Disease: Hypothyroidism During Pregnancy
(Thyroid Deficiency During Pregnancy)

    Hypothyroidism during pregnancy facts

    • Hypothyroidism, wherein the thyroid gland produces an inadequate amount of thyroid hormone, is a common disorder particularly in women of childbearing age.
    • Hypothyroidism of the mother during pregnancy may result in developmental delay in the child.
    • Treatment of hypothyroidism requires thyroid hormone medication.
    • There may be indications to start thyroid hormone therapy in women who are borderline in thyroid function and who are either pregnant or desiring pregnancy.
    • The treatment goal of hypothyroidism in pregnancy is to maintain a thyroid hormone level within high normal range.
    • Pregnant women who are on thyroid hormone should have blood testing frequently during pregnancy as requirements may change.
    • Early studies found that children born to mothers with hypothyroidism during pregnancy had lower IQ and impaired psychomotor (mental and motor) development. If properly controlled, often by increasing the amount of thyroid hormone, women with hypothyroidism can have healthy, unaffected babies.

    Introduction

    Thyroid disease is particularly common in women of child-bearing age. As a result, it is no surprise that thyroid disease may complicate the course of pregnancy. Frequency varies among different populations and different countries. While pregnancy itself is a natural state and not a "disease," thyroid disorders during pregnancy affect mother and baby. This article focuses specifically on hypothyroidism and pregnancy. After a general description of normal and abnormal thyroid function, recent data on long term consequences in children of mothers who had hypothyroidism during pregnancy will be reviewed.

    What is the thyroid gland?

    The thyroid is a gland weighing about 15 grams (about half an ounce) that is located in the front of the neck just below the Adam's apple (cricoid cartilage). The thyroid gland is responsible for the production of the body's thyroid hormone. The thyroid responds to hormonal signals from the brain to maintain a constant level of thyroid hormone. The hormone signals are sent by specialized areas of the brain (hypothalamus and pituitary), eventually sending thyroid stimulating hormone (TSH) that promotes thyroid hormone production by the thyroid gland.

    Picture of the Thyroid Gland

    What happens with thyroid disease?

    Disease of the thyroid gland is extremely common. In some conditions, the thyroid may produce too much hormone. In other conditions, the thyroid may be damaged or destroyed and little, if any, thyroid hormone is produced. The main thyroid hormone is called thyroxine, or T4.

    Symptoms vary depending on whether there is too much or too little T4 present in the blood. With an excess of T4 (hyperthyroidism), patients complain of feeling restless, emotionally hyper, and hot and sweaty. They may have tremors, trouble concentrating, and weight loss. Frequent bowel movements and diarrhea are common.

    If T4 levels are low (hypothyroidism) as a result of decreased production by the thyroid gland, patients often experience  fatigue, lethargy, and weight gain. Constipation is common and many patients report feeling excessively cold.

    How is hypothyroidism treated during pregnancy?

    In many respects, the treatment of hypothyroidism in pregnant women is similar to that in nonpregnant women.. A synthetic form of T4 is given to replace the missing hormone. The medication dose is regularly adjusted to maintain a steady blood level of thyroid hormone within the normal range. Therefore, it is routine practice to monitor the blood level of the thyroid stimulating hormone (TSH) during pregnancy. For more information, please read the article on Hypothyroidism.

    What are the consequences of hypothyroidism during pregnancy?

    For years, physicians have known of a link between mothers with hypothyroidism during pregnancy and developmental delay in their children after birth. This was particularly seen in mothers who came from iodine deficient areas of the country (iodine is necessary to produce thyroid hormone and is now a common component of the salt in our foods) and was also observed in mothers with autoimmune thyroid disease, such as Hashimoto's thyroiditis.

    There is a relationship between thyroid levels in the mother and brain development of her child. A large study reported in 1999 found that undetected or inadequately treated hypothyroidism in mothers was associated with IQ changes in the infants of these women. The average IQ scores were about 4 points lower in the children of hypothyroid mothers than in children of normal mothers. Larger IQ deficits were seen in the children of mothers who had more severe hypothyroidism. These children had an average IQ 7 points lower than normal. In addition, almost 20% of these children had IQ scores of less than 85 compared to 5% of the children of normal mothers. The children of hypothyroid mothers were also more likely to have difficulty in school or have repeated grades.

