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Getting pregnant is not easy, not at least for all women out there. There are many complications that a woman may face while trying to conceive. One of the most common problems that can make it harder for a woman to conceive is hypothyroidism. Hypothyroidism or underactive thyroid hormone, especially when left undiagnosed can make it difficult for a woman to conceive. One in ten women have some form of hypothyroidism before or during pregnancy, but most of the time it remains undiagnosed. Read on to know more about hypothyroidism and how it is linked with infertility in women.
What Is Hypothyroidism?
Firstly, let us understand what exactly the condition is. We all have a thyroid gland located under our voice box, near the neck. This gland produces the thyroid hormone which regulates metabolism in the body.
Sometimes, the thyroid gland does not function correctly and as a result, this hormone is produced in low amounts. Such a condition is known as hypothyroidism. Alternatively, hyperthyroidism can occur when the thyroid gland produces thyroid hormones in excess. It is safe to say that the thyroid gland is vital for major functions in your body to carry on seamlessly.
Causes of Hypothyroidism
The main cause of hypothyroidism is the improper functioning of the thyroid gland. However, few other causes may also be at play:
- Iodine is an essential mineral that keeps the thyroid gland in check to produce the right quantity of thyroid hormones. When there is too little iodine in the body, hypothyroidism can occur. Vice versa, too much iodine can also cause the same.
- If the thyroid gland gets infected or inflamed (thyroiditis), it can leak its hormones into the bloodstream. This causes hyperthyroidism, which can turn into hypothyroidism after a few months.
- When you are too stressed, your adrenal glands get activated and produce a hormone called cortisol in excess. Cortisol interferes with the normal production of the thyroid hormone and may be a cause of hypothyroidism.
- Exposure to heavy metals like mercury can also trigger hypothyroidism.
- Hashimoto’s disease, an autoimmune disease that inflames the thyroid gland and affects thyroid hormone production. It is one of the most common causes of hypothyroidism.
- Surgical removal of the thyroid gland during treatment of diseases like goitre, thyroid cancer etc., can affect the functioning of the thyroid gland and cause hypothyroidism.
How Does It Affect Conception and Pregnancy?
If a woman has an abnormally low (or high) level of thyroid hormone in her body, it can cause fluctuations in her menstrual cycle. This can also affect her ability to ovulate which may make it difficult to get pregnant or in worse cases, may result in infertility. On the other hand, if you are considering pregnancy with hypothyroidism, do remember that miscarriage is a risk. It could also lead to congenital disabilities in the child. We know it sounds daunting, but don’t worry, there are many ways to treat the condition and have a baby as normally as possible.
When Do I Go for a Thyroid Function Test?
If you are thinking of having a baby, first, you will have to schedule a thyroid function test. Your doctor will advise you to undergo a few tests before you start trying to get pregnant. Here are the two times when you can consider going for a thyroid function test.
1. Thyroid Profile Test Before Trying to Conceive
You should go to your doctor, if:
- Your family has a history of thyroid disorders.
- You’ve been trying to get pregnant for six months, but still, are unsuccessful.
- You experience symptoms like joint pain, muscle pain, hair loss, constipation, fatigue and lethargy, decreased libido, reduced heart rate and development of a goitre.
- You are intolerant to cold.
- Your menstrual cycles are irregular, and you experience severe period pain.
- You have already had more than two miscarriages.
- You gain weight rapidly and find it hard to shed the extra kilos even after exercising and following a healthy diet.
The doctor will take your blood test to determine the levels of two thyroid hormones – thyroid-stimulating hormone (TSH) and thyroxine (T4) in your body. If your T4 levels are low and TSH levels are high, then you might have hypothyroidism. If the vice versa occurs, then that might mean irregular or no ovulation.
2. Thyroid Profile Test After Conceiving
You should take the thyroid function test during the initial stages of your pregnancy, if:
- If you have any of the above symptoms.
- Your family has a history of thyroid disease.
- You have an autoimmune disease like type 1 diabetes or lupus.
- If you have had radiation to any part of your neck.
- If you are above 30 years of age (as the chance to get hypothyroidism increases with age).
How Can Hypothyroidism Affect the Mother and the Baby?
If you have hypothyroidism during pregnancy and you fail to get it treated, then complications like preeclampsia (rapid rise in blood pressure in later stages of pregnancy), miscarriage, premature birth, heart failure, anaemia, and post-birth depression can occur.
Likewise, your baby could be born with birth defects. He may have problems like low birth weight, thyroid conditions, mental retardation, etc. Chances of premature birth and stillbirth will also be high.
Measures to Take Before Conception
If you have hypothyroidism and you want to get pregnant soon, it is imperative that you seek medical help immediately. You should get the condition treated or in control before you conceive. The reason being that your unborn baby’s thyroid gland will start to function only after the first 12 weeks of pregnancy. Till then, the baby will depend on you for thyroid hormone. So it is essential to have your thyroid functioning properly and thyroid hormone levels stable before attempting to conceive.
The most common treatment for hypothyroidism is given in the form of a pill which your doctor will prescribe. The tablet contains synthetic thyroxine (identical to T4 produced by the thyroid gland) and is meant to substitute its deficiency in your body. Your doctor will advise you how often to take it and check your thyroid hormone levels every four weeks during the first three months, gradually adjusting the dosage till your thyroid function is back to normal again.
The treatment is safe, however, it may have minimal side effects. But you can try to get pregnant as soon as you are free of the condition. However, if your thyroid hormone levels remain low, plan a visit to a specialist.
What Is Subclinical Hypothyroidism?
This is a mild form of hypothyroidism which may go unnoticed due to its apparent lack of symptoms. A TSH test can detect it, but in case it is found during pregnancy, undergoing hypothyroidism treatment is still the best option.
Measures to Take During Pregnancy
If you get pregnant while you are still being treated for hypothyroidism, go to your doctor immediately. He will suggest the following measures:
- Increasing the dosage of the pill (synthetic thyroxine) as you will be already under the treatment.
- Checking the thyroid function every six to eight weeks during pregnancy.
- Monitoring the levels of the thyroid-stimulating hormone (TSH) to maintain steady hormone levels in the blood. Your doctor may also adjust medication according to these levels during each check.
Here’s what you can do on your part:
- Don’t be alarmed if your doctor increases medication up to 50% in the dosage of the pill. During pregnancy, your body needs double the amount of thyroid hormone as you are providing it to your unborn baby as well.
- Never switch suddenly from generic medicine to a brand or vice versa during your pregnancy. Stick to what you had been taking before getting pregnant and continue with it until your doctor says otherwise.
- Make sure to take the exact dose prescribed by your doctor—not more, not less. Each little action you take may have a huge consequence on your baby, so be very careful.
- Lastly, don’t worry. The medication is entirely safe, and it won’t harm you or your baby.
Hypothyroidism is a condition that can develop in a woman any time. If you are trying to get pregnant and have hypothyroidism, it is best to get the condition treated or controlled. Talk to your doctor and follow her instructions, and you will be fine! Do what your doctor suggests you and you will deliver a healthy and happy baby!
Also Read: Thyroid Disease In Pregnancy – A Quick Guide