memory, and coarseness or loss of hair. Unfortunately, these symptoms may be overlooked by the patient himself and the hormone deficiency remains uncorrected until its more overt characteristics are manifested.
Adverse Outcomes of Subclinical Hypothyroidism on Pregnancy
A study was conducted to determine the presence of antithyroid antibodies in women enrolled in an in vitro fertilization program in comparison to a control group of women who have never been pregnant. All women in the control group with normal thyroid function and have no history of autoimmune disease or miscarriage. The findings suggested that the presence of antithyroid antibodies may have a hand in unexplained and mechanical infertility.
In another study, it was observed that the prevalence of spontaneous miscarriages is higher in women found to have antithyroid antibodies in comparison to women who tested negative for antithyroid antibodies. This study suggested that the presence of said antibodies in the first trimester of the pregnancy played a significant role in the increased rate of spontaneous abortion.
Women with overt and subclinical hypothyroidism were also found to have a significantly higher risk of developing pre-eclampsia, eclampsia, and pregnancy-induced hypertension. There was also a prevalence of gestational hypertension in mothers who were hypothyroid at delivery. Thyroid replacement therapy may help prevent gestational hypertension and its sequelae.
Women with overt hypothyroidism were also most likely to deliver babies with low birth weight in comparison to the general population. Women with subclinical hypothyroidism were less likely than those with overt hypothyroidism to give birth to low birth weight babies but still more likely to do so than the general population.
Placental abruption and preterm birth was also found to be of higher prevalence in women with subclinical hypothyroidism than in those with normal thyroid function. In comparison to euthyroid mothers, there was a three-fold increase in the incidence of placental abruption, almost two-fold increase in preterm delivery, two-fold increase in neonate intensive care admission, and incidence of respiratory distress syndrome in the neonates birthed by subclinically hypothyroid mothers.
Screening and Treatment
It is of utmost important for expecting mothers to be screened for subclinical hypothyroidism in order for them to enjoy a safe and normal pregnancy. The dire consequences discussed above are not only physically traumatic for both the mother and the child but may be emotionally tragic for the whole family. Prompt detection of subclinical hypothyroidism could determine the difference between a life and a loss.
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Hypothyroidism and Pregnancy
The thyroid gland is located at middle part of the front of the neck. Hypothyroidism is underactive thyroid gland in which, the thyroid gland doesn’t produce enough thyroid hormones. These hormones play an important role in body metabolism.
Pregnant lady can be labeled as ‘hypothyroid’ patient in many ways. This includes; having Hashimoto’s Thyroiditis, thyroid nodules or goiter, elevated TSH (Thyroid stimulating hormone) etc. If she has had radioactive iodine (RAI) or any kind of surgery of the thyroid and now receiving any kind of thyroid hormone replacement then also she is labeled as person with hypothyroidism.
Statistically, woman has 25% higher risk to develop the hypothyroidism after pregnancy if she has diabetes or any other autoimmune diseases. During pregnancy, hypothyroidism can affect pregnancy in many ways like; it can cause infertility in woman as it prevents the egg production, pregnant lady is at higher risk for miscarriage if she has hypothyroidism. If the hypothyroidism is left untreated during the entire period of pregnancy, the lady is likely to develop high blood pressure and premature delivery.
One has to be very careful if she develops certain hypothyroidism symptoms like; dullness, droopy eyelids, abnormal weight gain, constipation, muscle cramps, thickening of skin, swelling around neck etc. However, during pregnancy, a lady is thoroughly checked by a doctor regularly, so any change in the blood report, they hypothyroidism is usually detected.
On the other hand, baby produced by mother who was untreated or partially treated hypothyroidism may not reach its full intellectual potential. The study was published in 1999, New England Journal of Medicine stating, “Women with untreated thyroid deficiency during pregnancy are four times more likely to have children with lower I.Q. scores”.
