~~ HYPOTHYROID IN PREGNANCY
Hypothyroidism means insufficient thyroid hormones. It is especially important during pregnancy.
Pregnancy is a stress for the thyroid gland and the need for iodine increases, the size of the thyroid gland increases and the amount of thyroid hormones increases. The reason for this is the increased level of Beta-HCG. As beta-HCG increases, TSH receptors are stimulated and the gland starts to work harder. However, in some pregnant women, the situation is different and the gland may become less active. We call this condition HYPOTHYROID. The reason for this may be Iodine deficiency or a disease called Hashimoto. Iodine is the substance used in the production of thyroid hormones, while the amount to be taken daily is normally 150 micrograms / day, it goes up to 220 micrograms / day in pregnant women. we normally get iodine from salt, vegetables, seafood and the water we drink. However, sometimes we can be insufficient. Hashimoto, on the other hand, is a disease that occurs when anti-TPO antibodies, which we call thyroid antibodies, are positive. We can normally think of the substances we call antibodies as soldiers defending our body. However, in diseases such as Hashimoto, which we call autoimmune, these antibodies perceive the organs in our own body as foreign, for example, perceive the thyroid gland as an enemy and try to destroy it and make the gland less functional. In this case, the work of the thyroid gland slows down.
WHAT HAPPENS IF THE THYROID GLAND SLOWS IN PREGNANCY???
This situation affects both the mother and the baby. Risks such as hypertension in the mother, a severe disease with hypertension, which we call preeclampsia, premature birth, bleeding after birth, increased possibility of cesarean section… leads to .
WHAT SHOULD WE DO TO PREVENT THIS???
The simplest and cheapest method is to have the level of TSH hormone checked. Now, even when pregnancy is planned, many of our doctor friends have this hormone checked or it should be checked immediately when pregnant.
WHAT SHOULD TSH LEVEL BE?
1st trimester (ie in the first 3 months of pregnancy) TSH should be < 2.5 mIU/L
2nd trimester (ie between 3-6 months in the second trimester of pregnancy) TSH should be < 2.5 mIU/L
3rd trimester (ie between 6-9 months in the third trimester of pregnancy) TSH should be < 3 mIU/L.
WHAT HAPPENS IF THESE VALUES ARE GREATER????
If the TSH level is higher than these values, then first of all, your doctor will start the treatment by looking at the other thyroid hormones and the antibody level we call anti-TPO.
WHAT IS THE TREATMENT?
Levothyroxine is a synthetic thyroid hormone. Dose adjustment is made by the doctor and varies according to the patient.
HOW FREQUENTLY SHOULD TSH LEVEL BE CHECKED AFTER STARTING THE DRUG???
Usually, TSH is followed at 3-4 week intervals (with approximately 1 month controls) and the drug dose is adjusted.
IS THE MEDICINE HARMFUL TO THE BABY???
One of the most frequently asked questions!!!! We already give the medicine to protect the baby and the mother from possible dangers. Of course it doesn’t hurt.
HOW TO USE THE MEDICINE??
You can use the medicine once in the morning on an empty stomach and eat your meal after half an hour.
It is useful to not take the drug with other stomach protectors, iron drugs, vitamins and use other drugs after about 4 hours.
HOW LONG WILL WE USE THE MEDICINE????
The goal is to have a good and uneventful pregnancy and we use the drug until the baby is born. Afterwards, your doctor will determine whether the mother will need to receive continuous treatment according to TSH and antibody levels or whether the treatment will be discontinued.
