Thyroid abnormalities and pregnancy
The thyroid is a small organ that lies in front of the trachea. Normally the thyroid gland is not visible or felt.
The thyroid gland creates thyroid hormones. These hormones are important for metabolism (the conversion of food into energy) and thus for growth and mental development.
Thyroid diseases
Thyroid diseases are more common in women than in men. The cause is usually an inflammation of the thyroid gland; This causes too rapid or too slow action of the thyroid gland. If the thyroid gland works too slowly, it is called hypothyroidism. If the thyroid gland works too fast, it is called hyperthyroidism. Thyroid cancer occurs but is rare.
Hypothyroidism
A slow thyroid gland creates too little thyroid hormone. This is usually congenital, but may also occur at a later age, for example, by thyroid gland inflammation. It is also possible that hypothyroidism occurs because the thyroid is treated with radioactive iodine or operated upon. In the Netherlands and Belgium, about 6 out of 1000 pregnant women have a slow thyroid gland. Usually this was known before pregnancy and these women already had medication. Symptoms of hypothyroidism may be:
• Fatigue • Dry, cold, pale yellow skin • Sluggishness in thinking and acting • Slow speech • Memory loss (concentration disorders) • Psychological complaints such as depression and apathy • Myxoidema thickened skin, eg around the eyes • and on the lower legs • Muscular weakness • Muscular pain and stiffness, especially in arms, legs and hips • Joint pain • Carpal tunnel syndrome: tingling in the hands • Heart complaints • Broken and thinning hair • Breakable brittle nails • Eyebrow failure • Weight gain • Shortness of breath Breathing), tightness • Breaking, cracking voice • Constipation • Deafness • Nervousness • Eye disorders (Hashimoto's disease) • Heavy menstruation
Hyperthyroidism
In hyperthyroidism, the thyroid gland creates too much thyroid hormone. Hyperthyroidism is almost always an autoimmune disease: a disease in which the body forms antibodies against itself, in this case against the thyroid gland. With more than 90 percent of hyperthyroidism, it is Graves Disease. About 1 to 2 in a thousand pregnant women have this disease. In Graves's Disease, those antibodies attack the site where the thyroid-stimulating hormone is absorbed in the thyroid gland (the TSH receptor). Those antibodies are called TSI antibodies (thyroid stimulating immunoglobulins). Complaints of hyperthyroidism may include: palpitation, weight loss, excessive perspiration, vibrating fingers, overactivity, fatigue or rapid heartbeat. Sometimes an enlarged thyroid gland may be felt or seen in the neck.
• Heart palpitations • Fatigue • Shortness of breath in exercise • Fast, regular pulse • Struma (enlarged thyroid) • Heat (excessive perspiration) • Warm, damp hands • Vibrating hands / fingers • Nervousness • Movement disorder Muscular weakness (Muscle loss in muscles) • Sore menstruation • Bowel complaints, diarrhea / more frequent stools • Foggy memory • Instability, irritability, anxiety, other psychological complaints • Insomnia fibrillation, irregular, rapid heartbeat • Retraction of the upper eyelid
Thyroid and pregnancy
The thyroid is indispensable for pregnancy and works for two at the beginning of pregnancy. That's one of the main reasons why you're so tired at the beginning of pregnancy. For the first 4 months, the fetus is completely dependent on the mother's body. The mammalian thyroid hormone plays an important role in growth, metabolism of all tissues, development and most importantly: the effect on the nervous system.
When there is a (untreated) hypo- or hyperthyroidism fertilization is difficult and sometimes even impossible. In most cases, the menstrual cycle is disrupted in the case of an underactive thyroid gland. This is usually corrected by using sufficient thyroid drugs in consultation with a specialist. As long as you do not use medication that adds the missing hormones, the risk to pregnancy is small.
With hyperthyroidism, the chance of pregnancy is reduced. As with hypothyroidism the risk of miscarriage or premature birth is greater. There is also the risk of congenital abnormality.
Thyroid problems after pregnancy
You may also suffer from a thyroid condition after birth. Often a thyroid condition is confused with postnatal depression. The complaints of postnatal depression closely match the symptoms of a thyroid disease. If you have any of the aforementioned complaints, please contact a doctor or nurse.
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