It is not that that hypothyroidism will take of your joy during pregnancy. It is to be well treated and total control over the disease will keep you as happy as normal. Once hypothyroidism is diagnosed, the thyroid hormone replacement therapy is started by doctor. The dosage is an important factor during pregnancy and is decided by your specialist. The treatment is safe and also essential to mother and fetus. One should not stop the medications by any means as this may result into dangerous irreversible situations. For the baby, it is quite rare case that you may give your hypothyroidism to your baby as hereditary. Congenital hypothyroidism appears one per 4 to 5 thousand infants. But be sure to have your thyroid treatment started as early as possible (like in first trimester) because untreated thyroid will not only affect the mother but will also make child’s physical and mental impairment.
After pregnancy also, your doctor may advise you to continue the pills for thyroid. As far as breastfeeding is concerned, trace amount of thyroid hormone medication are excreted in breast milk. But you have to see the doctor and continue nursing to baby. In fact, you must be having proper thyroid functioning and normal level of thyroid hormone to ensure enough breast milk to baby.
When a lady becomes pregnant, she is to be fed with high nutritional foods including iodine salt. She must follow the diet chart given by the specialist. All the elements like iron, vitamins, proteins, carbohydrates and fats should be supplied in well manner and with proper quantity. This will help her not only to prevent disease like hypothyroidism but also to produce a healthy child.
More articles on Hypothyroidism:
Relationship of hypothyroidism to diabetes
What Are The Symptoms Of Hypothyroidism?
Ranju is a publisher of Hypothyroidism causes, symptoms and treatment information
Hypothyroidism and Pregnancy
Facts about hypothyroidism and pregnancy:
Hypothyroidism is a condition marked by an underactive thyroid gland and may occur during pregnancy. Unfortunately, many symptoms of hypothyroidism are masked by symptoms of pregnancy, such as fatigue, weight gain, and abnormal menstruation and, as a result, the disease is left undetected and untreated. In addition, the risk for developing hypothyroidism increases with age, which is significant because more and more women are delaying pregnancy until they are older.
What are the symptoms of hypothyroidism?
Hypothyroidism is a common condition, which can go undetected if symptoms are mild. Hypothyroidism means the thyroid is underactive, producing insufficient amounts of thyroid hormones. Symptoms of hypothyroidism are usually very subtle and gradual and may be mistaken for symptoms of depression. The following are the most common symptoms of hypothyroidism. However, each individual may experience symptoms differently. Symptoms may include:
dull facial expressions
hoarse voice
slow speech
droopy eyelids
puffy and swollen face
weight gain
constipation
sparse, coarse and dry hair
coarse, dry, and thickened skin
carpal tunnel syndrome (hand tingling or pain)
slow pulse
muscle cramps
orange-colored soles and palms
sides of eyebrows thin or fall out
confusion
increased menstrual flow in women
The symptoms of hypothyroidism may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
How does hypothyroidism affect the fetus?
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 hormones due to hypothyroidism can have devastating effects on the fetus. A study published in the New England Journal of Medicine showed that children born to mothers with hypothyroidism during pregnancy had lowered IQ results and impaired psychomotor development.
Thyroid screening and pregnancy:
The American Association of Clinical Endocrinologists and The Endocrine Society both support thyroid function screenings for all pregnant women. In fact, a study published in the New England Journal of Medicine showed that children born to mothers who had untreated hypothyroidism (underactive thyroid) were more likely to have mental defects. Detection, early in pregnancy, may prevent the harmful effects of maternal hypothyroidism on the fetus.
Ideally, a woman should be tested for a thyroid disorder before becoming pregnant, according to the American Association of Clinical Endocrinologists. If a woman is tested before pregnancy, she is more likely to have thyroid hormone levels in balance throughout her pregnancy.
How is the thyroid function screened?
Screening for hypothyroidism involves a blood test that measures thyroid hormone (thyroxine, or T4) and serum TSH (thyroid-stimulating hormone) levels. Hypothyroidism is often suspected when TSH levels are above normal and T4 levels are below normal. Always consult your physician for a diagnosis.
