Thyroiditis and trying to conceive

For women who suffer from thyroid disorders, conceiving a child may be a tricky thing. There are two main types of thyroid disorders: too little hormone such as Hashimoto’s thyroiditis and too much hormone such as Graves’ disease. Both conditions are difficult to diagnose because in some cases the symptoms are very mild. Many times they are misdiagnosed as depression, aging or other causes of fatigue and forgetfulness.

There are several different tasks which women can take in order to determine the causes of their symptoms, whether Hashimoto’s or Graves’ disease. But the final conclusion is that a woman who experiences either one of these thyroid disorders, more commonly Hashimoto’s thyroiditis, will have a difficult time conceiving a child. (1)

In a study published in 2004 researchers from Italy strove to compare the effects of pregnancy on thyroxine levels in two groups of women who suffered from primary hypothyroidism. They concluded that the results suggest that women who are hypothyroid and anticipate pregnancy should have their dosages adjusted to results in adequate maternal function up to the first post conception evaluation in order to increase the chances of a safe pregnancy. But this is the opposite effect of women who have hyperthyroidism or Hashimoto’s disease. (2)

The thyroid gland secretes a hormone that is important to the overall function of the human body. Hashimoto’s disease or thyroiditis is a condition that affects the thyroid gland. It is actually the most common form of thyroid problem in the United States and affects more women than men. At this time researchers and physicians believe that Hashimoto’s disease is an autoimmune response in the body where are the body’s own immune system attacks the cells of the thyroid gland. (3)

The thyroid gland is located on the lower part of the neck and is shaped like a butterfly. It is wrapped around the outside of the trachea (windpipe) and secretes the hormones thyroxine and triiodothyronine. These hormones assist the body in the functioning of heart rate, blood pressure, body temperature and the metabolism of food. Women who have low thyroid secretion are often placed on a synthetic thyroid hormone in order to regulate their heart rates, blood pressure and stabilize their metabolism.

The thyroid gland also secretes calcitonin which is another hormone designed to keep bones healthy and strong.

Some of the more common symptoms that women will experience when they are suffering from Hashimoto’s disease is fatigue, weight gain, weakness, dry skin and hair, cold intolerance, depression and heavy menstrual cycles. The goal of treatment is to bring the thyroid gland into balance. Because thyroid levels are low the doctor will use a prescription called Synthroid to help raise these levels.

When left untreated, Hashimoto’s disease can actually affect ovulation and menstruation. But, once diagnosed and treatment begun, there is not usually a problem with getting pregnant. Women must have their TSH levels monitored regularly, especially if they become pregnant because the metabolism will change in the body as well as the need for specific doses.

During the initial 12 weeks of pregnancy the hormonal secretion is completely dependent on the mother but by the end of the first trimester the baby’s own thyroid gland begins to produce hormone.

Hypothyroidism can also occur in a woman during pregnancy. If it is suspected the doctor can perform a blood test which will show a lower level of thyroid hormone in the blood. Thyroxine, the most common medication used to treat hypothyroidism, is safe to take and well absorbed during pregnancy. However, because of the variation in metabolic rate, due to the growing baby, doctors must monitor low-level and increase the thyroxine dose if necessary.

Postpartum thyroiditis can happen in eight to 10% of women. This can also happen in the non-postpartum period and is also an immune disease related to Hashimoto’s thyroiditis. It usually lasts between six weeks to three months followed by hypothyroidism between three and nine months after delivery. Women at risk will be those who have had a previous history of postpartum thyroiditis or who have thyroid antibodies in their blood but are not taking thyroxine. Usually no treatment is required for the hyperthyroid phase in a short course of thyroxine for six to 12 months is sufficient for the hypothyroid phrase.

When determining how thyroiditis may affect the conception of a new child, physicians and potential new parents should fully discuss the options and potential side effects of treatment for the thyroiditis. There is equal concern for the welfare of both the mother and baby but it is fortunate that most conditions can be recognized and problems can be anticipated. In the case of thyroiditis the outcome is almost always a healthy one, for both mother and baby.

 

(1) Thyroid: Thyroid Dysfunction and autoimmunity in Infertile Women
http://www.ncbi.nlm.nih.gov/pubmed/12490077
(2) Medscape reference: Hypothyroidism Treatment and Management
http://emedicine.medscape.com/article/122393-treatment

(3) Mayoclinic: Hashimoto’s Disease
http://www.mayoclinic.com/health/hashimotos-disease/DS00567

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