Overactive Thyroid, Graves' Disease, and Pregnancy

Overactive Thyroid and Pregnancy - What are the Issues?

Hyperthyroidism in pregnancy can be complicated to diagnose and treat, but it's crucial to the health of mother and baby. istockphoto

Hyperthyroidism - or having an overactive thyroid gland - can pose special concerns during pregnancy. When the body delivers too much thyroid hormone, both the mother and the baby can suffer. Miscarriages, premature births, and intrauterine growth retardation can occur when the disorder goes undiagnosed or untreated. Pregnant women with hyperthyroidism can also develop high blood pressure, and are at greater risk of heart conditions.

Often referred to as Graves' Disease, there are many symptoms of hyperthyroidism, including:

  • Abnormal heart rhythm
  • Anxiety
  • Heat intolerance
  • Hyperactivity
  • Fatigue

While some of these symptoms could be considered within the range of a normal pregnancy, thyroid disease poses special challenges for a mother and her unborn child. For women with an underactive, or overactive, thyroid gland.  their baby could suffer developmentally.

A recent study added to a body of knowledge concerning the importance of screening women for thyroid disease before, or as they become pregnant. The study examined more than 3,000 mother/child pairs and collected data on the children. The children borne of women who had tested with high thyroid levels during pregnancy had a statistically lower IQ level than those whose mothers did not have elevated T4.

In addition to lower cognitive skills later in life, a newborn of a mother with untreated hypethyroidism can have low birth weight.

In approximately one percent of newborns with a hyperthyroid mother, the child is born with Grave's Disease, having received the thyroid antibodies during pregnancy. While Graves' Disease is treatable, it is a lifelong condition for which there is currently no cure.

For women who are unaware they have an overactive thyroid, pregnancy can be dangerous.Some women suffer gestational hyperthyroidism, which is temporary, and often does not require treatment.

For women already on thyroid medication for Graves' Disease, is important to work with your doctor throughout your pregnancy. You may find that your condition improves during pregnancy, but worsens in the three to six months after giving birth.

Women with untreated Graves' Disease have a higher likelihood of miscarriage and other complications can occur including:

  • Anemia
  • Heart failure
  • Miscarriage
  • Postpartum hemmorhage
  • Preeclampsia
  • Premature birth

For hyperthyroid mothers, there is also the possibility of suffering a condition called a "thyroid storm."  This life-threatening form of hyperthyroidism causes pregnancy complications including high fever, dehydration, irregular heart rate, and uncontrollable diarrhea. If untreated, the condition can be fatal.

Part of the diagnostic difficulty of thyroid disease with pregnancy are normal changes that occur to the thyroid gland during pregnancy. Levels of thyroid stimulating  hormone (TSH) fluctuate during pregnancy--which is perfectly normal if the mother is not suffering from an underlying thyroid condition. These changes can also lead to an enlarged thyroid, or goiter, particularly if the mother's diet is deficient in iodine.

After birth, if you are on medication for Grave's Disease, you can still typically breastfeed your baby.

  However, this requires close monitoring of your condition, and the thyroid status of your baby to ensure proper growth.

You'll have to be your own best advocate during pregnancy when you have an overactive thyroid -- beginning with finding a physician who will work with you to treat your condition within safe limits for the health of your baby. During pregnancy and breastfeeding, it is essential to work with a caregiver who understands your symptoms and is able to work closely with you throughout pregnancy and beyond.

Here are important resources to help you understand hyperthyroidism in pregnancy.

Hyperthyroidism in Pregnancy Information Center

Hyperthyroidism and Graves' Disease During Pregnancy: Signs, Symptoms, and Risks of an Overactive Thyroid in Pregnancy

Diagnosing Hyperthyroidism and Graves' Disease During Pregnancy

Treating Hyperthyroidism and Graves' Disease During Pregnancy: Overactive Thyroid Treatment for Pregnant Women

Hyperthyroidism in Pregnancy and Neonatal Hyperthyroidism: Implications for Newborns

Transient Hyperthyroidism of Hyperemesis Gravidarum in Pregnancy, Pregnant Women With Hyperthyroidism and Severe Vomiting

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