Who should undergo thyroid function screening?
Although the American Association of Clinical Endocrinologists advises that all pregnant women be screened for thyroid problems, they recommend, specifically, the following:
Whether to screen for thyroid disease or not should be a decision made by the physician and the pregnant woman.
Anyone considering becoming pregnant should have her thyroid checked in advance.
All pregnant women with a family history or symptoms of a thyroid disease should be tested.
How is hypothyroidism treated during pregnancy?
Once hypothyroidism is diagnosed, thyroid hormone replacement therapy may be used to treat the mother. Dosage of thyroid hormone replacement therapy is based on the individual’s levels of thyroid hormones. The treatment is safe and essential to both mother and fetus. When the fetus is born, routine newborn screening includes a test of thyroid hormone levels.
Discover How You Can Treat Infertility Naturally, Without Drugs or Surgery
Coping with Thyroid Disorders During Pregnancy
Pregnancy can sometimes be seen as a two-faced affair. On one side, it represents the blissful aspirations of a woman to finally give birth to a child, and on the other side, there lurks the dangers associated with the process that could undermine the health of both the mother and her child. As such, despite the joys associated with pregnancy, the stage is nonetheless mixed with an air of caution and vigilance to assure a safe journey to motherhood.
Pregnancy as a process involves numerous risk factors, some of which are potentially fatal if ignored or left untreated. Aside from the serious complications pregnancy brings, there are also the less serious but uncomfortable complaints such as frequent urination and back pains…
Thyroid Disorders in Pregnancy
One of the serious complications that could arise during pregnancy is thyroid disorders. Thyroid diseases affect around 25 percent of all women in their reproductive age.. Not surprisingly, thyroid disorders are a major concern affecting pregnant women. Most thyroid disorders that occur during pregnancy are autoimmune in nature, which means that the body’s own antibodies can take care of such disorders. The body develops antibodies, which are directed against thyroid cells. The action of antibodies on thyroid cells does affect the functions of the thyroid glands..
Hypothyroidism and Hyperthyroidism
In some instances, the antibodies reduce the function of the thyroid glands and the result is known as hypothyroidism, which is a reduction in the function of the thyroid glands. On the other hand, the action of antibodies on the thyroid tissue may stimulate thyroid cell function. This situation is known as hyperthyroidism because it is characterized by an overfunctioning of the thyroid. Both hypothyroidism and hyperthyroidism are anomalies in the function and state of the thyroid, which may occur during pregnancy and could bring about unwanted effects.
Careful Assessment in Treating Thyroid Disorder
In pregnancies where the mother is experiencing anomalies affecting the thyroids, medical treatment should be administered at once to avoid further complications that may worsen the situation for both mother and her child. However, in case of hyperthyroidism, caution should be exercised in assessing the symptoms experienced by the mother such as palpitations of the heart, sweating, and intolerance to heat. Although such may reveal the presence of hyperthyroidism, they are common in almost all pregnancies and are perfectly normal.
Treatment for Thyroid Disorders During Pregnancy
The following are the treatments for thyroid disorders during pregnancy.
Thyroid stimulating hormone treatment. When hypothyroidism is detected in a pregnant woman, the most common solution employed is the injection of thyroid stimulating hormone (TSH). The TSH will seek to balance the thyroid activity as doctors take care to religiously monitor the hormone level in the body. One of the common drugs administered is thyroxine. Thyroxine seeks to restore TSH level to normal.
Antithyroid medication. If hyperthyroidism is left untreated, the risks involve fetal death and other maternal comlications. The most commonly used method for treating hyperthyroidism is antithyroid medication. The most commonly used drug to treat hyperthyroidism is propylthiouracil.
Dr. James S. Pendergraft opened the Orlando Abortion Clinics in March 1996 to provide a full range of health care for women, including Abortion Clinics , physical examinations, family planning , counseling, laboratory services.
