What Are The Treatment Options For A Pregnant Woman With Graves’ Disease/ Hyperthyroidism
Mild hyperthyroidism often is monitored closely without therapy as long as both the mother and the baby are doing well. When hyperthyroidism is severe enough to require therapy, anti-thyroid medications are the treatment of choice, with PTU being preferred in the first trimester. The goal of therapy is to keep the mothers free T4 in the high-normal to mildly elevated range on the lowest dose of antithyroid medication. Addition of levothyroxine to ATDs is not recommended. Targeting this range of free hormone levels will minimize the risk to the baby of developing hypothyroidism or goiter. Maternal hypothyroidism should be avoided. Therapy should be closely monitored during pregnancy. This is typically done by following thyroid function tests monthly.
In patients who cannot be adequately treated with anti-thyroid medications , surgery is an acceptable alternative. Surgical removal of the thyroid gland is safest in the second trimester.
Radioiodine is contraindicated to treat hyperthyroidism during pregnancy since it readily crosses the placenta and is taken up by the babys thyroid gland. This can cause destruction of the gland and result in permanent hypothyroidism.
Can Thyroid Disorders Hurt Male Fertility Too
Hypothyroidism in men can lead to a variety of fertility issues – reduced sperm volume and motility , sperm defects, a lower libido, problems sustaining an erection, and lowered male fertility hormones such as testosterone, luteinizing hormone and follicle stimulating hormone . If thyroid issues are suspected, it is best to run a complete thyroid panel.
Estrogen Tends To Get All The Attention But Balanced Thyroid Hormones Are Equally Important For Conception
With Elena Christofides MD and David Unuane MD PhD
Thyroid hormone imbalances can affect both female and male fertility, making it difficult for the sperm to enter the egg for implantation.
Your thyroid gland is the butterfly-shaped organ in the front of your neck that produces hormones that regulate your bodys metabolism and affect vital functions. Fertility refers to a couples ability to conceive and bring a baby to term. The relationship between your thyroid health and fertility is an important and sometimes complex part of conception.
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Two: Eat Plenty Of Non
The best foods for PCOS and thyroid problem are whole foods and which are not processed, such as non-starchy vegetables, herbs and leaves, whole rice, raw nuts and seeds. These foods are highly nutritious and therefore nurture and support all your internal systems. Include these foods in your daily regimen so that you can cure PCOS and thyroid and enhance your fertility naturally.
Are you tired of listening to eat that and this then you have to read my blog post titled True or False: Dietary Changes Can Help You Get Pregnant
What About Thyroid Dysfunction And Male Fertility
An impaired thyroid doesnt just have the power to impact womens ability to conceive theres also an effect on male fertility. Why? Because T3 and T4 both play a role in the development and function of the testes.
Hyperthyroidism can lead to reductions in:
- Semen volume, or how much is ejaculated
- Sperm density, or the sperm count per milliliter of semen
- Sperm motility, or how well and efficiently the sperm move
- Sperm morphology, or the size and shape of sperm
Hypothyroidism can lead to reduction in:
- Sperm morphology
Just like the effects of thyroid dysfunction on people with ovaries, people with testes can reverse thyroid-related fertility issues once the gland is back in working order after treatment.
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What Are Clinical Trials And Are They Right For You
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
What Is Postpartum Thyroiditis
Postpartum thyroiditis is an inflammation of the thyroid that affects about 1 in 20 women during the first year after giving birth1 and is more common in women with type 1 diabetes. The inflammation causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage raises the hormone levels in your blood, leading to hyperthyroidism. The hyperthyroidism may last up to 3 months. After that, some damage to your thyroid may cause it to become underactive. Your hypothyroidism may last up to a year after your baby is born. However, in some women, hypothyroidism doesnt go away.
Not all women who have postpartum thyroiditis go through both phases. Some only go through the hyperthyroid phase, and some only the hypothyroid phase.
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How To Maintain Thyroid Levels During Pregnancy
Apart from taking daily medications, these are certain things you can do in order to maintain thyroid levels during pregnancy:
- Reduce stress:Stress increases the levels of cortisol hormone in the body which prevents the thyroid gland from releasing hormones. Thus, stress can increase the chances of getting hypothyroidism.
- Increase physical activity: Exercises and yoga can help in increasing the levels of thyroid hormones in the body and also help in the better absorption of the hormones.
- Maintain a healthy diet: Avoid sugar, refined grains and caffeine to avoid the chances of getting thyroid disease.
- Increase iodine intake: An iodine deficiency can lead to goitre. The demand for iodine increases during pregnancy, so the expecting woman should consume more iodine-rich foods like fish and dairy products along with the supplements given by the doctor.
