Thyroid in Pregnancy: Do I Need to Worry?

Pregnancy is a unique and memorable phase during which a woman embraces the natural process of motherhood. You go through a lot of changes when you’re expecting. This change comes with heightened emotions, spiritual contemplation, motivations, and sheer happiness. But at the same time, it demands care and safety. There are several things to take care of, one of which is the thyroid. Yes, the pursuit of a perfect and healthy pregnancy begins with your thyroid gland.

The thyroid, a butterfly-shaped gland, plays a significant role in fertility and pregnancy. At times, it makes too little or too much thyroid hormone. When this happens, it is an indication of thyroid disorder. Women can have it before pregnancy, during pregnancy or soon after delivery. A cross-sectional study shows that the thyroid disorder prevalence among pregnant women reaches 24.62%. Proper treatment and monitoring prevent detrimental effects on pregnancy. However, leaving it untreated might not be the best choice for you and your baby. 

How do Thyroid and TSH Affect Pregnancy?

A healthy thyroid is vital for your general well being. Still, it’s also necessary to avoid pregnancy issues down the line. To healthify the outcomes before and during pregnancy, one must properly care for the thyroid gland. Even borderline abnormalities in the thyroid gland can increase the risk of miscarrying the baby.

TSH or thyroid-stimulating hormone controls your thyroid gland. When there’s a high level of TSH, it indicates that your thyroid is producing fewer hormones. The ideal TSH range should be between 0.5 to 2.5 mU/L for a healthy pregnancy in the first trimester. It should be 0.3 to 3 mU/L for the second trimester. 

A study shows that women with TSH level 4.5-10 mU/L, especially early in pregnancy, shows a significant risk of miscarriage. In addition, higher TSH levels can lead to pregnancy loss in the second half, premature delivery, large infants, and caesarean section. Even if they have a normal vaginal delivery, there’s a strong possibility of using vacuum and forceps. Thus, the rate of pregnancy complications is directly related to TSH levels.

Will Having Thyroid in Pregnancy Affect My Baby?

Although rare, babies of women with Hashimoto’s thyroiditis can be born with thyroid problems. It happens when the antithyroid antibodies pass through the placenta and reach the foetus’s bloodstream. One out of five babies born to a mother with hyperthyroidism also show signs of an overactive thyroid when they’re born. Other health effects on the baby can include the following.

Low Birth Weight

Babies can be born before 37 weeks of pregnancy or when it’s too early for delivery. It could lead to a lower than average weight. A baby gets diagnosed as underweight when they weigh less than 5 pounds, 8 ounces.

Infantile Myxedema

It is a condition for a child born to a mother with severe hyperthyroidism. It comes with intellectual disabilities and dwarfism. If the child is born with dwarfism, their height is less than 4 feet 10 inches even after adulthood. The baby also shows lower-than-average intelligence due to infantile myxedema.

Developmental Retardation

There’s a high chance of problems with the nervous system and brain development. As a result, the baby is born with a low IQ if you do not treat the thyroid condition within the first trimester. In addition, it leads to a lack of essential skills to perform daily activities.

Hypothyroidism and Pregnancy

Hypothyroidism is when the thyroid gland fails to produce enough hormones and becomes underactive. It occurs during pregnancy because of an autoimmune disorder called Hashimoto’s disease. At first, the symptoms might go unnoticed. However, the delivery can happen before the predicted due date when left untreated. Sometimes, you might even miscarry. Therefore, women need to receive treatment or have their thyroid hormones checked for ensuring a healthy pregnancy. Moreover, untreated hypothyroidism has significant effects after birth as well.

Here are the problems linked to hypothyroidism in pregnancy. 

• Gestational Hypertension: A case of high blood pressure that develops after twenty weeks of pregnancy. It usually goes away after delivery.
• Preeclampsia: Gestational hypertension can develop into a more severe form called preeclampsia. It comes with sudden weight gain, blurriness, swelling, and persistent headaches. 
• Anaemia: There is a drop in healthy red blood cells in the mother’s body, leading to insufficient oxygen transport to meet the needs. 
• Thyroid Storm: It is a case when the existing thyroid condition worsens. It is a hypermetabolic state that can be life-threatening. 
• Heart Failure: Although very rare, untreated hypothyroidism increases maternal heart failure risk during pregnancy. It is a condition when the heart fails to pump blood as it should.

Hyperthyroidism and Pregnancy

Hyperthyroidism happens when your thyroid gland becomes overactive. As a result, it produces too many hormones. Pregnant women naturally synthesise 50% more thyroid hormones than before pregnancy. However, certain pregnancy complications come at risk if they go above the optimum level. In other terms, hyperthyroidism in pregnancy can cause the following complications.