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Thyroid Function in Pregnancy – The Thyroid Connection Between Mother and Child
In pregnancy, the physiologic functions of the mother prior to conception are altered to provide the needs of the fetus growing in her womb. The placenta itself starts producing several hormones that are vital for a safe and normal pregnancy. These changes may also affect thyroid function and thyroid screening tests.
One of these changes is the increase in renal blood flow and the filtration rate of the kidneys, leading to an increased secretion of the circulating iodides in the body. Normally, most of the iodides acquired through ingestion of iodine-rich foods are quickly excreted by the kidney but not before the thyroid gland manages to “trap” about a fifth of the circulating iodides for the production of thyroid hormones. Because normal physiologic changes gets rid of some of the iodides before the thyroid manages to trap them, dietary iodide requirements are raised to around 200 micrograms per day in the pregnant woman in contrast to only 150 micrograms per day for normal persons.
In pregnancy, the mother’s thyroid gland ordinarily enlarges up to 50 percent with a corresponding increase in thyroxine or T4 secretion. One of the reasons for this change is that the human chorionic gonadotropin (hCG) secreted by the placenta has a stimulating effect on the thyroid. There is a broad structural homology between the beta subunits of hCG and thyroid-stimulating hormone (TSH), which gives hCG a weak thyroid-stimulating effect. Another hormone which may also affect the increase in thyroxine production by the mother is human chorionic thyrotropin, which is also secreted by the placenta.
Thyroid Function in the Fetus
The thyroid gland of the fetus begins to function by the end of the third month of gestation but prior to that time, the fetus is largely dependent on maternal thyroid hormones. The fetal thyroid gland gains the ability to produce thyroid hormones by around the eighth to tenth week of gestation. In the twelfth week of gestation, it begins to exhibit the ability to trap iodine actively and begins to produce thyroxine soon after.
Thyroid hormone is vital for fetal brain development as in neuronal multiplication, migration, and the structural organization of the brain of the fetus. Brain development occurs mostly during the second trimester, wherein the fetus is yet unable to produce its own fetal thyroid hormones and is largely dependent on maternal thyroid hormones for normal brain development.
Evidence supports the transfer of maternal thyroid hormones to the fetus via the placenta before and after fetal thyroid functionality. Thirty percent of the thyroxine found in the cord blood of neonates is maternal thyroxine and it has been found in the amniotic sacs of fetuses from 4 months to 6 months in gestation.
Thyroid Problems in the Newborn
The endocrine system of the newborn is usually highly developed at the time of birth and the neonate rarely exhibits thyroid function problems immediately. However, in some instances, thyroid function in the infant must be monitored.
One such example is that if the mother experienced hyperthyroidism or was treated with excess thyroid hormone during her pregnancy. If such is the case, the infant may be born with a thyroid gland that secretes less than the normal amount of thyroid hormone due to the excess in maternal thyroid hormone.
On the other side, if the mother had a thyroidectomy or surgical removal of her thyroid gland, the child may be born with temporary hyperthyroidism. This may be because the pituitary gland of the mother secretes increased amounts of thyroid-stimulating hormone due to her hypothyroid state. The thyroid gland of the fetus then responds to the maternal TSH and starts producing thyroid hormone in excess.
In a fetus with a problem in thyroid hormone secretion, there is poor bone development and mental retardation. This may cause the condition cretin dwarfism. If the newborn is not treated within several weeks, mental retardation becomes permanent. It is for this reason that newborns are routinely screened for hypothyroidism so as to prevent the devastating and permanent effects of cretinism.
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Thyroid Disease And Pregnancy
Thyroid disease affects different aspects of pregnancy and postpartum health for the mother and the newborn child. There have been varied and contradicting practices with regards to thyroid disease and pregnancy. As a result a group of endocrinologists came together to publish a journal containing clinical guidelines for the management of thyroid problems during pregnancy and during the postpartum period. The creation of this group came about over a two-year period and their findings were published in the Journal of Endocrinology and Metabolism, the August of 2007 issue. This journal represents the methods and practices of endocrinologists all over the world.
