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Hypothyroidism during pregnancy more common than previously thought

 

A new study shows hypothyroidism during pregnancy may be more common that previously thought, thanks to new guidelines for evaluating thyroid stimulating hormone (TSH). The study showed hypothyroidism in one in six pregnant women, a 10 percent increase after changing to a narrower TSH range.

The new guideline for normal TSH is now 0.3 to 3.0, narrower than the former guideline of 0.5 to 5.0. In functional medicine and at The Holistic Wellness Center of Charlotte we use a range of 1.8 to 3.0.

Gestational hypothyroidism poses many risks, including miscarriage, hypertension, gestational diabetes, low-birth weight, and a potential risk for a lower IQ in the baby.

Hashimoto’s hypothyroidism screening important during pregnancy

This recent study illustrates the importance of screening for hypothyroidism during pregnancy. Only about 25% of the more than 500,000 women in the study were tested for TSH, meaning many more may have gone through pregnancy with an undetected thyroid condition.

TSH should never be the only marker ordered. Pregnant women should also test other thyroid levels, such as T4 and T3, as well as TPO and TGB antibodies. The antibody tests determine whether the hypothyroidism is resulting from an autoimmune disorder called Hashimoto’s, which attacks the thyroid gland’s tissue.

Studies show that about 90 percent of hypothyroidism cases in the USA are due to autoimmune Hashimoto’s hypothyroidism. Thyroid hormone medication alone does not effectively manage Hashimoto’s. Instead, appropriate thyroid treatment should also involve managing the immune system.

Hashimoto’s hypothyroidism risk to baby’s health

Although it’s always imperative to manage an autoimmune disorder, it’s especially important during pregnancy. Autoimmune Hashimoto’s hypothyroidism is a sign that the pregnant woman’s immune system is out of balance. It also signals a high probability of intestinal permeability, or leaky gut (which permits undigested foods and pathogens to enter into the bloodstream, where they trigger an immune reaction). People with Hashimoto’s commonly have food allergies, most often to gluten, and high levels cortisol.

These are all health conditions that can affect the fetus. Studies show that infants born to mothers with high cortisol are at greater risk of developing allergies. An intolerance to gluten or other foods can be passed on to the child, as can immune imbalances, which can raise the risk of such disorders as asthma, eczema, and food sensitivities.

Hypothyroidism is a red flag that the body is out of balance and that the health of the child could be compromised.

Addressing Hashimoto’s hypothyroidism during pregnancy

It is always important to screen for hypothyroidism and Hashimoto’s during pregnancy. And it’s even better to screen for it before conception.

If lab tests identify hypothyroidism, optimal health of the mother and the baby depends on restoring good functioning thyroid activity.

While thyroid hormones may be necessary, a pregnant woman also should address all the underlying causes of the hypothyroidism. We can do this through lab testing, an autoimmune diet, and nutritional support appropriate for pregnancy.

Detecting hypothyroidism early can help ensure a healthier pregnancy, child, a reduced risk of postpartum depression, and more energy for the mother during the demanding post-partum period.