HYDERABAD: Hypothyroidism has solutions at hand
Several women who aren’t able to conceive end up spending thousands of rupees on treatment and go through invasive medical procedures, even before ensuring that their thyroid is functioning at its optimum. Hypothyroidism remains a leading cause of difficulty in pregnancy, however this condition is more common than most women realise. Thyroid dysfunction can have a threatening impact on fertility in various ways some including an imbalance in anovulatory cycles, luteal phase defect, high prolactin levels, and sex hormone imbalances. Therefore, a healthy thyroid balance is necessary for fertility, pregnancy, and to sustain a healthy pregnancy.
The thyroid is an organ located in the front of our neck, just below the voice box and above the collar bones. It releases hormones that regulate our metabolism, heart and nervous system, weight, body temperature, etc essentially making every cell in our body dependent on this gland. The gland produces two hormones that it releases into the bloodstream, one called triiodothyronine (T3), and the other, Thyroxine (T4). It is T3 that is primarily needed for the proper functioning of body cells and it also influences bone formation, muscles, heart health, and cholesterol levels.
It is the over production or under production of the T3 hormone that leads to thyroid imbalances which may vary from the small and often harmless goiter, to life-threatening disorders such as cancer. Excess production of the thyroid hormone results in hyperthyroidism, causing the body’s functions to speed-up, while inadequate amount causes hypothyroidism, causing the body’s functions to slow down. Frequency of hypothyroidism in the reproductive age group is 2–4% and has been shown to be one of leading causes of infertility and habitual abortion. While there are many and varied reasons for infertility, thyroid imbalances may be a reason in disguise, especially for those with no specific reproductive problems.
There are various explanations for thyroid dysfunction, one being that the gland may not make enough of the T4 form of thyroid hormone due to a problem with the thyroid itself. Hashimoto’s Disease is an example of this in which the thyroid can’t keep up with the body’s needs because it is being targeted by the immune system for destruction, otherwise known as autoimmunity. This is usually the cause of Hypothyroidism in pregnancies and occurs in three to five out of every 1,000 pregnancies.
Another major source that is responsible for hypothyroidism is iodine deficiency, a key component necessary for the production of thyroid hormone. Deceivingly, symptoms of hypothyroidism, such as extreme fatigue and weight gain, may be easily confused with regular symptoms of pregnancy, making the diagnosis rather difficult. Other symptoms include:
lConstipation
lDifficulty concentrating or memory problems
lSensitivity to cold temperatures
lMuscle cramps
Thyroid hormone is critical for the development of the baby’s brain and nervous system. While the baby’s thyroid will begin to function on its own at around 12 weeks’ gestation, for the first trimester, the baby completely dependent on the mother’s supply of thyroid hormone, which comes through the placenta. Untreated, maternal hypothyroidism can cause miscarriage, premature birth, stillbirth and low birth-weight, as well as long-term neuro-cognitive consequences for the baby.
Hypothyroidism can be treated with a synthetic hormone called thyroxine—a medication which is identical to the T4 made by the thyroid. Women previously diagnosed with hypothyroidism must increase their pre-pregnancy dose of thyroxine to maintain normal thyroid function. It is imperative that during pregnancy, the thyroid function be checked every 6 to 8 weeks. Synthetic thyroxine is a safe and necessary treatment for the well-being of the foetus as well as the mother.
Poor eating habits, a busy schedule, emotional stress, caffeine, food intolerances, immune disorders and other triggers must be avoided for a smooth and healthy pregnancy. Pregnant woman, or those wanting to conceive, must focus on a nutrient dense and anti-inflammatory food diet. The majority of the diet should be a variety of colorful vegetables and fruits, augmented with a smaller amount of healthy proteins, fats and whole grains. A few key nutrients important for thyroid health include: Iodine, Selenium, Zinc, L-Tyrosine, Omega-3, ·Vitamins A, B, C & E.(The writer is an IVF Specialist & Consultant Reproductive Medicine Manipal Fertility, Ongole)