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What is Gestational Hypothyroidism?

About

Women require a higher amount of thyroid hormones during pregnancy, and many take boosted doses of synthetic hormones early in pregnancy. These changes can lead to hypothyroidism.

The prevalence of hypothyroidism during pregnancy is estimated to be 0.3–0.5% for overt hypothyroidism and 2–3% for subclinical hypothyroidism [1]

- It is usually asymptomatic
- The disorder may have a postpartum flare up

During pregnancy, profound changes occur in thyroid physiology, resulting in different thyroid-stimulating hormone and free thyroxine reference intervals.

Symptoms

- anemia
- shaking hands (slight tremor)
- trouble sleeping
- intrauterine growth retardation
- abruption placenta (the premature separation of the placenta from the uterus)
- respiratory distress
- inappropriate weight gain
- cold intolerance
- dry skin
- delayed relaxation of deep tendon reflexes
- constipation
- fatigue
- somnolence

Treatment

Self-care: Iodine rich food items should be incorporated into the daily diet of the patient.

Adequate follow-up is required as women with hypothyroidism during pregnancy might have a flare up of the disorder, or might continue to require thyroxine replacement, post-partum. A follow-up every 4–6 weeks with free T4 and TSH value till delivery should be mandatory for women to be able to facilitate periodic adjustment of the LT4 supplementation. In rare cases, in which women do not respond to these medications or have side effects from the therapies, surgery to remove part of the thyroid may be necessary.

Medication: Over-the-counter medication can be purchased. In severe hypothyroidism, a
thyroxine dose twice the estimated final replacement daily dose may be given by the doctor for the first few days, to rapidly normalize the extrathyroidal thyroxine pool.

Specialist: Medical care suitable to the patient’s needs can be found at mfine.

 

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