Side Effects Of Thyroid Medication During Pregnancy
The most commonly prescribed anti-thyroid medication, called Methimazole or Tapazole , may be associated with birth defects. Current recommendations are to stop MMI during the first trimester and to use Propylthiouracil with a switch back to MMI at the start of the second trimester and for the remainder of the pregnancy. Use of radioactive iodine, in the form of a pill or liquid, damages thyroid cells and is not safe during pregnancy or during lactation . For women who are given radioiodine ablation therapy to treat Graves disease, it is recommended that they wait at least one year after radioiodine treatment to become pregnant. Your healthcare provider will discuss the risks and benefits of treatment with you.
Women with hyperthyroidism can increase their chances for a healthy pregnancy by getting early prenatal care and working with their healthcare providers in the management of their disease.
Getting Pregnant Despite Having Hashimotos Thyroiditis
All over the world, there are millions of women who have an unfulfilled desire for children. This can place a lot of pressure on both partners, affecting the overall quality of life in a negative manner. Often times, the cause behind such difficulties is the condition known as Hashimotos thyroiditis. This is an autoimmune condition, in which the immune system practically attacks the thyroid gland.
If you are having difficulties conceiving, you might want to ask your doctor about this condition as the potential root cause. There are many women who have visited all sorts of specialists, hoping they will finally be able to enjoy the privilege of becoming mothers. Unfortunately, the diagnosis of Hashimotos thyroiditis is rarely thought as the first cause of infertility.
Aside from infertility, Hashimotos thyroiditis can cause one to experience low levels of energy, as well as weight gain and hair loss. Women might suffer from hormonal imbalances and cycle disruption. In the situation that one does manage to conceive, the risk of miscarriage is considerably higher.
If you have already been diagnosed with Hashimotos thyroiditis, and you are experiencing difficulties getting pregnant, you should visit a specialist. The fertility doctor can point you in the right direction, providing you with treatment solutions that are meant to increase your chances of having a baby.
Hashimotos thyroiditis, a hormonal imbalance that affects fertility
Fresh Fruits And Vegetables
Fruits and vegetables supply the body with minerals, vitamins, enzymes, antioxidants, fiber and water. Oh, and the magic! The magic of food is in veggies and fruits: color, flavor, freshness, texture and aroma.
You should eat a rainbow of fresh fruits and veggies to get all of the different nutrients you and your baby need.
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How Is Hashimotos Thyroiditis Treated
In the situation that you suffer from hyperthyroidism and you are interested in conceiving, the treatment might initially consist of partial thyroid hormone inhibitors. The anti-thyroid treatment can include but is not limited to propylthiouracil, thiamazole and carbimazole. In deciding on the treatment for your individual case, the physician will take into account your age, desire to conceive, medical history and co-existent conditions.
If you are already pregnant and suffering from Hashimotos thyroiditis, you might be prescribed such medication in a low dose. However, the treatment with anti-thyroid medication is not always necessary. In fact, it is reserved only for the cases of pronounced hyperthyroidism. During pregnancy, the administration of this treatment in regular or high doses can lead to malformations, miscarriage or premature birth, as well as placental detachment.
Mild cases of thyroiditis do not require treatment but the levels of thyroid hormones should be carefully monitored, in order to ensure that the condition does not progress. In the situation that these are out of the normal range, the doctor can adjust the medication accordingly.
If you are pregnant and suffer from hypothyroidism, you might also be recommended to take iodine supplements. This is essential so as to prevent developmental defects in the growing fetus. Use our pill reminder app to manage your medication.
CareClinic helps manage both Hashimotos thyroiditis during pregnancy
Can I Have A Healthy Pregnancy With Hypothyroidism
Yes you can! But, you need to do three things:
#1: Get your thyroid treated properly before getting pregnant. Remember: TSH should not be above 2.5 mIU/L.
#2: Work with your doctor closely to properly manage and likely increase your medication dose by 30% as soon as you get that positive pregnancy test.49 More on this below.
#3: Monitor your labs closely and frequently, which typically means every 4 weeks if pregnant and/or taking fertility drugs.
