PREGNANCY AND THYROID
1- IODINE DEFICIENCY IN PREGNANCY:
Iodine element is an element required for thyroid hormone synthesis. The daily iodine requirement of a normal healthy woman is 150mcg/day on average. Since this need does not increase up to 300 mcg/day in pregnant women, it is attached. Therefore, iodine deficiency is common in pregnant women. Since the baby in the womb does not have any other source of iodine, iodine deficiency in the mother also affects the baby and creates a negative effect on the baby’s intelligence development. For this reason, iodine levels of pregnant women who can be looked at should be checked with a urine test and iodine supplementation should be started for those who are necessary.
2- PREGNANCY AND HYPOTHYROID (low thyroid hormone):
The two most common causes of hypothyroidism in pregnant women are Hashimoto’s disease and hypothyroidism due to iodine deficiency. Hypothyroidism is a very important finding. because it can lead to some irreversible negative effects on pregnancy and baby. Depending on hypothyroidism, effects such as mental retardation, developmental delay, miscarriage risk, placental abruption, preeclampsia, premature birth, and respiratory distress in the baby at birth can be seen in the baby. For this reason, it is recommended that women who are planning pregnancy should be checked for hypothyroidism. Again, the thyroid hormone needs of patients who received thyroid hormone replacement therapy due to hypothyroidism before becoming pregnant increase by about 25% on average when they become pregnant. For this reason, women in this situation should immediately contact their doctors and determine the new drug doses that will be suitable for pregnancy.
In order to determine the risk of hypothyroidism in pregnant women, TSH, fT4 and fT3 hormones are routinely checked. In some special cases, your doctor may also look at tT4 and tT3 hormones together with TSH if needed. If your TSH values are higher than your pregnancy patient, then the Anti-TPO test and thyroid USG test can be checked for the cause of hypothyroidism. After the results of the tests, thyroid hormone treatment is started as soon as necessary.
|
TSH LOWER LIMIT |
TSH UPPER LIMIT |
|
|
PLANNING PREGNANCY |
0.5 mIU/mL |
2.5 mIU/mL |
|
FIRST 3 MONTHS OF PREGNANCY |
0.1 mIU/mL |
2.5 mIU/mL |
|
3-6th PREGNANCY. MONSTERS |
0.2 mIU/mL |
3 mIU/mL |
|
LAST 3 MONTHS OF PREGNANCY |
0.3 mIU/mL |
3 mIU/mL |
The table above shows the TSH values that pregnant candidates and pregnant women should have. If your hormone value is outside these limits, it would be beneficial to contact an Endocrinology doctor.
3- PREGNANCY AND HYPERTHROID (Excess of thyroid hormone):
The most common cause of permanent hyperthyroidism during pregnancy is Graves’ disease. However, in many pregnant women, due to the stimulating effect of Beta HCG, which is a pregnancy hormone, on the thyroid gland, thyroid hormones tend to increase slightly, especially in the first 3 months of pregnancy, which leads to physiological (normal) hyperthyroidism. nausea, vomiting) occurs more clearly in patients with For this reason, an Endocrinologist should be contacted in order to distinguish these two conditions in hyperthyroidism that occurs during pregnancy. In cases where Graves’ disease is considered, TSH receptor antibody titer should be checked. Treatment should be started in pregnant women who are found to have high levels of hormones that may adversely affect the course of pregnancy. Because in the case of untreated hyperthyroidism, symptoms such as palpitation, sweating, tremor, weight loss, insomnia, irritability may occur in the mother, along with very serious pregnancy complications such as stillbirth, premature birth, preeclampsia, miscarriage and growth retardation in the baby. In the treatment, primarily antithyroid drug therapy is preferred. Surgical treatment may come to the fore in cases that cannot be treated with medication or are not controlled by medication.
4- POSTPARTUM THYROIDIT:
It is the inflammation of the thyroid gland that occurs in the first year after birth in pregnant women who did not have a known thyroid disease before pregnancy. This disease occurs more frequently, especially in women with positive anti-TPO antibodies. In the clinic, the disease has stages with both high hormone levels and low hormone levels. Hyperthyroidism symptoms such as palpitation, sweating, tremor, insomnia, irritability, and weight loss may occur in patients during the hormone elevation phase. In the hypothyroid stage, it manifests itself with symptoms such as edema, constipation, chills, hair loss, depression, and weight gain. Beta Blocker or Hormone replacement therapy can be started according to the stage of the disease.
