Managing THYROID Disorder During Pregnancy

Thyroid disease is present in 2-5 percent of all women and 1-2 percent of women in the reproductive age group.

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Thyroid problems are common in women who are pregnant. Several of the thyroid disorders which tend to occur during pregnancy are autoimmune in nature. By this we mean that the body develops antibodies directed against thyroid cells, which then affect the way the thyroid gland functions. Antibodies which damage the thyroid cells may result in lymphocytic thyroiditis (inflammation of the thyroid), also known as Hashimoto's disease. These damaging antibodies can reduce the function of the thyroid and lead to hypothyroidism. On the other hand, your body can make antibodies against thyroid tissue which can stimulate thyroid cell function. In this case, hyperthyroidism due to over-function of the thyroid (Graves' disease) may be the result.

Hypothyroidism. If hypothyroidism is suspected in a pregnant patient, the physician can perform a TSH blood test. Just as in non-pregnant women, the TSH will be increased if hypothyroidism is present. If a woman is already being treated with thyroxine when she becomes pregnant, she should continue to take this medication during pregnancy. Thyroxine is safe to take and is well absorbed during pregnancy. Although there is usually no need for a dose change, some women require somewhat higher doses when they are pregnant. Physicians generally monitor the TSH level to detect even mild hypothyroidism and increase the thyroxine dose, if necessary.

Guidelines For Treatment 

The following is a summary of the key components of the guidelines, which have important implications for women who develop hypothyroidism