Thyroid disorder in pregnancy

Hormonal imbalances during pregnancy are not uncommon and occur mainly due to the huge physiological changes. Here are some of the statistics that highlight the issue of thyroid disorder during pregnancy:

  • 14% pregnant women from India showed subclinical presence of hypothyroidism during first trimester (Dhanwal et al 2013)
  • Thyroid dysfunction is significantly associated with miscarriage (Nambiar et al 2011)
  • Children born to untreated or under-treated mothers have profound effect on future intellectual development.

Increased thyroid hormone levels in pregnancy result due to two pregnancy-related hormones—human chorionic gonadotropin (hCG) and estrogen. The thyroid enlarges slightly in healthy women during pregnancy, but not enough to be detected by a physical exam. A noticeably enlarged thyroid can be a sign of thyroid disease and should be evaluated.

Role of thyroid hormones in pregnancy

  • Thyroid hormone plays a critical role during pregnancy both in the development of a healthy baby and in maintaining the health of the mother.
  • Thyroid hormone is critical to normal development of the baby’s brain and nervous system.
  • During the first trimester, the foetus depends on the mother’s supply of thyroid hormone, which comes through the placenta.
  • Women with thyroid problems can have a healthy pregnancy and protect their foetuses’ health by learning about pregnancy’s effect on the thyroid, keeping current on their thyroid function testing, and taking the required medications.

Dietary inputs for thyroid disorders in pregnancy

  • Thyroid uses iodine to make thyroid hormone, iodine is an important mineral for a mother during pregnancy. Women need more iodine when they are pregnant—about 250 micrograms a day
  • Pregnant women maintain a balanced diet and take a prenatal multivitamin and mineral supplement containing iodine to receive most nutrients necessary for thyroid health.
  • Choosing iodized salt—salt supplemented with iodine—over plain salt and prenatal vitamins containing iodine will ensure this need is met.

Following these nutritional tips may help reduce symptoms:

  • Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), fresh vegetables, and sea vegetables.
  • Avoid foods that interfere with thyroid function, including broccoli, cabbage, brussels sprouts, cauliflower, kale, spinach, turnips, soybeans, peanuts, linseed, pine nuts, millet, cassava, and mustard greens.
  • If you take thyroid hormone medication, talk to your doctor before eating soy products. There is some evidence soy may interfere with the absorption of thyroid hormone.
  • Taking iron supplements may interfere with the absorption of thyroid hormone medication, so ask your doctor before taking iron.
  • Eat foods high in antioxidants, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell pepper).
  • Avoid alcohol and tobacco. Talk to your doctor before increasing your caffeine intake, as caffeine impacts several conditions and medications.

It is important for an expecting mother to get blood tests done which include thyroid hormone levels as well as antibodies. Impaired thyroid function can be very dangerous and needs to be managed well.

References: eatright.org, UMMC