How Are Hashimoto's and Pregnancy Related?

In normal state, the immune system produces antibodies that identify and destroy foreign invaders such as bacteria, viruses and parasites. But in the case of Hashimoto's disease, a defect in the autoimmune system makes antibodies attack and destroy a victim’s thyroid gland. The disease is found among pregnant women. 

How Are Hashimoto's Disease and Pregnancy Related?

A pregnant woman may have Hashimoto’s disease triggered by the pregnancy. Research suggests this is due to women’s intricate hormonal systems which are more active during pregnancy. Other possible causes include:

  • Change of the immune system during pregnancy
  • Food intolerance
  • Gut infection
  • Imbalance of blood sugar level
  • Genetics

These complexities are thought to relate with Hashimoto’s during pregnancy, although the disease may also be present before pregnancy.

How Does Hashimoto's Disease Affect Pregnancy?

Hashimoto's and pregnancy relationship is that most cases of hypothyroidism during pregnancy are the result of Hashimoto’s disease. According to many studies, about 50 percent of pregnant women are diagnosed with subclinical hypothyroidism and 80 percent with overt hypothyroidism. 

Left untreated, hypothyroidism during pregnancy can lead to the following:

  • ŸAnemia
  • Low birth weight
  • Stillbirth
  • Miscarriage
  • ŸPreeclampsia
  • Congenital heart disease

Thyroid hormones play an important part in the development of the body, brain and nervous system of a fetus. This is even more critical during the first trimester. So pregnant women should receive treatment without delay.

  • Studies show that pregnant women with uncontrolled hypothyroidism have an increased risk of giving birth to babies with abnormalities such as cleft palate, kidney and brain defects, etc.
  • Such children are also likely to suffer from other problems in intellectual and physical development.
  • Some studies also suggest that presence of the thyroid antibodies associated with Hashimoto’s disease reduces chances of conceiving.

How to Diagnose Hashimoto's Disease During Pregnancy

The symptoms of Hashimoto's and pregnancy are similar, which makes it difficult to diagnose Hashimoto’s. The symptoms include:

  • Weight gain
  • Feeling depressed
  • Tiredness
  • Constipation
  • Cold feeling
  • Getting muscle cramps
  • Dry skin and dry hair

Your doctor can examine your thyroid and arrange further tests. Routine thyroid function screening can identify an underactive thyroid. Tests for Hashimoto’s disease include:

Thyroid Function Test

The test is done on a blood sample to determine the levels of thyroid hormone (T4) and TSH. TSH is a hormone produced by the pituitary gland to trigger production of T4 by the thyroid gland. High level of TSH signals an underactive thyroid. 

If the thyroid is not producing enough T4, more TSH is produced to trigger increased T4 production. A failing thyroid may cope for some time, in which case there will be high TSH and normal thyroid hormone. However, as thyroid damage progresses, there will be high TSH and low T4.

Antibody Test

The test is done on a blood sample and involves identifying antibodies suggestive of Hashimoto’s disease. These antibodies are usually only present in people with the disease. In some cases people having these antibodies will not have the disease; hence the presence of the antibodies will not cause symptoms.

Because the symptoms of Hashimoto's and pregnancy are similar, it may be difficult to know if you have the disease when pregnant. And yet, an underactive thyroid can have negative effects on the development of your unborn baby. To prevent this, ask your doctor for the above tests.

How to Treat Hashimoto's Disease During Pregnancy

1.     Medical Treatment

Hypothyroidism during pregnancy is treated with thyroxine, a synthetic thyroid hormone that is identical to the natural T4 produced by thyroid gland. The synthetic hormone is safe for both the mother and the fetus. Those who have had the condition prior to pregnancy need a higher dose of thyroxine. Additionally, pregnant women with Hashimoto's need a checkup once every six to eight weeks.

2.     Iodine

Pregnant women require more iodine than normal (about 250 micrograms). It is estimated that in the United States, 7% of pregnant women don’t get sufficient iodine in the normal diet. Using iodized salt instead of plain salt, and taking prenatal supplements containing iodine can meet the need.

But people who have autoimmune thyroid conditions can get adverse effects or be sensitive to iodine. For such people, eating iodine-rich foods such as seaweed, kelp and dulse, and taking iodine drops can worsen hypothyroidism. To avoid such effects, you should consult your healthcare provider.

Postpartum Thyroiditis

Besides the relation of Hashimoto's and pregnancy, here is another thyroid condition. This is an inflammatory condition of the thyroid in which stored thyroid hormones leak into the bloodstream, leading to excess level of the hormone. It affects about 40 percent of women in their first year following childbirth.

Postpartum thyroiditis is thought to be an autoimmune condition that causes hyperthyroidism for one to two months. For most women, this condition is followed by hypothyroidism for the next 6 to 12 months, after which they regain normal thyroid function. Some women’s thyroid glands are so damaged that they don’t regain normal thyroid function, leaving them with permanent hypothyroidism. Postpartum thyroiditis may recur during future pregnancies.

Most cases of postpartum thyroiditis go undiagnosed as symptoms are assumed to be postpartum blues. For this reason, a woman whose lethargy and fatigue stay for longer than a few months or who gets postpartum depression needs to consult a healthcare provider. Serious cases of hypothyroidism may require medication.

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