What women need to know about thyroid conditions

Woman getting ultrasound of a thyroid from doctor.
Thyroid problems can make it difficult for women to become pregnant and negatively impact a developing fetus.

It’s estimated that about 12 percent of Americans will develop a thyroid condition during their lifetime, and women are five to eight times more likely than men to have thyroid problems.

According to UT Southwestern endocrinologist Alex Tessnow, M.D., a specialist in the treatment of thyroid disorders, no one is entirely sure why women are more susceptible, but because thyroid problems can have a direct bearing on conceiving and having a successful pregnancy, understanding the various conditions and taking precautions are all the more important.

Vague symptoms

As Dr. Tessnow explains, thyroid hormone regulates metabolism and helps many of the body’s organs to function. Because of this, thyroid problems can cause a wide range of vague symptoms, including:

  • Abnormal bowel function (constipation or loose stools)
  • Changes in mood
  • Changes in heart rate
  • Fatigue
  • Hair loss
  • Irregularities in the menstrual cycle
  • Trouble regulating body temperature
  • Weight gain or loss

“These symptoms are non-specific and similar to those of a number of other conditions,” Dr. Tessnow says. “Some of them also can be related to the rigors of a woman’s everyday life.”

Dr. Tessnow notes that as vague as the symptoms are, diagnosing thyroid conditions usually can be done with a simple blood test to measure thyroid hormone levels. He encourages women to see their doctor if they have any of the above symptoms in combination or seemingly out of proportion to what they should be or if one or more of the symptoms just won’t go away.

Thyroid disorders and pregnancy

It’s especially important for women to see their doctor if they have a thyroid problem and are planning to have a baby, Dr. Tessnow adds.

“Thyroid problems can make it harder to get pregnant,” he says. “If the condition isn’t diagnosed or is poorly managed, it can result in irregular ovulation or no ovulation. Some studies suggest that underlying thyroid disease also may increase a woman’s risk for miscarriage.

“If, on the other hand, the thyroid condition is well-managed, meaning thyroid hormone levels are kept normal, it shouldn’t affect a woman’s ability to become pregnant. However, it’s important to understand the changes your thyroid will undergo during pregnancy.”

Dr. Tessnow notes that a woman’s thyroid production increases by 30 percent during pregnancy. This, he explains, is because the baby is completely dependent on mom for production of thyroid hormone until its own thyroid is fully developed and functioning, which occurs about halfway through the pregnancy.

He adds that because thyroid hormone is essential for brain development, women with untreated or undertreated hypothyroidism, in which the thyroid does not make enough hormone, may have babies who are at higher risk for neurological or developmental problems. Meanwhile, women with hyperthyroidism, in which the thyroid makes too much hormone, may be at increased risk for preeclampsia and giving birth before 37 weeks.

Treatment before/during/after pregnancy

“If you have a thyroid condition, I strongly encourage you to have a preconception counseling visit with your thyroid doctor and Ob/Gyn before becoming pregnant or immediately after you find out you’re pregnant,” he says. “We’ll evaluate your thyroid hormone and begin adjusting your medication to support the baby’s healthy development.

“We also need to monitor your thyroid levels frequently – at least every month during the first half of pregnancy – to make sure your thyroid hormone levels remain where they should be. After giving birth, we’ll likely begin reducing your medication dosage to pre-pregnancy levels.”

To schedule an appointment with Dr. Tessnow, call 214-645-8300.

Avoiding thyroid medication mistakes

Thyroid medication is one of the most commonly prescribed drugs in the U.S., but, as with any medication, it has to be taken the right way for it to work. According to UTSW endocrinologist Alex Tessnow, M.D., however, too often patients aren’t taking it the right way.

“With hormone replacement medications, the instructions are basically the opposite of most other drugs,” Dr. Tessnow explains.

Basic guidelines for hormone replacement medications include:

  • Take these medications on an empty stomach with water only (not with food, juice, or milk – just water)
  • Maintain a consistent intake regimen (taking the medication on an empty stomach one day and with food the next can cause thyroid hormone levels to vary)
  • Don’t take it with other medications or multivitamins, especially those that include calcium or iron (the replacement hormone can bind to other drugs and become insoluble, which means it will go right through you and won’t be absorbed into the bloodstream)

According to Dr. Tessnow, one of the keys for thyroid medication success is having a healthy and regular dose of doctor-patient communication.

“The best thing to do is be honest with your doctor if you’re unsure about anything concerning thyroid medication,” he says. “If you’re not taking it properly and we don’t know that, we may try a new medication or dosage when, in fact, the best solution is the medication and dosage already prescribed.”

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