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Last Updated: Oct 23, 2019
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Thyroid Disease In Pregnancy: What To Know?

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Dr. Mudit SabharwalDiabetologist • 17 Years Exp.PG Fellowship In Diabetes, PGC in Diabeties, DFM - RCGP, MBBS, PG Diploma in Diabetes, FRCP (UK)
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It is important for you to know how pregnancy affects your thyroid gland. The thyroid hormone plays an important role during pregnancy in the development of the baby and also regarding the health of the mother. If you suffer from thyroid problems during pregnancy, you should take medicines and certain thyroid function tests.

How pregnancy affects normal thyroid function?
The pregnancy hormones known as human chorionic gonadotropin or hCG and estrogen lead to increased thyroid hormone levels in your blood. The hCG made by the placenta stimulates the thyroid to produce excessive hormones. Increased estrogen leads to higher levels of the thyroxine binding globulin, which transports the thyroid hormone in the blood.

Because of these normal hormonal changes, thyroid function tests are difficult to perceive during pregnancy. The thyroid hormone is very important for the normal development of a baby’s nervous system and brain. During the first trimester of pregnancy, the foetus depends on the supply of thyroid from the mother via the placenta.

In healthy women, the thyroid enlarges during pregnancy. An enlarged thyroid can indicate a thyroid disease, which should be diagnosed immediately. Thyroid problems are difficult to diagnose during pregnancy because of the increased hormone levels, increased thyroid size, fatigue and other factors.

Hyperthyroidism in pregnancy
Hyperthyroidism may occur in pregnancy because of Graves’ disease where enough thyroid hormones are not produced. Graves’ disease is an autoimmune disorder in which the immune system attacks the cells and organs of the body instead of fighting bacteria or viruses. With Graves’ disease, an antibody is released by the immune system called the thyroid stimulating immunoglobulin or TSI. This causes the thyroid gland to produce excess thyroid hormone. In many cases, the antibody is also associated with eye problems like bulging, irritation and puffiness.

Graves’ disease commonly appears during pregnancy, but women with this disease from before may actually observe improvements in the symptoms during the second and third pregnancy trimesters. The remission or the disappearance of the symptoms of Graves’ disease may occur due to the general suppression of the immune system, which occurs during early pregnancy. The disease is likely to recur and worsen in a few months after the delivery. It is important for pregnant women with Graves’ disease to be monitored carefully.

Hypothyroidism during pregnancy may lead to a developmental delay in the child. Sometimes, hormone therapy is given to women who are at the borderline stage in thyroid function during pregnancy or just before pregnancy. The treatment of the condition aims at maintaining a proper and balanced thyroid hormone level in the body.

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