Thyroid Problems And Infertility: What’s The Connection
The body-wide hormone changes that hypothyroidism can cause may lead to irregular menstrual cycles and other problems with menstruation that can affect fertility. Both hypothyroidism and hyperthyroidism are known to prevent ovulation, the monthly process in which an egg is released to be fertilized. If no egg is released, you can’t get pregnant, even if you’re having regular menstrual periods.
There are other ways that thyroid problems can lead to infertility. Hypothyroidism can cause cysts to form on the ovaries. It can also lead to increased production of prolactin the hormone that controls milk production, or lactation in women who aren’t pregnant. When your prolactin levels are high, you may not ovulate.
Hypothyroidism has also been tied to a definite increase in the risk of miscarriage. Women who are hypothyroid are about four times more likely to have a miscarriage than women who aren’t. Women with untreated hypothyroidism are also at risk for having babies with developmental problems and slightly lower IQ levels.
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Why Do Thyroid Issues In Women Affect Pregnancy
Your thyroid is a small butterfly-shaped gland, located in your neck, that produces hormones to influence the speed of your metabolism. If your thyroid hormones fall out of balance, your metabolism can become too fast or too slow .
Either kind of thyroid imbalance can alter your testosterone, estrogen, and progesterone levels, which can cause you to stop ovulating. When your thyroid isnt functioning properly and your body stops releasing eggs, it becomes very difficult to get pregnant. Furthermore, thyroid imbalances can cause miscarriages and other problems during pregnancy.
If you have thyroid problems, you have to address it and get your thyroid hormones balanced before trying to conceive. Here are a few ways to bring your thyroid back into balance.
Exercise To Boost Your Thyroid Function
Regular exercise is one of the best things you can do for your thyroid. Working out consistently improves almost all markers of thyroid dysfunction .
Exercise also increases fertility, particularly in women who arent ovulating regularly . Just make sure you give yourself time to rest training too hard for too long without down time can actually decrease fertility. So, if youre feeling sore or exhausted, dont push yourself too hard in the gym.
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What Are The Symptoms Of Hypothyroidism
When the thyroid gland produces less thyroid hormone than it should , metabolism slows down and causes a variety of symptoms. At first, the symptoms of hypothyroidism may not be noticed, but over time these symptoms may become more obvious and severe and can include the following:
- Fatigue
- Repeated miscarriage
How Hyperthyroidism Affects Ovulation
The more common of the two main thyroid disorders is hyperthyroidism, the over-production of thyroid hormones. This can happen over either a short or long period of time, and it can affect many different functions of the body because of the thyroid’s influence over metabolism .
When the thyroid produces too much hormone, it can send the body into a state of over-activity, including high blood pressure, an increased appetite, and intolerance to heat and frequent sweating, as well as other side effects. When it comes to a woman’s ovulation cycle, hyperthyroidism can cause irregular or even a complete lack of menstrual cycles .
Most instances of hyperthyroidism are cause by Graves’ disease, an autoimmune disorder that directly affects the thyroid. It is often treated by correcting the body’s output of thyroid hormones .
It is not impossible for a woman to get pregnant if she shows signs of hyperthyroidism. But, if she does have hyperthyroidism, it has to be treated and monitored by a doctor to protect both her and the baby during pregnancy.
Left unchecked, hyperthyroidism can lead to complications like preeclampsia, a spike in blood pressure late into the pregnancy, as well as premature birth, a low birth weight or even miscarriage . But these are only symptoms of severe hyperthyroidism. For women who have a mild case of the condition, treatment is not generally needed during pregnancy .
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What Does The Thyroid Gland Do
The thyroid gland produces two hormones: triiodothyronine and thyroxine . These hormones play an important role in metabolism. Metabolism is the bodys ability to transform food into energy. The thyroid gland is controlled by thyroid-stimulating hormone . TSH is produced by the pituitary gland, which is located in the brain.
Optimising Thyroid Health For Conception And Beyond
Women with diagnosed hypothyroidism who are planning a pregnancy should have their thyroid hormone and TSH levels checked and, if required, their treatment adjusted.
“We like the thyroxine level to be a bit higher during pregnancy than in the non-pregnant situation, and the same applies with trying to get pregnant,” says Dr Morton.
She also recommends all women have a thyroid function test if they’ve been trying to get pregnant for more than six months, even though the NHS does not endorse routine fertility-related thyroid testing.
A 2015 study makes the case for universal thyroid screening for women who are subfertile or experience recurrent early pregnancy loss, concluding that the risks of “significant effects on reproduction from to conception to birth … can be significantly reduced if not ameliorated”.
That may be a way off, but women struggling to get pregnant should adopt a healthy diet and lifestyle – whether or not they have or suspect a thyroid problem. And if they do, a good starting point is to talk with their GP.
