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  • Category: Gynaecology

    Problem in pregnancy due to thyroid


    Does your wife have a thyroid problem during pregnancy? Get quick advice on what you could do.

    I have a question regarding my wife's pregnancy. We have had two miscarriages in since 16 months. Firstly my wife has a problem of constipation and, secondly, she has thyroid value 20. However, we have taken another chance and baby is being conceived but thyroid value is 10 - what should we do?
  • #147494
    Please seek the advise of a qualified Obstetrician and an Endocrinologist.

    The thyroid gland produces hormones that are important for daily functions and well being. At periods of stress or increased demand like puberty, pregnancy, the need for thyroid hormone goes up and the gland has to work more.
    The values you are referring to would be the TSH value. A high TSh value 20 or 10 suggests HYPOTHYRIODISM that is know to produce constipation and is linked to miscarriages.

    A word of caution.
    Interpretation of thyriod reports depends on the lab normal range units, it may vary based on the kit used.

    Please see the specialists mentioned above. They would assess you wife, carry out further tests like T3, T4, TSH and Free T4 with an ultrasound of the neck and advise you accordingly. Based on all the reports, she would be prescribed thyroid hormone supplements in the appropriate dosage in the form of tablets.

    Please attend the check-ups regularly because HYPOTHYROIDISM IN THE MOTHER CAN IMPACT THE GROWTH AND WELL BEING OF THE CHILD IN THE WOMB. Given that there have been two miscarriages, many experts would suggest to treat this pregnancy as a precious pregnancy which basically means extra care, monitoring and more frequent follow-ups.

  • #147498
    It is important during the pregnancy under the guidance of a qualified and experienced gynaecologist. We should follow the doctor's instruction and we should take her help in all the aspects wherever we have a problem. Your wife is conceived. So please take the advice of the doctor at all levels. Don't go by any advises that are coming without fully understanding the problem. the value indicated in the question appears she is having a problem with hypothyroidism (underactive thyroid). It is the situation where the thyroid gland doesn't produce enough of certain important hormones. The signs and symptoms of hypothyroidism will depend on the severity of the hormone deficiency. If your Gynecologist advises you to see a qualified Obstetrician and an Endocrinologist, you can do that.
    drrao
    always confident

  • #147507
    Greetings!
    According to my knowledge the Thyroid hormone values which you have quoted here are the values of Thyroid Stimulating Hormone (TSH). These levels are the primary tests that are done to diagnose Thyroid diseases. But note that during pregnancy there is increased size of Thyroid gland (about 50%) and increased secretion of TSH (about 10%). Since you have already stated that the level as 10 now, please note the following levels of TSH during pregnancy:
    1st Trimester: Between 0.1 to 2.5 and not more than 2.5
    2nd Trimester: 0.2 to 3.0
    3rd Trimester: 0.3 to 3.0.

    Since you have high TSH levels analyze your T4 levels also. As you have stated about miscarriage twice, am assuming that T4 levels are low and it is called as Overt Hypothyroidism. This condition must be treated without delay. Please consult your Gynecologist and Obstetrician to access hormonal levels. Since TSH levels are 10, it must be treated irrespective of T4 levels.
    Follow up the TSH levels every four weeks. If not treated there can be neurological disorders of the baby, low birth weight and finally miscarriage. Note that iodine levels must be increased during pregnancy. According to WHO (World Health Organization) recommendation the minimum iodine intake per day should be 250 micro grams. Seaweed is great source of iodine. Please note that excess consumption of iodine will initiate fatal results. Consult your doctor/dietician about the foods and dietary supplements to be consumed. Thyroid medication must be started as early as 6th week of pregnancy. Ideally most clinicians suggest TSH levels to be 2.5 before getting pregnant. Regardless you start the medication immediately. Ideally Levothyroxine is the drug used during pregnancy. Before you start medication consult your doctor immediately.

    Thank You
    Dr. V. Shashikanth

  • #147523
    Normal thyroid value is important especially when your wife is likely to conceive. The normal TSH value so that our body functions at peak lies between 0.27 and 4.5 and hence the value of TSH of 10.0 is not acceptable in the case of your wife. A detailed analysis in this s regard such as T3, T4, TSH and a free T4 is essential in order to get a clear picture of thyroid profile.
    However, the treatment - pattern is simple and by having a look of the report of your wife, the Endicronologist would prescribe Levothyroxine of appropriate intensity so that TSH value should lie utmost 3.0 since any value beyond this may pose problem. Your wife would remain under the close supervision of the specialist till the baby is delivered.
    The concerned medicine should be started as early as possible, preferably in the second month of the pregnancy so as to get a healthy baby devoid of any complication in the later stage.


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