Pregnancy Nutrition : Special Pre-Pregnancy Conditions - Thyroid Disease

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The most common types of thyroid disease include hypothyroidism and hyperthyroidism (Graves’ disease). Because thyroid disease often affects younger women, it is not unusual for women to enter pregnancy with this preexisting condition. Most women can have a completely normal pregnancy if their thyroid condition is treated properly and well controlled.

Dealing with Hypothyroidism

Hypothyroid means that you have been diagnosed with an underactive thyroid or that you have had hyperthyroidism and had radioactive iodine or surgery of the thyroid and are now taking thyroid hormone replacement. You can also be considered hypothyroid if you have had your thyroid removed and are now on thyroid hormone replacement. The most common thyroid hormone replacement medications include Synthroid, Levoxyl, Levothroid, Armour, and Thyrolar.

The key to dealing with thyroid conditions during pregnancy is close monitoring. Thyroid function tests should be conducted every two to three months throughout the entire pregnancy. The main thyroid function test performed is a TSH (thyroid stimulating hormone). TSH is a chemical that is released by the pituitary gland and triggers hormone production in the thyroid. This test can help diagnose and monitor hypothyroidism or hyperthyroidism. Also monitored would be T3 (Triiodothyronine) and T4 (Thyroxine) levels, which are both thyroid hormones within the thyroid gland that control the body’s metabolism.

Thyroid hormone replacement medications should be taken at the same time every day. Antacids as well as iron supplements can make this medication less effective, which can be detrimental during pregnancy. Take prenatal supplements or any other iron-containing supplement at least two to three hours before or after thyroid medication. Most experts recommend taking thyroid hormone medication on an empty stomach and at least two hours after or one hour before eating to increase absorption.

It is important to get to the doctor for a thyroid function test as soon as you find out you are pregnant. You may need adjustments to your medication very early in your pregnancy. Until about week twelve, when the baby’s thyroid gland is fully functional, you are the only source of thyroid hormones for both of you. A baby’s thyroid gland will develop normally even if the mother’s thyroid is underactive. If you are not getting a sufficient dosage of thyroid hormones early in your pregnancy, you can be at an increased risk of miscarriage, and the baby can be at an increased risk for developmental problems. It is perfectly safe for mothers to take thyroid hormone medication during pregnancy, and it is essential to take medications as prescribed throughout the entire pregnancy. There are no side effects for the mother or the baby as long as proper dosages are used. Women with a preexisting hypothyroid condition may need to have their medication dosages increased during pregnancy.

Dealing with Hyperthyroidism

Hyperthyroidism means you have an overactive thyroid gland, which can pose special concerns for pregnant women. The most common type of hyperthyroidism is called Graves’ disease. It is important that hyperthyroidism be properly controlled during pregnancy because too much thyroid hormone can increase the risk for miscarriages, premature births, and birth defects. Uncontrolled hyperthyroid in pregnancy also increases the mother’s risk for high blood pressure and heart problems. Because it can be tricky to treat hyperthyroidism during pregnancy, it is best for women with the condition to have it permanently taken care of before planning to become pregnant.

Antithyroid medication can be used during pregnancy but must be monitored very closely with examinations and blood tests because it can affect the baby’s thyroid gland. These medications are used to cut down the thyroid gland’s overproduction of thyroid hormones. The most common and safest type of medication used during pregnancy is propylthiouracil (PTU). Radioactive iodine, which is used to permanently treat the condition outside of pregnancy, is not safe for those who are pregnant because the baby’s gland can be damaged. Antithyroid medication is the best form of treatment during pregnancy for hyperthyroid disease.

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