Hippocrates also drew attention to the thickening of the neck in pregnant women, and Professor Pende, one of the first endocrinologists, pointed out that the thyroid gland is tensed to varying degrees in every pregnant woman. This means that thyroid hormones are very important for ensuring the development of the fetus, etc. But in some women, pregnancy can lead to excessive strain and gland disease. These features need to know.
Pregnancy is the physiological stress of the body. All body systems strain and accordingly change, including energy supply systems, which include the thyroid gland.
During pregnancy, the body begins to increase consumption and, of course, the production of thyroid hormones. Here is a source of thyroid tension amplification.
Are you planning a pregnancy?
First of all, do the right blood test and professional clinical ultrasound of the thyroid gland. No matter what the doctors say, BLOOD ANALYSIS should include the following INDICATORS (remember this word): TTG, T3fr., T4fr., T4total, AT-TPO, AT-TG and general analysis (red blood cells, hemoglobin ...).
An ultrasound of the thyroid gland must necessarily evaluate: 1) the volume (not more than 8-9 ml for women up to 170 cm tall, and not more than 11-12 for taller ones), 2) the amount of full tissue (isoechogenic), 3) the amount of altered tissue ( if any), 4) the intensity of blood flow in the lobes and PSSK (peak systolic blood flow velocity, which should be in the range of 20-30 cm / s). An increase in PSSC and blood flow intensity is a sign of thyroid overstrain - a sign of increased thyroid hormone consumption by the body. During pregnancy, in this case, you can expect more overstrain and already exhaustion of the gland.
Analysis of the concentration in the urine of iodine (everywhere, but not in "Invitro"). It is reliable for every one person and shows the need for help in iodine, prompting the competent doctor with a dose for replenishment.
All of the above is appropriate to do at the beginning of pregnancy (because it can happen "unplanned").
Hypothyroidism during pregnancy?
It’s too late to treat - the pregnancy has begun. Treatment for hypothyroidism should be attributed to the period after childbirth and initial recovery.
The main thing is not to worry. "Calm, only calm. The matter is something everyday ...", - as Carlson said. It is important to determine the dose of auxiliary hormonal and iodine-containing drugs. And using these funds, you can endure and give birth to a healthy baby. Or baby. Whoever you want or ... "God will give" (as they say too).
Yes, with hypothyroidism, help with drugs is harmless and necessary. She is forced. Worry about taking them should not. After childbirth and several months of recovery, the dose of the drug is usually reduced and canceled if the drug has not been used before.
BUT! Have but". Even two buts.
1) The first "but". If pregnancy provoked hypothyroidism, then this is an occasion to start treatment after childbirth. Please note that hormonal drugs (Eutirox and L-thyroxine) do not cure, and the treatment is not to reduce TSH.
2) The second "but". Adequacy is important, not the REDUNDANCE of the dose of the hormonal drug. Endocrinologists like to generously increase the dose and prescribe the drug in a standard manner.
Hyperthyroidism (thyrotoxicosis) during pregnancy?
This is worse. Thyrostatics that inhibit the formation of thyroid hormones (Tyrosol, Propicil, Merkazolil ...) adversely affect developing tissues, and also penetrate the fetus with blood with blood.
The least harmful thyreostatic drug is Propitsil. But it is still harmful during pregnancy. And, of course, undesirable.
The best tactic for hyperthyroidism (in the case of diffuse toxic goiter (DTZ) or Graves' disease) is to first cure the body, strengthen it, and only then plan to start reproductive tasks. Or, as many women write and say, get pregnant. Well, that’s a good thing.
If a BLOOD ANALYSIS has shown the occurrence of hyperthyroidism, then it is better to protect yourself and begin real treatment.
After Pregnancy - AUTOIMMUNE Thyroiditis?
This happens if the thyroid gland during pregnancy is significantly overstrained and depleted, trying to provide an excessive amount of thyroid hormones, i.e. provide increased hormone needs.
To improve the state of the gland tissue and remove its dead cells, cells of the immune system (lymphocytes) rush into the gland with blood flow and produce antibodies to the gland (AT-TPO and AT-TG). Thus, the immune system tries to cleanse its important organ and help it regenerate regeneratively. This usually happens afterwards.
After pregnancy, the need to overstrain the thyroid gland is naturally eliminated. Lymphocytes leave the gland tissue, and it regenerates regeneratively. Therefore, endocrinologists know about the reversibility of postpartum autoimmune thyroiditis, but do not know why this happens. Yes, this is very often the case in endocrinology (you, reader, still don’t guess much).
The next pregnancy in a year or two?
Do not rush to the next pregnancy. If this happens, then keep in mind that repeated stress on the thyroid gland with such a short period for its relaxation can have a more pronounced effect - overstrain and change the state of the gland.
And the most interesting thing is honest advertising from our Clinic of the thyroid gland for pregnant women and those who love children and want to give birth.
For more than 10 years, our patients have received recommendations on the dosage of hormonal and auxiliary drugs during pregnancy. Under our control, several dozen healthy babies and babies were born. Some of them already go to school.
If necessary, we will carry out highly professional diagnostics and consultation. Then, during pregnancy and after childbirth, we will be able to correctly correct the hormonal metabolism of the thyroid gland and treatment.
The main thing is to have your timely knowledge. Therefore, we propose to pay attention to the book "Blood Analysis for Thyroid Diseases", where a separate chapter is devoted to blood analysis during pregnancy. It is important to understand the principles of diagnosis and control of hormonal metabolism and so on. There are important circumstances!
The article was prepared by the Head Physician of the Thyroid Clinic (Moscow), Ph.D. A.V. Ushakov.