Your treatment options will vary based on your lab work, history, and if you have antibodies or not. So, youll want to talk to your doctor and/or midwife OR you can work with me on the Hashimotos and hypothyroidism piece if youre in Colorado, Texas, or Michigan.
I cannot stress the importance of treatment enough as hypothyroidism during pregnancy has been associated with many adverse outcomes, including: up to a 60% increased risk of pregnancy loss, in addition to increasing your risk for hypertension, premature birth, low birth weight, fetal death, impaired cognitive development, and lower IQ in baby.50 So yeah, its important!!
Now, the medication management piece is incredibly importantand not enough people know about it, so lets review.
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What Do Women With Hashimotos Disease Have In Common
They are often struggling with infertility and miscarriage. By addressing the potential immune dysfunction upon the T-cells, we aim to rebuild new uninfected T-cells with our Immune Balancing Protocol that have improved fertility outcomes from 42% to 65% without moving to IVF and getting 96% of recurrent miscarrying patients to carry to term. As a sideline, patients have related improvement in their Inflammatory Bowel Disease, Primary Biliary Cirrhosis, Chronic Urticaria, Migraines, and FMS. Hashimotos thyroiditis or chronic lymphocytic thyroiditis is thought to be an autoimmune disease in which the thyroid gland is attacked by a variety of cell- and antibody-mediated immune processes. It was the first disease to be recognized as an autoimmune disease but this presumes the immune system is the primary inciting event. It was first described by the Japanese specialist Hakaru Hashimoto in Germany in 1912.
How To Get Pregnant With Hypothyroidism And Pcos
Hypothyroidism or PCOS has a major impact on a persons overall health and well-being. Insufficient thyroid hormone secretion can trigger a domino effect or a series of reactions, which will affect your quality of life.
Hypothyroidism is not only related to the thyroid itself but also has other complications. In this case, there are many. One of these possible complications is polycystic ovary syndrome , which will be discussed in this article. Scroll down to see if there is a relationship between Hypothyroidism and PCOS.
Medications may be needed. High androgen levels can interfere with healthy ovulation. If healthy eggs are not released during ovulation, women will not be able to get pregnant. Many women with Hypothyroidism and PCOS cannot get pregnant without the help of ovulation drugs. These drugs can help women ovulate and become pregnant. Women can work with a doctor or fertility specialist to find the most effective correct dosage and type of medication.
Reducing stress
Maintaining stress can be challenging when dealing with infertility. But long-term stress can negatively affect hormones and fertility. Too much stress can cause cortisol levels to rise, which can trigger a surge in insulin. People struggling with stress can benefit from talk therapy, meditation, exercise, or contact with loved ones.
Try assisted reproductive technology.
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Tsh And Thyroid Medication Dosage Adjustment During Pregnancy
If you are being treated for hypothyroidism, its imperative to have at least a TSH level checked as soon as your pregnancy is detected. The TSH level results will indicate what adjustments have to be made to your medication levels.
TSH levels may be checked one to two weeks after the initial dose adjustment to be sure its normalizing. Once the TSH levels drop, less frequent check-ups are necessary during your pregnancy.
Although thyroid hormone requirements are likely to increase throughout the pregnancy, they tend to eventually stabilize by mid-pregnancy.
Levothyroxine/Synthroid and desiccated thyroid hormone medication is safe for use during pregnancy.
I suggest that for best absorption of the medication, you ought to take your thyroid hormone pills at least one-half hour to one hour before eating breakfast.
If you are consuming iron-containing prenatal vitamins and calcium supplements, be sure you take your thyroid medication at least one-half hour to one hour beforehand.
In addition, nutritional counseling to help lower antibody levels is ideal prior to conception to help support both the mother and babys health.
Unusual Signs Or Symptoms After Delivery May Indicate Thyroid Complications
Some thyroid complications can occur postpartum. People with a history of thyroid problems are at an increased risk of postpartum thyroiditis, a condition that occurs in about 5%-10% of people with ovaries when the thyroid becomes inflamed after having a baby. It may first cause the thyroid to be overactive, but it can eventually lead to an underactive thyroid.
