Pregnancy and Thyroid Disorders: What You Need To Know
No matter if this is your first pregnancy or you consider yourself as an old hand at it, a thyroid condition can show up during any one of the pregnancies even if it has never happened before. I speak from experience that no two pregnancies are the same. My son's pregnancy was uncomplicated and the only thing that was adjusted the entire time was my Synthroid replacement from 1 to 112. This current pregnancy has been a trial from the very beginning. I was first told that the nausea and vomiting were from morning sickness even though it just felt different than the sickness I had the previous week. By the seventh day after being told it was morning sickness and to suck it up and deal with it from a nurse at my OB's office I had started having tremors in my hands and muscle fatigue. I ended up in the ER where they took my thyroid levels where the T4 came back at double the accepted limit of the range (2.0 ng/dL for their scale and I got 4.0 ng/dL). It is said that 1 in 200,000 have both the antibodies for Grave's Disease and Hashimoto's Thyroiditis however when I was first diagnosed my Endocrinologist told me that there were four other patients within their practice with the same condition.
From Thyroid.org about thyroid issues in pregnancy including recommendations for controlling the disorders (need Adobe Reader to open the brochure).
American Pregnancy Association: states that "Hyperthyroidism (overactive) can lead to premature birth and low birth weight if left untreated. Hypothyroidism (underactive) can lead to infertility or miscarriage when left untreated." This demonstrates that thyroid disorders can cause problems when left untreated but also not being treated properly can cause the same problem. If a thyroid level is taken once during a pregnancy, there is a potential for a condition to be missed because hormone levels and thyroid requirements change over the course of the pregnancy instead of staying the same.
The biggest things to remember about your health is that you are the greatest source of information. If something doesn't feel right, bring it up to your provider. If your provider dismisses your concern, get a second opinion. A thyroid condition that develops in the first trimester can be missed due to similar pregnancy symptoms such as morning sickness. This can be life threatening especially if the mother develops a hyperthyroid condition which the of the main symptoms are nausea and vomiting with tremors starting at higher hormone levels and can cause a Thyroid Storm. The only way to verify if the thyroid hormone levels are abnormal is to have your blood drawn and the following tests performed: (TSH), (free T3), and (free T4). Many providers will write off the symptoms since they mimics first trimester pregnancy side effects and most will think it's morning sickness or the flu. You will need to stand firm because you are the best source of information about your body. Those with a diagnosed thyroid condition should be consulting an Endocrinologist experienced in treating pregnant women due to the requirement to be closely monitored throughout the pregnancy. Remember, if it doesn't feel right the chances are it probably isn't and should be checked out by your OB or Midwife.
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