4 Pregnancy Planning Tips For Hashimoto’s Moms-To-Be
Hashimoto’s thyroiditis is a chronic autoimmune disorder of thyroid function, where the patient has lower than normal levels of thyroid hormones (caused by misdirection of antibodies), and is therefore in a hypothyroid state. While thyroid physiology changes quite significantly in normal pregnancies (to accommodate the changing metabolic needs of the mother and fetus), hypothyroid states such as Hashimoto’s, which are considered pathologic (not normal), demand special consideration. Below we discuss some of these issues for mothers-to-be.
What are some considerations for planning to become pregnant if I have Hashimoto’s?
Specific considerations will vary depending on each patient’s particular situation, but since hypothyroidism does present issues of infertility, this should be the first thing to consider with your physician. Also, you should be aware that women with this condition have a higher rate of miscarriage in the first trimester. For women who suspect hypothyroidism but haven’t been diagnosed, some doctors may elect to perform screening tests to determine this prior to becoming pregnant. But perhaps most important is that you continue to take your medications on a regular basis prior to becoming pregnant, so that you can maintain your hormone levels within normal limits – which may reduce the risk of miscarriage – offering the best chance for a normal, uncomplicated pregnancy.
Will I still be able to take my medicine while pregnant?
Absolutely. Not only can you take your medications, but it will be required in order to maintain your thyroid hormone levels during this time. There are trimester-specific target ranges for these blood levels, and your physician will prescribe the proper doses for these periods, depending on current dosing regimens and thyroid panel (a series of thyroid tests) results. He or she will then make any adjustments as necessary throughout the pregnancy and in the postpartum period. To be sure, do not stop taking these meds unless specifically instructed by your doctor.
If I am hypothyroid, is my likelihood of passing on a thyroid condition to my child(ren) higher than if I were hyperthyroid?
Since both conditions can be the result of autoimmune pathologies, the answer really depends on whether the aberrant antibodies manage to cross the placenta and initiate a reaction in the fetus. However, after searching online and in textbooks, there doesn’t seem to be a clear answer as to which is more likely to be passed on. While not conclusive regarding this question, the NIH provides a nice overview of the possible consequences for mother and baby during both of these states.
Is there anything homeopathic I can do to help my body adjust to pregnancy while managing my hypothyroid symptoms, especially if they change while I am pregnant?
As with most diseases these days, there are a host of purported natural remedies to be found in books and online, though very few have been studied scientifically, with some being little more than a layperson’s idea of “common sense”. Most of the naturopathic recommendations revolve around proper nutrition and avoidance of suspected triggers of or contributors to Hashimoto’s. Good nutrition is solid advice for all pregnant women, though the substances to avoid tend to differ substantially, depending on the source of information. There are literally dozens, if not hundreds, of specific food and supplement recommendations for preventing or treating hypothyroidism of pregnancy. Since the literature seems to differ substantially regarding these suggestions, it is mandatory that you discuss any plans to ingest these substances before beginning to do so with your doctor or midwife.
Questions for your doctor:
- When should I adjust my medication during pregnancy, and by how much?
- Are there any natural remedies that you have found to be both safe and effective?
- How often do I need to be tested for hormone levels during pregnancy?
- Is there anything I can do while pregnant to minimize the chances of antibodies crossing the placental barrier?
- What are some specific signs/symptoms to watch for that may indicate there is a thyroid-related problem during pregnancy?
Originally published June 27, 2012, updated January 18, 2015
About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians. After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time. He may be reached at firstname.lastname@example.org.
This blog post was originally published by AutoimmuneMom.com, written by Dr. Rothbard, and first published on Jan 18, 2015.
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