05 Oct 2012

Healthy pregnancy idea: get your thyroid tested

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New estimates suggest that up to 10% of pregnant Aussie women could have an underactive thyroid. Rosie Brogan reports.

Pregnancy and preconception

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In the early stages of your pregnancy? Make time to have your thyroid checked, advises endocrinologist Professor Creswell Eastman, chief medical advisor to the Australian Thyroid Foundation.

According to Eastman, new research from the USA has found the incidence of underactive thyroid – or hypothyroidism – among pregnant women is far greater that previously thought. He cites a study that tested for the condition in a sample of 500,000 ladies with baby bumps. 15.5% of them were found to have underactive thyroids.

Classically, hypothyrodism is a bigger risk for women over 50. It’s a condition whereby the thyroid gland doesn’t produce enough of the thyroid hormone, thyroxine, which, amongst other things, controls your metabolism. Weight gain, fatigue and hypersensitivity to the cold can throw out the red light, hinting that your thyroid isn’t functioning properly.

But, Eastman says the symptoms that can afflict pregnant women are even more severe: “Gestational hypothyroidism poses a serious risk to the pregnancy and the welfare of the baby even if it survives the pregnancy. It is a risk factor for miscarriage, pregnancy-induced raised blood pressure, premature labour, low birth weight infants and brain damage to the baby resulting in a lower IQ.”

The most likely reason for the roll call of risks is that pregnancy increases your need for thyroxine by 50 %, which can trigger hypothyroidism.

Eastman estimates between 2.5 and 10% of all Aussie pregnancies can put mothers into this category, hence his shout-out to check if your thyroid is functioning at its best. At present only expectant mothers deemed “at risk” are tested. But the endocrinologist believes all pregnant women should undergo a test.

“Every pregnant woman should have TSH testing as soon as her pregnancy has been confirmed,” he says. “The only way subclinical hypothyroidism can be detected and treated is to test thyroid function.”

His second tip: “We know that if pregnant women take an iodine supplement to prevent hypothyroidism and we treat a woman with subclinical hypothyroidism due to autoimmune thyroid disease as early as possible during pregnancy, then we can prevent the obstetric and foetal complications.”

What is the thyroid and what does it do?
The thyroid gland is a soft, small, bow-shaped gland, which is located in the front of the neck, below the voice box or larynx. The thyroid gland uses iodine (mostly from foods such as seafood and salt) to produce thyroid hormones. These hormones help to regulate the body's metabolism and affect processes, such as growth and other important functions in the body.

How can I keep my thyroid healthy?
Include iodine-rich foods in your diet, such as fortified bread, eggs, seafood, dairy milk, and products with iodised salt. Iodine supplements are also available. The National Health and Medical Research Council recommends all pregnant women take a daily pregnancy supplement containing 150 mg of iodine.

References available on request

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