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The Foods You Eat The Lifestyle You Live Causing Pcos And Thyroid
Eating junk foods is the characteristic of modern lifestyle. So we are predominantly taking sugars and carbohydrates. Our intake of vegetables, fruits and protein is very limited. Excess intake of sugars and carbohydrates disturbing the hormonal balance and therefore it is affecting the endocrine system.
PCOS and thyroid is a problem of a damaging endocrine system. It is, therefore, a wake-up call that something is going wrong in your body. If you can wake-up and take corrective measures, you can fix this problem.
Important Resources For Healing Hashimotos
I cured my Hashimotos disease even though none of my medical doctors believed that I could. It is important to share my story so that other people can know that it is possible.
It is definitely not easy, but it is completely possible to stop your body from attacking your thyroid.
A wonderful resource for healing from Hashimotos is Izabella Wentzs book, HASHIMOTOS THYROIDITIS: LIFESTYLE INTERVENTIONS FOR FINDING AND TREATING THE ROOT CAUSE . She is a pharmacist who is trying to bring awareness to the ability to heal from Hashimotos.
This book is a must read for understanding the possible root causes of Hashimotos. I highly recommend ordering it. Reading it was one of the very first steps I took when I began to heal my thyroid.
Another book that helped me on my journey is AUTOIMMUNE: THE CAUSE AND THE CURE by Annesse Brockely and Kristin Urdiales. This book focuses on autoimmune diseases as a whole and is broken into two parts.
Part one of the book is very technical in explaining how the body begins to breakdown into autoimmune disease and the second part tells you how to recover from it. Even if you dont get through the first part- the second part is the most important!
This book was pivotal in helping me understand how different foods impact your gut bacteria and how to restore the balance in your gut. It is also full of wonderful resources to find the foods that you need.
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Scrutinizing Screening: Why The Tsh Test Isnt Enough
Butand this is keyI would argue that you need more than just the standard Thyroid Stimulating Hormone test to evaluate for thyroid dysfunction.
There are a number of reasons for this, and best summarized in the Journal of Thyroid Research:
While this approach has been successful in many ways, it has some grave limitations. This includes the basic question of what constitutes an agreed reference range and the fact that the population-based reference range by far exceeds the variation of the intraindividual set point. Both problems result in a potential misdiagnosis of normal and pathological thyroid function in a substantial proportion of patients.47
Be aware that this is even more controversial than what Ive outlined above about subclinical hypothyroidism, so this may not be your doctors practice. However, I fall back on risk vs. benefits and clinical experience on this one.
To get a full picture of a patients thyroid health and manage thyroid medication, I find some of the following labs to be clinically very helpful in managing and titrating medication:
- TSH
- Total T4 and T3 if pregnant
- Free T4 and T3 outside of pregnancy
- Thyroid Peroxidase and Thyroglobulin antibodies
In pregnancy, specifically, a total T4 is recommended over free T4. This is because pregnancy increases serum binding proteins and free T4 may yield lower values based on reference ranges established with nonpregnant people.48 Likewise I would check a total T3 in pregnancy over a free T3.
What Is Hashimoto’s Disease
Hashimoto’s disease is an autoimmune disease that affects the thyroid gland. Your thyroid is a small gland at the base of your neck. Your thyroid gland makes hormones that control many activities in your body, including how fast your heart beats and how fast you burn calories.
In people with Hashimoto’s disease, the immune system makes antibodies that attack the thyroid gland. This damages your thyroid gland, so it does not make enough thyroid hormone. Hashimoto’s disease often leads to hypothyroidism. Hypothyroidism, when severe, can cause your metabolism to slow down, which can lead to weight gain, fatigue, and other symptoms.
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Need Help Getting Pregnant With Hashimotos Disease Try My Program
Send me a message if you would like more information about my fertility program.
integrativethyroid
Hi, I’m Ro, a Certified Integrative Health Coach. In 2016, I was diagnosed with Hashimoto’s Thyroiditis along with several other autoimmune issues and unexplained infertility. In 2018, after intensive research, I put my autoimmune diseases into remission naturally through diet and lifestyle choices and eventually gave birth to a healthy baby boy.