Some of the main components of that journal are being discussed below. The points bear crucial implications for women who are diagnosed with thyroid disease during their pregnancy or even at the postpartum stage. Some of the information also has a bearing on women who develop thyroid disease before they get pregnant.
Hypothyroidism & Pregnancy
The condition of hypothyroidism in a mother or an unborn child can cause serious health problems on the unborn baby. If a woman is aware of her condition as properly diagnosed hypothyroidism, she should reconsider trying to get pregnant or avoid maternal hypothyroidism altogether.
If a woman should develop hypothyroidism prior to her pregnancy and it has been properly diagnosed by a doctor or endocrinologist, her thyroid medication will need to be adjusted so that the thyroid stimulating hormone (TSH) level goes no higher than 2.5 prior to entering pregnancy.
A woman diagnosed as hypothyroid during her pregnancy should undergo treatment immediately. The goal is to restore her thyroid levels back to normal as soon as possible. Upon entering the first trimester, her thyroid-stimulating hormone (TSH) level should be held at less than 2.5. Upon entering the second and third trimester, her thyroid-stimulating hormone (TSH) should be maintained at less than 3.0. Thyroid function tests need to be reviewed and re-evaluated within 30 to 40 days after the initial diagnosis.
When a pregnant woman reaches week four to six, her thyroid medication dosage will almost always need to be increased. It is possible that her dosage will increase by anywhere from thirty to fifty percent.
Some women have a thyroid auto-immunity as in cases where she has been previously examined and found to be positive for thyroid antibodies. Woman who have an auto-immunity and who possess normal thyroid stimulating hormone (TSH) levels in early stages of pregnancy can still be at risk of becoming hypothyroid at any point in the pregnancy. It is recommended that she be monitored regularly throughout the pregnancy for elevated thyroid stimulating hormone (TSH).
If a woman is diagnosed with subclinical hypothyroidism which involves a thyroid stimulating hormone (TSH) level above normal with normal free T4 levels, her condition can lead to a negative health outcome for her and her unborn child. Immediate treatment of the mother can help to ensure a healthier pregnancy and birth outcome. However, treatment has not been proven to guarantee long-term neurological development of the baby. In spite of this, experts believe that the possible benefits of treatment still outweigh any possible risks if the mother went without treatment. The consensus is that treatment is recommended even in women with subclinical hypothyroidism.
Once childbirth has occurred, most women who have been diagnosed with hypothyroidism will need to have their medication dosage reduced.
Hyperthyroidism & Pregnancy
It has been found that hyperthyroidism can be brought on by Graves’ disease. Transient hyperthyroidism can also trigger hyperemesis gravidarum, which is a condition of pregnancy that causes severe morning sickness. The diagnosis involves determining whether a woman has a goiter, tests positive for thyroid antibodies or both.
If a pregnant woman’s hyperthyroidism is triggered by Graves’ disease or nodules are found in the gland, she should begin treatment for hyperthyroidism immediately. Generally, pregnant women are given anti-thyroid medication as part of treatment especially when initially diagnosed.
The most common antithyroid medication given usually during the first trimester is propylthiouracil. Propylthiouracil is generally the drug of choice because methimazole contains has a slightly higher risk of birth defects. Methimazole is used, but it is only prescribed if propylthiouracil is not available or if a woman is experiencing complications with it.
There are situations where surgery may be the only recommended method for treatment instead of drugs. They are:
If there is a severe negative reaction to anti-thyroid drugs. If a woman requires an extremely high dosage to control her hyperthyroidism. Uncontrolled hyperthyroidism remains despite treatment.
If the above cases are evident, surgery is recommended usually during the second trimester. The second trimester for this operation poses less risk to the unborn child and danger to the pregnancy.
