I recently switched an OB/GYN to someone I now truly like. He’s more detailed and into getting me to a fertile state than the other doctor who just tried to perform surgery on me with no further testing. This doctor asked me for a couple symptoms and he suspected I have hypothyroidism. Some symptoms include (from About.com):
feeling run down and sluggish
difficulty concentrating, brain fog
unexplained or excessive weight gain
dry, coarse and/or itchy skin
dry, coarse and/or thinning hair
feeling cold, especially in the extremities
increased menstrual flow
more frequent periods
Symptoms that I had: constipation, fatigue (but probably due to running my own business and dealing with this whole ordeal), feeling cold (before I started my endometriosis diet), increased menstrual flow (I’m always heavy days 2 and 3 with some blood clots so I guess I belong in this one), difficulty losing weight (maybe because I’m aging and I’m not 21 anymore!).
Well, again, I was annoyed as I waited for the results to get back but they came back today and I have a normal functioning thyroid. Whew. However, there are so many things to watch for when you do have hypothyroidism. This could the result that some women miscarry and the doctors never tested for this! Some women may confuse pregnancy symptoms with hypothyroid symptoms.
Hypothyroidism in Pregnancy
Newly diagnosed hypothyroidism in pregnancy is rare because most women with untreated hypothyroidism do not ovulate or produce mature eggs in a regular manner, which makes it difficult for them to conceive.
It is a difficult new diagnosis to make based on clinical observation. The signs and symptoms of hypothyroidism (fatigue, poor attention span, weight gain, numbness, and tingling of the hands or feet) are also prominent symptoms of a normal pregnancy.
Undiagnosed hypothyroidism during pregnancy increases the chance of stillbirth or growth retardation of the fetus. It also increases the chance that the mother may experience complications of pregnancy such as anemia, eclampsia, and placental abruption.
Probably the largest group of women who will have hypothyroidism during pregnancy are those who are currently on thyroid hormone replacement. The ideal thyroxine replacement dose (for example, levothyroxine [Synthroid, Levoxyl, Levothroid, Unithroid]) during pregnancy may rise by 25% to 50% during pregnancy. It is important to have regular checks of T4 and TSH blood levels as soon as pregnancy is confirmed; and frequently through the first 20 weeks of pregnancy to make sure the woman is taking the correct medication dose.
Hyperthyroidism in Pregnancy
Newly diagnosed hyperthyroidism occurs in about 1 in 2,000 pregnancies. Grave’s disease accounts for 95% of cases of hyperthyroidism newly diagnosed during pregnancy.
As with hypothyroidism, many symptoms of mild hyperthyroidism mimic those of normal pregnancy. However, anyone experiencing symptoms such as significant weight loss, vomiting, increased blood pressure, or persistently fast heart rate should have blood tests to evaluate whether hyperthyroidism is present.
Untreated hyperthyroidism does cause fetal and maternal complications including poor weight gain and tachycardia (an abnormally fast heart rate).
Treatment of hyperthyroidism during pregnancy is primarily medical. Propylthiouracil or methimazole (Tapazole) are the usual first-line agents to block the synthesis of thyroid hormone. They appear to be equally effective and have the same rate of side effects. The rate of side effects of each medication is not increased in pregnancy.
Iodine will cross the placenta, so its use in either a thyroid scan or in treatment with radioactive iodine is prohibited in pregnancy.
One positive note for women with hyperthyroidism is that those with Grave’s disease or Hashimoto’s thyroiditis may have improvement in their symptoms during pregnancy.