    This study demonstrates that uncontrolled hypothyroidism in pregnant women can have long-term effects on the children of these mothers. Also, the effects occur even if the hypothyroidism is mild and the woman does not exhibit any symptoms. However, the more significant the hypothyroidism, the greater the likelihood of developmental problems.

    What is the thyroid gland?

    The thyroid is a gland weighing about 15 grams (about half an ounce) that is located in the front of the neck just below the Adam's apple (cricoid cartilage). The thyroid gland is responsible for the production of the body's thyroid hormone. The thyroid responds to hormonal signals from the brain to maintain a constant level of thyroid hormone. The hormone signals are sent by specialized areas of the brain (hypothalamus and pituitary), eventually sending thyroid stimulating hormone (TSH) that promotes thyroid hormone production by the thyroid gland.

    Picture of the Thyroid Gland

    What happens with thyroid disease?

    Disease of the thyroid gland is extremely common. In some conditions, the thyroid may produce too much hormone. In other conditions, the thyroid may be damaged or destroyed and little, if any, thyroid hormone is produced. The main thyroid hormone is called thyroxine, or T4.

    Symptoms vary depending on whether there is too much or too little T4 present in the blood. With an excess of T4 (hyperthyroidism), patients complain of feeling restless, emotionally hyper, and hot and sweaty. They may have tremors, trouble concentrating, and weight loss. Frequent bowel movements and diarrhea are common.

    If T4 levels are low (hypothyroidism) as a result of decreased production by the thyroid gland, patients often experience  fatigue, lethargy, and weight gain. Constipation is common and many patients report feeling excessively cold.

    How is hypothyroidism treated during pregnancy?

    In many respects, the treatment of hypothyroidism in pregnant women is similar to that in nonpregnant women.. A synthetic form of T4 is given to replace the missing hormone. The medication dose is regularly adjusted to maintain a steady blood level of thyroid hormone within the normal range. Therefore, it is routine practice to monitor the blood level of the thyroid stimulating hormone (TSH) during pregnancy. For more information, please read the article on Hypothyroidism.

    What are the consequences of hypothyroidism during pregnancy?

    For years, physicians have known of a link between mothers with hypothyroidism during pregnancy and developmental delay in their children after birth. This was particularly seen in mothers who came from iodine deficient areas of the country (iodine is necessary to produce thyroid hormone and is now a common component of the salt in our foods) and was also observed in mothers with autoimmune thyroid disease, such as Hashimoto's thyroiditis.

    There is a relationship between thyroid levels in the mother and brain development of her child. A large study reported in 1999 found that undetected or inadequately treated hypothyroidism in mothers was associated with IQ changes in the infants of these women. The average IQ scores were about 4 points lower in the children of hypothyroid mothers than in children of normal mothers. Larger IQ deficits were seen in the children of mothers who had more severe hypothyroidism. These children had an average IQ 7 points lower than normal. In addition, almost 20% of these children had IQ scores of less than 85 compared to 5% of the children of normal mothers. The children of hypothyroid mothers were also more likely to have difficulty in school or have repeated grades.

    This study demonstrates that uncontrolled hypothyroidism in pregnant women can have long-term effects on the children of these mothers. Also, the effects occur even if the hypothyroidism is mild and the woman does not exhibit any symptoms. However, the more significant the hypothyroidism, the greater the likelihood of developmental problems.

    Source: http://www.rxlist.com

    In many respects, the treatment of hypothyroidism in pregnant women is similar to that in nonpregnant women.. A synthetic form of T4 is given to replace the missing hormone. The medication dose is regularly adjusted to maintain a steady blood level of thyroid hormone within the normal range. Therefore, it is routine practice to monitor the blood level of the thyroid stimulating hormone (TSH) during pregnancy. For more information, please read the article on Hypothyroidism.

    Source: http://www.rxlist.com

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