October 16, 2020

The Thyroid Gland Plays an Essential Role in Pregnancy

The Thyroid Gland Plays an Essential Role in Pregnancy

The thyroid gland plays an essential role in pregnancy. It makes hormones that enable your body to function. It also controls metabolism and plays a key role in the development of an early pregnancy. Maternal thyroid hormone works for the mother and the early fetus. The maternal source provides reinforcement until the fetal thyroid system is developed and starts to function. Fetal programming starts early – at conception – at implantation. The presence of a competent maternally-derived thyroid hormone reduces risk during the fetal programming stage of fetal development.

Can Your Thyroid Affect Your Pregnancy?

If a thyroid deficiency is untreated during early pregnancy it can be associated to more severe complications with the pregnancy, including miscarriage, premature birth and stillbirth. Significant thyroid hormone deficiency during early development results in severe central nervous system damage in that early fetal stage. Significant absence of thyroid hormone and iodine deficiency results in devastating effects. These deficits and defects are not disputed; they are also, rarely found.

What remains to investigate is the small disturbances and whether they have an effect. Fetal endocrine systems both capitalize on the usage of maternal thyroid hormone in maternal circulation as that hormone that crosses into fetal circulation. Additionally, hormones and enzymes within the fetus act to protect it from the potential of surging maternal levels. Thyroid hormone for fetal development is so essential that the fetus provides a redundant system of protection.  It represents more of a dimmer switch control than strict on and off.

Can I Get Pregnant With Hypothyroidism?

Hypothyroidism is when the thyroid does not produce enough hormones. The most common cause of hypothyroidism is Hashimoto’s thyroiditis which is an autoimmune disorder. Sings and symptoms associated with hypothyroidism include muscle weakness, weight gain, feeling tired and dry skin.The presence of maternal hypothyroidism has resulted in lower IQ scores in age matched controls (women of similar demographics with competent thyroid hormone). If this overt hypothyroidism is treated, the fetal system is preserved.

How Does Thyroid Hormone Affect Pregnancy?

TSH is short for thyroid stimulating hormone. When a TSH test is ordered it is to determine if your thyroid gland is working the way it should. The results can indicate if your thyroid gland is overactive or underactive. Maternal subclinical hypothyroidism is defined as slightly elevated TSH. The effects on the offspring is less clear. There has been some implication with slightly lower IQ scores but it seems to be more in the presence of maternal antibodies to thyroid hormone.

What is a Normal TSH Level for a Pregnant Woman?

An appropriate thyroid hormone supply is essential. If you have thyroid problems, a healthy pregnancy is still possible. It is important to treat it and have regular test to determine function. Measuring TSH should be part of the initial evaluation of infertility and recurrent pregnancy loss. Keeping the range of TSH between 0.1 and 2.5mIU/L may enhance fertility and reduce the obstetrical, neonatal and early childhood development risks associated with an elevated TSH.

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Danielle Vitiello, Ph.D., M.D.

Danielle Vitiello, Ph.D., M.D. Board-Certified in Obstetrics and Gynecology, Reproductive Endocrinology and Infertility