Thyroid disease in pregnancy

Thyroid disease in pregnancy

Thyroid Diseases in Pregnancy: A Patient Education Guide

Thyroid diseases during pregnancy can affect both the mother and the baby. Proper diagnosis and management are essential for a healthy pregnancy and outcome.

Types of Thyroid Diseases in Pregnancy:

  1. Hypothyroidism: Underactive thyroid gland leading to low thyroid hormone levels.
  2. Hyperthyroidism: Overactive thyroid gland leading to excessive thyroid hormone levels.
  3. Postpartum Thyroiditis: Temporary inflammation of the thyroid gland after delivery.

Why is it Important?

  • Thyroid hormones are crucial for the baby’s brain and nervous system development, especially in the first trimester.
  • Poorly controlled thyroid disease can lead to complications such as miscarriage, preterm delivery, preeclampsia, and low birth weight.

Symptoms of Thyroid Diseases:

Hypothyroidism:

  • Fatigue
  • Weight gain
  • Dry skin
  • Hair thinning
  • Cold intolerance
  • Constipation

Hyperthyroidism:

  • Weight loss despite increased appetite
  • Nervousness or anxiety
  • Rapid heartbeat
  • Heat intolerance
  • Tremors
  • Excessive sweating

Do's and Don'ts for Managing Thyroid Diseases in Pregnancy

Do's:

  • Attend Regular Check-ups: Monitor thyroid hormone levels (TSH and Free T4) frequently.
  • Take Prescribed Medications: Ensure consistent and correct dosage as recommended by your doctor.
  • Eat a Balanced Diet: Include foods rich in iodine, selenium, and zinc (important for thyroid health).
  • Take Prenatal Vitamins: Check that they do not interfere with thyroid medications (e.g., avoid taking iron or calcium supplements simultaneously with thyroid medication).
  • Report Symptoms Promptly: Notify your doctor of any changes in symptoms or new concerns.

Don'ts:

  • Avoid Skipping Medications: Missing doses can affect both mother and baby.
  • Do Not Self-Adjust Medication Dosage: Always consult your doctor before making changes.
  • Limit Excessive Iodine: Avoid high-iodine supplements or excessive iodine-rich foods.
  • Avoid Stress: Practice relaxation techniques to stabilize hormone levels.
  • Do Not Delay Treatment: Untreated thyroid diseases can lead to serious complications.

Medications for Thyroid Diseases in Pregnancy

For Hypothyroidism:

  • Levothyroxine: Safe and effective; the dose may need adjustment during pregnancy.

For Hyperthyroidism:

  • Propylthiouracil (PTU): Preferred during the first trimester.
  • Carbimazole: Preferred after the first trimester (risk of birth defects if used early in pregnancy).

Safe Medications for Breastfeeding Mothers:

  • Levothyroxine: Safe for use and does not affect the baby.
  • Propylthiouracil (PTU): Compatible with breastfeeding but monitor baby for any symptoms.
  • Carbimazole: Generally safe, but use the lowest effective dose and monitor the baby.

When to Seek Emergency Help:

  • Severe symptoms such as rapid heart rate, chest pain, or shortness of breath (could indicate a thyroid storm in hyperthyroidism).
  • Sudden severe fatigue, swelling, or difficulty breathing (could indicate complications in hypothyroidism).
  • Changes in fetal movement or growth concerns.

Conclusion:

Managing thyroid diseases during pregnancy requires close monitoring and adherence to treatment plans. Proper management helps ensure a healthy pregnancy and baby. Always work closely with your healthcare team and report any symptoms or concerns immediately.