Hypothyroidism
Most cases of hypothyroidism in pregnancy are the result of Hashimoto's disease. In some cases, a woman may develop hypothyroidism because the dosage of thyroid hormone replacement became inadequate in pregnancy. Women can also develop hypothyroidism from overtreatment with antithyroid medications for hyperthyroidism.
Untreated hypothyroidism has serious consequences for both mother and baby. A mother may be at risk for:
Anemia
Muscle weakness
Pre- eclampsia, high blood pressure and protein in the urine that can lead to kidney damage
Heart failure
Problems with the placenta
Postpartum bleeding
A baby whose mother has untreated hypothyroidism may be at risk for:
Low birth weight
Congenital hypothyroidism
Impaired brain development
Developmental abnormalities
Learning problems
Mental retardation
Treating Hypothyroidism in Pregnancy
Fortunately, treatment for hypothyroidism is relatively easy. Like anyone with hypothyroidism, pregnant women need thyroid hormone replacement, which, in the right dose, is perfectly safe to take in pregnancy. Establishing the right dose is critical, and you will need frequent testing to determine if your thyroid hormone levels are healthy.
Pre-existing Hypothyroidism
In women who already have hypothyroidism, it's important to have your thyroid tested as soon as you find out you're pregnant. Don't let your doctor delay your appointment, and take steps to clear your schedule so that your doctor's visit is a top priority.
Your dose of levothyroxine can increase with pregnancy, especially in the second half of pregnancy, often by 25 to 50 percent. In some cases, it may even double. Your doctor should do regular tests of thyroid function throughout your pregnancy to ensure that your TSH levels remain normal, and if a change in your dosage becomes necessary, more frequent testing may be needed.
Alert
Don't take your thyroid hormone at the same time you take your prenatal vitamins. The American Thyroid Association (ATA) recommends separating the two drugs by two to three hours. Prenatal vitamins contain iron, which can inhibit absorption of thyroid hormone.
Careful monitoring of your thyroid is essential throughout your pregnancy, not only for you, but for your developing baby, who relies on you to supply her with enough thyroid hormone. Take your medicine diligently, keep all your doctor appointments, and follow through on changes in the dosage of your medication.
