Hyperthyroidism in pregnancy can affect anyone. hey, parents! This condition occurs when the thyroid gland produces excessive amounts of thyroid hormone. you know! Pregnancy is one cause of major changes in hormone levels.
The thyroid gland itself is a butterfly-shaped gland that functions to produce thyroid hormone, a hormone that plays a role in regulating the body’s metabolism.
This hormone has the function of maintaining body temperature so that it is always warm and supports the performance of body organs, such as muscles, heart or brain.
Therefore, the causes or symptoms of hyperthyroidism should be watched out for by pregnant women. Here are some explanations about hyperthyroidism in pregnancy that you must know.
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Causes of Hyperthyroidism in Pregnancy
A common cause of hyperthyroidism in pregnancy is Graves’ disease. This disease occurs when the immune system becomes overactive and forms antibodies (immune proteins) that attack the thyroid.
This causes the gland to enlarge and make too much thyroid hormone. Most women with Graves’ disease will get treatment before they become pregnant.
Later, pregnant women with severe nausea and vomiting or those expecting twins may develop temporary hyperthyroidism.
Called transient gestational thyrotoxicosis, this hyperthyroidism is caused by high levels of a pregnancy hormone called human chorionic gonadotropin or hCG.
Because it heals at 14 to 18 weeks of pregnancy, pregnant women do not need antithyroid drugs to treat this condition.
Sometimes, hyperthyroidism appears during pregnancy due to the presence of nodules (small lumps) in the thyroid. These nodules make too much thyroid hormone.
The thyroid can also become overactive after delivery. In the first year after giving birth, about 7% of women develop postpartum thyroiditis (inflammation of the thyroid).
This problem starts with hyperthyroidism. Most often, hyperthyroidism goes away without treatment within a few weeks or months.
However, sometimes this inflammation causes hypothyroidism, the opposite condition in which the thyroid gland does not produce enough thyroid hormone. In most cases, this hypothyroidism goes away on its own.
Apart from that, the following are some other causes of hyperthyroidism in pregnancy:
- Transient gestational hyperthyroidism.
- Toxic multinodular goiter.
- Single toxic adenoma.
- Subacute thyroiditis.
- trophoblastic tumor.
- Iodide-induced hyperthyroidism.
- Ovarian goiter.
- Thyrotropin receptor activation.
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Symptoms of Hyperthyroidism in Pregnancy
The following are the symptoms of hyperthyroidism in pregnancy, as quoted: Hormone.org:
- Feeling too hot when other people are comfortable.
- The heart beats very fast.
- shaking hands
- Weight loss even if you eat enough.
- Fatigue and/or difficulty sleeping.
- Feeling irritable and anxious.
How is Hyperthyroidism in Pregnancy Diagnosed?
In some cases, the way women know they have hyperthyroidism is before they become pregnant. To detect hyperthyroidism, doctors can perform a physical exam and order blood tests to measure thyroid hormone levels.
If the diagnosis is a low TSH level, plus a high T4 (also called thyroxine) level, it indicates hyperthyroidism.
Another test for hyperthyroidism is a radioactive iodine uptake test. However, women who are already pregnant and breastfeeding should not have this test, so let your doctor know if you are pregnant or breastfeeding Parents!
This test measures how much iodine the thyroid absorbs, because the thyroid uses iodine to make thyroid hormones.
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Hyperthyroidism in Pregnancy Can Cause Complications
Research published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism shows that the risk of complications increases for both women with an underactive thyroid gland (hypothyroidism) and those with an overactive thyroid gland (hyperthyroidism).
Reported healthline, This study uses data from Consortium on Safe Labor in 223,512 singleton pregnancies, researchers found that this condition could increase the risk of obstetric problems, and childbirth.
Dr. Pauline Mendola of the Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD) says women need proper thyroid hormone levels to support a healthy pregnancy, so it’s important to closely monitor pregnant women with thyroid disease.
Women with hyperthyroidism are at increased risk of serious pregnancies, including hypertension and premature birth. They also had higher rates of labor induction and other birth interventions.
How to Treat Hyperthyroid Patients
Treatment of hyperthyroidism in pregnancy can be done through two phases, namely during pregnancy and breastfeeding:
1. During Pregnancy
The preferred treatment for pregnant women with hyperthyroidism due to Graves’ disease is antithyroid drugs. These medications prevent the thyroid from producing too much thyroid hormone. However, for patients with transient (gestational) hyperthyroidism, this treatment is not required.
Pregnant women with Graves’ hyperthyroidism or thyroid nodules should start antithyroid medication or, if already taking these medications, see a doctor to discuss the dosage.
Hyperthyroidism due to Graves’ disease most often improves as pregnancy progresses, but can worsen during the first six months after delivery. Therefore, your doctor may need to change the dose of your antithyroid medication during and after pregnancy.
In the first trimester of pregnancy, the drug of choice for treating hyperthyroidism is propylthiouracil (PTU). Meanwhile, another antithyroid drug, methimazole can cause birth defects if taken during early pregnancy.
Women may need to consume methimazole in the first three months of pregnancy if they cannot tolerate PTU. Antithyroid drugs can treat most cases of Graves’ disease in pregnancy.
Meanwhile, women who are pregnant should not receive treatment with radioactive iodine. This radioactive drug usually destroys the patient’s thyroid gland from being overactive and can harm the unborn baby’s thyroid.
2. During Breastfeeding
Women who are breastfeeding should not receive radioactive iodine treatment. They can continue antithyroid drug therapy if they take the medication as prescribed.
Do Babies Need Special Care?
Most people with Graves’ disease have measurable antibodies in their blood known as thyroid-stimulating immunoglobulins. In pregnant women with Graves’ disease, these antibodies can cross the placenta to the baby.
Although it doesn’t happen often, it can lead to thyroid disease and other medical problems that can be passed on to the newborn.
Thus, all newborns to mothers with Graves’ disease who are positive for these antibodies should be checked for thyroid problems and treated if necessary.
Potentially more worrying for the baby is when the mother has been treated for Graves’ disease (eg radioactive iodine or surgery) and no longer requires antithyroid drugs.
It is very important to tell your doctor if you have been treated for Graves’ Disease in the past so that proper monitoring can be done to ensure that the baby remains healthy during pregnancy.
Article has been reviewed by:
dr. Permatasari Gita
General Practitioner and Lactation Consultant
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