During pregnancy, the thyroid can naturally change and increase in size. Extreme enlargement is known as a goiter, and the condition is most often seen in women in iodine-deficient communities. Goiters are less commonly seen in pregnant women from the United States. In most cases, size changes are much smaller, and the thyroid often only increases by 10-15%. Pregnant women with hypothyroidism can take steps to maintain TSH levels.
1. Routine hormone monitoring
Thyroid hormone replacement is the most common solution for treating hypothyroidism in pregnant populations. Throughout the pregnancy, a woman may need routine monitoring to test TSH levels. In hypothyroidism, this hormone tends to be found in excess, with T4 below normal levels. The hormones will be adjusted based on the individual’s needs. Thryoid levels affect fetal development and can have a long-lasting influence on a child’s cognitive development
2. Separate hormones and prenatals
While thyroid hormone replacement therapy is safe for pregnant women, timing is important. Most fertility specialists recommend that women avoid taking hormones simultaneously as prenatal vitamins. Research has shown that minerals in the prenatal can interfere with the thyroid hormone being adequately absorbed by the body. Remember that hormones are critical for fetal development.
3. Talk to a specialist
Most pregnant women with hypothyroidism will require medication to replace the T4 thyroid hormone. Such prescriptions are considered safe to consume during gestation with no risk to the fetus. However, women who develop hypothyroidism during pregnancy usually need to avoid medications that contain the T3 hormone. While evidence regarding fetal outcomes in women taking T3 is limited, T3 should be taken with caution. Women with hypothyroidism before conception who are currently on T3-based medications might be encouraged to continue using those prescriptions.
Stay on top of hormone levels
While prescriptions for pregnant women with hypothyroidism can vary, regular monitoring is critical. Knowing if hormone levels have shifted is important to ensure the baby receives the right amounts of hormones for proper development and function. Women concerned with hypothyroidism during pregnancy should speak with an endocrinologist about managing the condition.