How to Control Thyroid During Pregnancy: Causes, Symptoms & Treatment

The Role of Thyroid Hormones in Pregnancy

• Balances energy expenditure between mother and foetus.
• Contributes to the development of the foetal brain and nervous system.
• Regulates metabolism and temperature.
• Supports the normal functioning of the placenta.

What Causes Thyroid in Pregnancy?

Key Insight: Women who are planning a pregnancy should get their thyroid checked early. Before conception, managing thyroid levels reduces the risk for both mother and baby.

What Are the Signs of a Thyroid Issue During Pregnancy?

Thyroid signs and symptoms can be difficult to recognise because they often appear similar to the usual effects of pregnancy, such as tiredness, mood changes, or minor changes in weight. However, when these signs/symptoms happen more frequently or with greater severity, they might indicate thyroid dysfunction.

Common Signs that Indicate You Might Have a Condition Include:

• Fatigue or lethargy
• Unexplained weight gain/loss
• Increased heart rate or irregular heart rate
• Paranoid or irritable, or depressed feelings
• Sweating a lot or feeling cold more than normal
• Dry skin, brittle nails, or hair loss
• Constipation or diarrhoea
• Muscle cramps or weakness

While symptoms may suggest a thyroid disorder, on their own, they do not diagnose thyroid dysfunction, and your doctor will order blood tests (TSH, Free T4, Free T3) to confirm an accurate diagnosis.

Types of Thyroid Disorders in Pregnancy

There are many different thyroid disorders that can occur during pregnancy, and each has different effects and needs to be managed differently.

Significance of Managing Thyroid Disorders in Pregnancy

Thyroid disease affects more than just the mother's comfort during pregnancy. It impacts both the baby's growth and development and the overall outcome of the pregnancy.

Benefits for the Baby:

• Ideal growth for the baby’s brain and nervous system.
• Normal growth for the baby’s bones and skeleton.
• Lower risk of low birth weight and developmental delay.

Benefits for the Mother:

• Reduced risk of miscarriage, preeclampsia, or early labour.
• Reduced risk, or avoidance, of placental problems and anaemia.
• Stable mood, metabolic rates and energy for the mother.

An uncontrolled thyroid could cause complications that can include developmental delay in the infant, heart failure in the mother due to severe hyperthyroidism, or postpartum depression stemming from hypothyroidism.

Diagnosis & Monitoring of Thyroid in Pregnancy

The management of thyroid dysfunction relies heavily on prompt identification through blood tests.

Important Tests:

• TSH (Thyroid Stimulating Hormone): A principal measure of thyroid function.
• Free T4 and Free T3: To evaluate the available thyroid hormones.
• TPOAb / TRAb antibodies: To assess for autoimmune thyroid disease.

Trimester-Wise Ideal TSH Levels

Frequency of Monitoring:

Pregnant women with a thyroid disorder should check their levels every 4–6 weeks, as hormonal requirements vary with each trimester.

Thyroid Problems During Pregnancy (Therapy Options)

• For hypothyroidism, treatment involves hormone replacement therapy to maintain normal thyroid hormone levels. Dosage: The dose is adjusted according to TSH monitoring, and some women may require a 30–50% increase during pregnancy.
• For hyperthyroidism, treatment approaches may vary by trimester. Certain medications are preferred during early pregnancy, while others are used later for long-term management.
• Symptomatic management: Short-term therapy may be used to control symptoms such as palpitations or tremors.
• Monitoring and Physician Management: Do not change or adjust your dose; both undertreated and overly treated put the foetus at risk. Doctors should coordinate care with an endocrinologist and a gynaecologist for teamwork and oversight. Remember, hormone levels can change significantly postpartum so continue monitoring.

Diet and Lifestyle Tips to Manage Thyroid During Pregnancy

Diet plays a major role in maintaining healthy thyroid function. Combining nutritious eating with stress management creates a balanced hormonal environment.

Thyroid-Friendly Foods

Foods to Avoid or Limit Each Day:

• Too much raw goitrogenic vegetables (e.g. cabbage, broccoli/cauliflower, soy) can interfere with iodine absorption.
• Highly processed/refined sugar.
• Caffeine and carbonated drinks may worsen heart palpitations.

Lifestyle Recommendations:

• Be active: Light exercise, such as prenatal yoga, walking, or swimming is ideal.
• Get enough sleep: 7-8 hours of sleep will help regulate hormones.
• Reduce stress: Meditation and deep breathing can reduce cortisol, which can affect thyroid function.
• Hydration: Drink 2-3 litres of water a day.
• You can see that simple changes in lifestyle habits can help balance thyroid function and improve pregnancy comfort.

To Summarise

A thyroid condition during pregnancy can sound worrying; however, with appropriate medical care, ongoing testing, and the healthiest approach to lifestyle and activity possible, it can be successfully managed. Whether hypothyroid or hyperthyroid, sticking to your doctor's treatment plan and engaging in the healthiest, low-stress life and lifestyle possible will be important to your own pregnancy and developing baby.

You should always prioritise medical treatment over self-treatment, and your thyroid should be monitored throughout your pregnancy and delivery. A balanced thyroid leads to a balanced pregnancy.