THYROID DISEASE, FERTILITY AND PREGNANCY

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Thyroid Disease, Fertility and Pregnancy

When in the pregnancy should a woman with thyroid disease start receiving

prenatal care and monitoring of her thyroid levels?

Changes in estrogen levels have effects on thyroid function. This is one key

reason that thyroid hormone dosage requirements can change during pregnancy,

a period of tremendous hormonal fluctuation. Dr. feld indicated that it

takes approximately six weeks for the thyroid dosage requirements to

fluctuate in response to the change in estrogen from pregnancy, so the first

prenatal visit should take place no earlier than six weeks, and no later

than 12 weeks. From that point on, his suggestion would be to check the

thyroid levels at least every three months. If dosages are changed,

additional follow-up blood tests should typically occur within five to six

weeks after the dosage change. Above all, Dr. feld stressed regular

visits with the doctor to monitor thyroid hormone levels. In particular, Dr.

feld felt that careful and regular monitoring is essential for women

who have no thyroids due to surgical removal.

What are the chances the baby will inherit/develop thyroid problems?

The chances of inheritable thyroid disease being present at birth are fairly

small. Dr. feld said that Hashimoto's autoimmune thyroid disease is the

thyroid disease most commonly passed on genetically. However, since

Hashimoto's typically doesn't appear until the second decade of life, it's

not likely to be seen in infants.

Is thyroid hormone truly safe during pregnancy?

Taking thyroid hormone is the process of replacing something that a woman's

body -- especially when pregnant -- would normally already have. Dr.

feld said, in fact, that the greatest danger is the hypothyroid woman

who thinks taking all drugs during pregnant -- including thyroid hormone --

is bad for her baby, and discontinues her thyroid hormone replacement.

During pregnancy, it is even MORE important to make sure to take the proper

dosage of thyroid replacement, as this ensures that the mother's thyroid

function will meet the demands of pregnancy.

Thyroid Hormones During Pregnancy

Thyroid hormone is one of the few drugs in pharmaceutical category " A " (Low

Risk) for pregnant women. Studies in pregnant women show no adverse effects

on the fetus during the first trimester of pregnancy, and there is no

evidence of adverse effects in later trimesters.

Are there any supplements/foods should pregnant women on thyroid replacement

hormone should avoid? And how far apart should a pregnant woman take a

prenatal vitamin with iron and her thyroid hormone?

According to Dr. feld, the main concern is making sure that the

prescribed amount of thyroid hormone is fully absorbed into the system. The

key items that can prevent maximum absorption in anyone taking thyroid

hormone include eating a high-fiber diet and taking antacids, two activities

often more common during pregnancy. (Consumption of large amounts of soy

products can also interfere with thyroid hormone absorption.) And of

particular concern to pregnancy women is the iron in prenatal vitamins,

which can interfere with thyroid hormone absorption. To maximize absorption

and make sure the proper amount of thyroid hormone is processed, Dr.

feld's recommendation is: " Ideally, take your thyroid hormone without

food, on an empty stomach, at least two hours after or one hour before

eating, and do not take your prenatal vitamin with iron within two hours of

taking your thyroid hormone. "

How to Take Your Thyroid Hormone

" Ideally, take your thyroid hormone without food, on an empty stomach, at

least two hours after or one hour before eating, and do not take your

prenatal vitamin with iron within two hours of taking your thyroid hormone. "

Dr. feld does say that consistency is also important. If for some

reason, you can't take your pill on an empty stomach, it's better to decide

to take your thyroid pill every day with food, than miss taking it or take

it erratically - - some days with food, some days without. You may stabilize

at a slightly higher dosage than if you weren't taking your pill with food,

but you'll get to the right dosage.

Any other thoughts?

Overall, Dr. feld said that a woman should approach pregnancy with the

mindset that thyroid disease is not likely to be a problem in her

pregnancy. In fact, hyperthyroidism tends to improve somewhat in some

pregnancies, and pre-existing nodules and goiters don't tend to create any

additional concern, and treated hypothyroidism adds only a slight risk

during pregnancy.

The keys to a healthy pregnancy with thyroid disease?

Compliance and care. Taking your thyroid hormone as prescribed for maximum

absorption, and at least two hours apart from the prenatal vitamin with

iron, and receiving regular medical care are the most important things a

woman can do to help ensure a healthy pregnancy.

Hart

Wife to Jon, Love of My Life

Mom to 4:

Arianne (16) ~ a(7)

(4) ~ (My TR Baby - born 6/20/02)

Glory to God and Many Thanks to Dr. Levin

http://www.geocities.com/thehartclantx/Thehartclantx.html