• Miscarriage
• Premature delivery
• Maternal heart failure
• Preeclampsia
• Stillbirth 
• Low birth weight

Data suggests that about 1 to 4 of every 1,000 pregnancies in the United States is affected by hyperthyroidism. In some women, hyperthyroidism develops for the first time during pregnancy. During the first trimester, the level of the hormone human chorionic gonadotropin (hCG) increases rapidly. If it becomes too high, the thyroid gland gets stimulated, leading to hyperthyroidism. You may be tested for hyperthyroidism if you have more than one of the following conditions.

• Racing heartbeat or shaky hands
• Had difficulty conceiving
• Had a case of previous miscarriage or stillbirth
• Have type 1 diabetes
• Existing autoimmune disorder
• Family history of thyroid diseases
• Have goitre

Impact of Thyroid on Fertility

Everyone has probably heard about the vital role of sex hormones in conception. However, a balance in thyroid hormones is equally essential for getting pregnant. There is a complex relationship between thyroid health and fertility. It influences your ability to conceive and carry a baby to term.

Both hypothyroidism and hyperthyroidism negatively impact fertility. For example, too few thyroid hormones disrupt your periods, making it harder to conceive. In addition, there will be evident signs of a menstrual cycle malfunctioning when you have any thyroid disorder. It can either be a shorter or longer cycle. Sometimes, it might be lighter or heavier bleeding. It also interferes with the ovulation process. Autoimmunity related to thyroid disease indicates immune system imbalance. It causes sperm and egg fertilisation difficulty. It, in turn, leads to impregnation issues because there will be no proper implantation.

First and foremost, thyroid conditions do not make pregnancy impossible. But, yes, it can complicate fertility and mess up your chances of getting pregnant. Therefore, once you’ve got the thyroid gland in control, there’s no reason why you shouldn’t start planning for a baby. Receiving timely treatment can prevent fertility issues and help you with conception. 

According to a study, nearly 76.6% of the participating women with hypothyroidism could get pregnant within a year of treatment. However, remember that no two women are alike, and each case is individual. 

Thyroid in Pregnancy: Foods to Avoid

From conception to delivery, food matters at every stage of pregnancy, especially when you have thyroid issues. You can still ensure a healthy pregnancy by avoiding foods that might hurt the thyroid gland. But there is no one-size-fits-all approach while determining the diet plan for thyroid in pregnancy. It all depends on your health and needs. However, you must avoid some foods when pregnant and facing thyroid problems.

Goitrogenic Foods

As the name suggests, goitrogenic foods contain goitrogens, a compound that disrupts thyroid gland functions. As a result, they interfere with the production of thyroid hormones, leading to thyroid gland enlargement. Excess goitrogenic foods lead to thyroid inadequacy for pregnant women. What’s more, a study shows that thyroid inadequacy during pregnancy can cause developmental delays in the foetus. 

The goitrogen content varies widely in different foods. Therefore, steaming or boiling such foods can make a beneficial difference in the goitrogen levels. 

Here is the top list of highly goitrogenic foods, and you should preferably avoid them during pregnancy. 

• Cruciferous vegetables: cauliflower, collard greens, cabbage, kale, radishes, Brussels sprouts, broccoli, and turnips. 
• Soy-based foods: tofu, soy milk, edamame, and tempeh.
• Other goitrogenic foods: yuca, tapioca, millet, and bamboo shoots.

Highly Processed Foods

Pregnant women with hypothyroidism should avoid highly processed foods due to their calories. Hypothyroidism makes you prone to abnormal weight gain, so eating calorie-rich foods will only make it worse. Healthy weight gain is not an issue, but gaining extra pounds more than recommended can trigger delivery complications and other health problems. So you might want to avoid processed ones, including salty snacks, cookies, cakes, packaged goodies, and hot dogs.

Ways to Reduce TSH Levels Naturally

1. Evening Primrose Oil

Evening primrose oil is the extract of primrose flower seed. It is rich in gamma-linoleic acid- a fatty acid, making it ideal for lowering TSH levels. In addition, it shows improvement in thyroid hormones and provides relief from inflammatory symptoms. It is available as herbal supplement capsules.

2. Coconut Oil

Coconut oil offers a plethora of benefits. One such use is to combat increased TSH levels quickly. In addition, it is rich in healthy saturated fats, medium-chain fatty acids, and lauric acid, forming a unique fat balance for nourishing the thyroid gland. You don’t need to put in a special effort for incorporating coconut oil into the diet. Use it for cooking or add in smoothies.