Treating subclinical or mild hyperthyroidism has not been shown to improve or better the outcome of pregnancy. Therefore, treating subclinical or mild hyperthyroidism is not because of the potential negative effects on the unborn child.
Note: Radioactive iodine should never be administered to any woman who is or may be pregnant.
Antibodies, Graves’ Disease and Newborns
There are two antibodies in a mother that can cross the placenta and affect the unborn child’s thyroid gland. They are called TSH receptor-stimulating or TSH receptor-binding antibodies. If a woman is diagnosed positive for any of these antibodies while pregnant, her child can be born with hyperthyroidism. It is very important that these antibodies be measured in both women who have Graves’ disease or who have given birth previously to newborn children who developed Graves’ disease. It may be necessary to treat the mother with anti-thyroid drugs in order to reduce any risk to the newborn child.
If a woman has elevated TSH receptor-stimulating or TSH receptor-binding antibodies and is treated with anti-thyroid drugs, a doctor should conduct a fetal ultrasound evaluation. This scan will search for any evidence of dysfunction in the thyroid gland of the still developing baby. Such would include finding any evidence of slow growth and enlargement in the baby’s thyroid.
If a new mother has been diagnosed with Graves’ disease, her newborn child should still be evaluated after birth for any dysfunction in its thyroid gland.
Pregnancy with Severe Morning Sickness and Hyperthyroidism
Hyperemesis gravidarum is severe morning sickness that may also include dehydrations and significant weight loss. All pregnant women diagnosed with hyperemesis gravidarum should have their thyroid gland examined for any dysfunction.
If a woman is diagnosed with overt hyperthyroidism due to Graves’ disease and gestational hyperthyroidism with substantially elevated thyroid hormone levels treatment may be required.
Thyroid Nodules, Thyroid Cancer & Pregnancy
A fine-needle aspiration (FNA) biopsy evaluation is recommended for pregnant women with thyroid nodules measuring larger than 1 cm in size.
Once a pregnant woman is diagnosed with malignancy or cancerous thyroid nodules and they are such nodules are found during the first or second trimester, surgery should be recommended in the second trimester.
Note: Well-differentiated thyroid cancers grow at a much slower rate. If the evaluation or biopsy shows the cancer to be papillary or follicular without any evidence of advanced disease, a woman may be able to choose having the surgery after childbirth.
A pregnant woman previously diagnosed with thyroid cancer or a woman (as in the above case) diagnosed with a well-differentiated thyroid cancer opting to have surgery after her child is born can still receive treatment that can help to suppress thyroid stimulating hormone (TSH). Though her thyroid stimulating hormone (TSH) level may be suppressed, it would still be detectable. The desirable situation is to have free T4 or total T4 levels remain within the normal range for the pregnancy.
Note: Radioactive iodine should never be administered to women who are breastfeeding.
Women who are receiving therapeutic doses of radioactive iodine should wait a minimum of six months and up to a year before becoming pregnant. This will ensure stability of thyroid function and that the cancer is in remission.
Postpartum Thyroid Problems After Pregnancy
A thyroid evaluation should be conducted three to six months after a woman has given birth if she has already tested positive for thyroid peroxidase antibodies.
In women with type 1 diabetes, postpartum thyroiditis is three times more likely to occur. That being the case, woman with type 1 diabetes should have thyroid evaluation three months and six months after childbirth.
Women who already have a history of postpartum thyroiditis have a significantly increased risk of developing hypothyroidism within five to ten years after a postpartum thyroiditis episode. Any women that fall into this group should have their thyroid checked and evaluated annually.
Screening for Thyroid Dysfunction During Pregnancy
In particular, women who face a higher risk of thyroid disease should be screened and evaluated. It is recommended that these evaluations occur in women who are having an infertility evaluation.
It is also recommend that women who fall into the at-risk groups below be evaluated.
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