A 25-year-old girl came to me with irregular menses for 6 months and weight gain. After a thorough examination and blood tests, she was diagnosed to be hypothyroid. Her parents started to panic, as she was about get married within 6 months and had many queries and worries about hypothyroidism. Here is an excerpt of the conversation with her.
Thyroid disease is arguably among the commonest endocrine disorders worldwide. India too is no exception. The prevalence of hypothyroidism in India is 11%. Approximately 1 in 10 Indians suffer from Hypothyroidism.
What is hypothyroidism?
A condition in which the thyroid gland does not produce enough thyroid hormones to meet the needs of the body.
How does thyroid affect fertility?
Thyroid tends to impact women between the ages of 18- 35, which is the most productive period of their life. Thyroid disturbs other hormones like Prolactin and sex hormones, due to which there is impaired ovulation (release of egg) or delayed ovulation leading to disturbed menses. Hence one of the causes of infertility.
Can hypothyroid patient get pregnant?
Yes, definitely. Medications will be given to replace the missing thyroid hormone and with proper treatment thyroid hormone comes back to normal.
How long treatment should be taken?
Thyroid comes to normal within a month or two, but treatment should not be discontinued without consulting your doctor. Only about 15 % of women may not need it and may stop it after sometime.
Will the medications cause side effects when taken for long time?
No, IT IS ABSOLUTELY SAFE. Thyroid medication does not have any side effect. Only if you do not take the medication regularly effects of hypothyroidism will persist.
And in pregnancy, should we continue taking the tablets?
Yes, the baby is dependent on the mother for thyroid hormone in the early gestation; it is required for the development of the brain of the baby. So, a hypothyroid mother should supplement thyroid to herself and the baby growing in her womb. If not, it can lead to miscarriage, high blood pressure during pregnancy & preterm delivery. Untreated hypothyroidism in mother during pregnancy can affect the overall mental and physical, growth and development of the baby.
What are the other symptoms of Hypothyroidism?
Tiredness, weight gain, Hair fall, poor concentration, muscle and joint pain, depression, constipation, etc
How to diagnose Hypothyroidism?
Hypothyroidism cannot be diagnosed by symptoms alone, it can mimic other conditions. so, it is diagnosed by a simple blood test- Thyroid Profile
The hormone TSH (Thyroid stimulating hormone) should be less than or equal to 2.5, before planning for pregnancy.
Should all young women be screened for hypothyroidism?
1. Women with family history of Hypothyroidism or with the symptoms as I have stated above should definitely get themselves checked
2. Women who are planning pregnancy or any infertility treatment should be screened before.
3. Women who are on thyroid medication should also be tested and make certain that their levels are normal before planning pregnancy.
How often thyroid test should be done in pregnancy?
Regular blood test every 2 to 3 months should be done, because as pregnancy progresses, doses requirement may change.
Knowledge, lifestyle changes and proper medication will not let Hypothyroidism harm you.
Dr. Swetha Patil (M.S OBG, FRM) Infertility Specialist
Assisted Reproduction Centre, KLES Dr. Prabhakar Kore Hospital & MRC Belagavi.