3. Exercises

A brisk walk for about 10 minutes a day is healthy enough for your thyroid gland. Heavy aerobics and intense cardio are out of the question during pregnancy. But you can manage the TSH levels by slow walking and simple yoga. Bhujangasana can be beneficial for the thyroid but refrain from complicated asanas like Setu Bandhasana, especially during the last stage of pregnancy.

4. Add Whole Wheat

Pregnant women with thyroid should avoid completely or reduce the inclusion of refined wheat in their diet. Instead, add more whole wheat products to support the proper functioning of the thyroid gland and reduce TSH levels. Moreover, it can also help with subsiding constipation associated with thyroid issues.

Thyroid in Pregnancy: Safety Measures

• Women who have undergone radioiodine treatment for thyroid have to wait for six months before becoming pregnant. 
• Measuring the TSH receptor antibodies early in pregnancy can reduce the risk of miscarriage and other pregnancy complications.
• Please take prenatal vitamins that include iodine, vitamin B12, vitamin D, and folic acid to meet the demands of pregnancy. It should be under medical supervision.
• Regular blood tests and monthly TSH monitoring must be done throughout the pregnancy to keep the thyroid levels in check. In addition, do thyroid function tests every 4-6 weeks. 
• There can be adjustments in antithyroid medications depending on the trimesters. Therefore, please do not stop taking them without consulting the doctor first.
• Notify the doctor if you’ve been taking a synthetic hormone called levothyroxine to adjust the dose accordingly. For better results and safety, do not take prenatal vitamins within 3-4 hours of taking levothyroxine medication as it would interfere with thyroid hormone absorption. 

Conclusion

Pregnancy is an exciting yet complex process. It demands your body to be healthy and fit enough to carry a baby. Getting pregnant is possible even if you have a thyroid condition. But only if you receive proper treatment. Undiagnosed thyroid conditions can make it difficult to conceive. Or it can cause pregnancy complications if you have a personal history of thyroid problems, so better run test for abnormal thyroid hormone levels before trying for a baby. These hormone levels naturally change throughout pregnancy, but that shouldn’t keep you regularly monitoring them. For a healthy pregnancy to flourish, develop an approach that works for you and your baby.

Frequently Asked Questions (FAQs)

Q. Can my thyroid affect my pregnancy?

A. Yes, there’s a delicate connection between thyroid and pregnancy. Untreated thyroid conditions lead to serious health problems, including the risk of miscarriage, premature birth, and stillbirth. It also makes pregnant women prone to anaemia, gestational hypertension, and thyroid storm.

Q. What happens if the TSH level is high during pregnancy?

A. When TSH level becomes high during pregnancy, it simultaneously increases the risk of miscarriage. Women with a TSH range of 2.5 and 4.87 mIU/L are the most vulnerable. If this happens during early pregnancy, the baby’s brain development can get severely affected. Moreover, high TSH levels can cause premature delivery and higher chances of caesarean delivery.

Q. How can I reduce my thyroid naturally during pregnancy?

A. You can keep TSH levels under control by managing stress and avoiding goitrogenic foods. For example, you can add whole wheat, coconut oil, and primrose oil to the diet. Moreover, simple exercises like brisk walking are suitable for TSH level management.

Q. Is thyroid transfer from mother to baby?

A. A thyroid disorder does not necessarily transfer from mother to baby; however, there are high chances of long-lasting effects. Since the baby relies on the mother for adequate thyroid hormones, any fluctuations will directly affect the growth and brain development of the foetus. In addition, sometimes, a child can be born with hypothyroidism, which is genetic.

Q. Can a woman with thyroid problems get pregnant?

A. Yes, women with a history of or with an existing thyroid condition can get pregnant. But your best chance of getting pregnant is when your thyroid is healthy and properly managed. That’s because an overactive and underactive thyroid makes conception difficult. In addition, they lead to irregular menstrual cycles, increasing the likelihood of fertility issues.

Q. Can I have a healthy pregnancy with hypothyroidism?

A. You can still have a healthy pregnancy even if you have thyroid problems. The thyroid hormone levels must reach the normal range for patients with hypothyroidism. Once it’s under control, you can have a healthy pregnancy and a healthy baby.

Q. Can hyperthyroidism cause a miscarriage?

A. Hyperthyroidism causes an abnormal rise in thyroid hormones, leading to a high risk of miscarriage. Even minor cases of hyperthyroidism pose a problem for both mother and foetus. Hence, hyperthyroidism must not occur in early pregnancy. If left untreated, it could trigger adverse health effects.

Q. Which food should be avoided in the thyroid?

A. Pregnant women with thyroid must avoid goitrogenic and highly processed foods. It includes cruciferous vegetables, soy-based foods, and processed foods with high sodium and calories are also not preferred. If you’re consuming goitrogenic foods, make sure to boil or steam them. It lowers the goitrogenic content.