While There Is Little Controversy About The Importance Of Treating Overt Hypothyroidism In Reproductive Health Subclinical Hypothyroidism Is A Whole Different Ball Game
And its important to understand this is not your doctor or midwifes fault the problem lies in a lack of understanding about the symptoms and risk factors for thyroid disease coupled with insufficient evidence surrounding subclinical hypothyroidism and conflicting recommendations about who needs to be screened and when.
And thats what this article is all aboutso buckle your seatbelts and get ready to take back control of your maternal health.
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Who Gets Hashimoto’s Disease
Hashimoto’s disease affects more women than men. It can happen in teens and young women, but it most often appears between ages 40 and 60.1 Hashimoto’s disease often runs in families.
Your risk of getting Hashimoto’s disease is higher if you have another autoimmune disease, such as rheumatoid arthritis, celiac disease, type 1 diabetes, pernicious anemia , or lupus.
Management Of Hyperthyroidism During Pregnancy
Treatment for hyperthyroidism is very specific for each patient. The goal of treatment is to maintain normal levels of thyroid hormone. Treatment may include:
- Frequent monitoring of thyroid levels throughout pregnancy
- Use of anti-thyroid drugs that help lower the level of thyroid hormones in the blood
- Surgery to remove part of the thyroid
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Who Is Most Likely To Develop Hashimotos Disease
Hashimotos disease:
- Is more common in women than men.
- Commonly appears between the ages of 30 and 50.
- Tends to run in families .
- Is more likely to develop in people who have other autoimmune diseases, like certain liver conditions, B12 deficiency, gluten sensitivity, rheumatoid arthritis, type 1 diabetes, lupus and Addisons disease .
So What Are The Official Recommendations
The 2012 AACE guidelines recommend treatment with thyroid medication for women of childbearing age with the following lab parameters:31
- TSH > 2.5 mIU/L during preconception
- TSH > 2.5 mIU/L in the first trimester of pregnancy
- TSH > 3.0 mIU/L in the second trimester
- TSH > 3.5 mIU/L in the third trimester
According to the 2017 ATA guidelines despite imperfect data, the majority of evidence appears to support an association between overt thyroid dysfunction and an increased risk of infertility. Thyroid dysfunction is also reversible, and treatment is generally safe and may exert a positive effect on fertility. Therefore, it is reasonable to treat overt thyroid dysfunction in infertile women, with the goal of normalizing thyroid function.32
However, given the lack of controlled trials, the 2017 ATA Guidelines state that there is insufficient evidence to determine if treatment with medication improves fertility for subclinical hypothyroidism. Yet they recognize that treating subclinical hypothyroidism may be considered given its ability to prevent the progression to hypothyroidism once pregnancy is achieved, and the minimal risk.33
Im all about risk vs benefit, and in this situation there are low risks and potentially profound benefits with a very simple, widely available and inexpensive intervention.
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I Have Personal Reasons To Share This Story
I can identify with the mother, although my storys series of events is very different.
Im a person with indirect evidence of both TSAb and TBAb in my lab history, who was treated with LT4 after a TSH over 150, without any sign of a goiter, and without being tested for any antibodies.
My doctors didnt care to fully diagnose my rare form of hypothyroidism because they were taught the common mantra that antibodies make no difference to LT4 therapy. Well heres the news. TSAb and TBAb can destabilize the bodys response to thyroid therapy. I didnt get antibody tests or a thyroid ultrasound until 13 years later, when I was very sick with very low T3 during a TBAb antibody flare, when I learned that my thyroid gland was completely atrophied at 0.5mL and my TPOab was normal.
Fortunately for others, my blind LT4 treatment began shortly after my childbearing years, so my antibody fluctuations and my chronic low T3 could not harm a future babys life. Women past childbearing age apparently dont deserve autoimmune diagnoses when they become hypothyroid.
But I did have a miscarriage in my teens. I cant help but wonder if undetected, untreated thyroid autoimmunity was a reason. I look back and see many symptoms that make it likely.
So, thats why I had to write about this article.
It is a clear and accurate title, but only if you already know what those words mean. And as of 2021, both my body and my mind know what those words can mean.