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When Should Treatment Be Considered
Thankfully, hypothyroidism can be treated very simply, by taking daily medication called levothyroxine that replaces the thyroxine hormone your body isn’t producing sufficiently. The problem is that often, subfertile women don’t know they might have an underactive thyroid gland, and many doctors don’t look for it.
Dr Jane Stewart, secretary of the British Fertility Society, explains that when hypothyroidism has the effect of reducing fertility, physical symptoms will typically be present – and it’s those symptoms that prompt doctors to investigate thyroid function.
“Hypothyroidism may result in menstrual irregularities and reduced fertility because of reduced ovulation it would usually be clinically evident, and if appropriately replaced those effects would be reversed,” she says. “Consequently, screening for thyroid problems for fertility purposes is not recommended.”
However, as Professor Pearce highlights, symptoms of hypothyroidism are nonspecific, usually develop over several years and could indicate any number of other medical problems. “One study showed that 20% of people with fully normal thyroid blood tests had four or more symptoms of thyroid underactivity,” he says.
As such, he suggests that doctors adopt a strategy of “aggressive case finding” when a woman is having unexplained fertility problems.
Women with a history of miscarriage or any other obstetric problem should also be investigated, he says.
How Low Hypothyroidism Affects Ovulation
Though it is the most common type of thyroid disorder, hyperthyroidism isn’t the only problem a woman could have. Her levels could swing the other way in a condition called hypothyroidism.
With hypothyroidism, the thyroid gland doesn’t produce enough T3 and T4 hormones, which can affect a person’s metabolism in a completely different way than over-production. Some symptoms of the condition include weakness and fatigue, depression, brittle hair or fingernails and unintentional weight gain .
The most common cause of low thyroid production is a condition called Hashimoto’s disease, similar to Graves’ disease in that it’s an autoimmune disorder. With Hashimoto’s disease, the body’s immune system mistakenly attacks the thyroid itself, damaging the gland’s cells and reducing the amount of hormone it can produce .
With cases of hypothyroidism that are less severe, ovulation can occur normally, much like with hyperthyroidism. However, the condition has to be closely monitored and possibly treated if a woman becomes pregnant.
In addition, there is one type of hypothyroidism that is extremely dangerous both to women trying to get pregnant and those already carrying a child. Though rare, a condition known as myxedema coma can occur in women with hypothyroidism.
In a fetus, thyroid hormones are essential to brain and nervous system development. Left unchecked, the mother’s hypothyroidism could negatively affect the baby’s growth .
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What Is The Thyroid
The thyroid is a tiny, butterfly-shaped gland in your neck. A gland is an organ that makes substances that help your body work. The thyroid makes hormones that play a big role in your health. For example, thyroid hormones can affect your heart rate and your metabolism .
Sometimes the thyroid gland makes too much or too little of certain hormones. When this happens, you have a thyroid disorder. Some women have a thyroid disorder that begins before pregnancy . Others may develop thyroid problems for the first time during pregnancy or soon after giving birth.
With treatment, a thyroid condition may not cause any problems during pregnancy. But untreated thyroid conditions can cause problems for you and your baby during pregnancy and after birth.
How Do I Know That I Have A Thyroid Problem
A simple blood test with your physician can assess TSH levels. Normal TSH levels fall between 0.5 to 4.5, with higher levels being associated with hyperthyroidism and lower levels associated with hypothyroidism. Should hormone levels fall outside normal ranges, your physician will also test your T4 to assess further.
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What Are The Risks Of Graves’ Disease/ Hyperthyroidism To The Baby
The risks to the baby from Graves disease are due to one of three possible mechanisms:
Tracking Your Tsh At Home With Modern Fertility
Whether you have a diagnosed thyroid condition or you’re experiencing possible symptoms of one , the Modern Fertility Hormone Test is an easy way to check in with your TSH levels and understand how they’re changing over time. Even if you’re currently on hormonal birth control, you can measure your TSH with a simple at-home finger prick as well as fT4 if your TSH levels suggest more thyroid testing is needed.
However you’re measuring TSH levels, it’s always important to talk to your healthcare provider about how to best monitor your thyroid health as you go after your fertility goals, move through your pregnancy, and navigate new parenthood.
This article was reviewed by Dr. Jennifer Conti, MD, MS, MSc.
| *This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. |
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How Does Pregnancy Affect The Thyroid
Normal hormone changes during cause thyroid hormone levels to increase. The thyroid gland may also enlarge slightly in healthy women during pregnancy, but not enough to be felt. These changes do not affect the pregnancy or your unborn baby.
Undiagnosed thyroid gland problems can harm you and your unborn baby. Symptoms of normal pregnancy, such as fatigue and feeling hot, can make it easy to overlook thyroid problems that cause the same symptoms. Tell your doctor or nurse if you have symptoms of overactive thyroid or notice a goiter.
