Miscarriages may be a symptom of thyroid problems. Don’t panic: Up to 60 percent of conceptions fail in the first three months, and treatment can be simple.
It happens all the time. You miss your period, and may even have a positive result on a pregnancy stick, but the pregnancy doesn’t last. Don’t panic: Up to 60 percent of conceptions fail in the first three months. Often the woman never knew she was pregnant. You may simply be more aware of those failed conceptions.
Still, it’s also true miscarriage may be a symptom of thyroid problems. This small gland, shaped like a butterfly, lies low in front of the windpipe, where you normally can’t feel it. The thyroid regulates your metabolism, heart and nervous system, weight, body temperature, and many other processes in the body, releasing thyroxine (called “T4”) and other hormones. Your body needs more of these hormones during a pregnancy, and if your thyroid isn’t up to the challenge, called hypothyroidism, treatment could help you avoid miscarriages and other pregnancy complications. Too much thyroid hormone (hyperthyroidism) is dangerous for the fetus as well.
According to the American Society of Reproductive Medicine, you suffer from “recurrent pregnancy loss” if you’ve lost at least two pregnancies within the first 20 weeks, and the pregnancies were confirmed by an ultrasound or from tissue after a miscarriage.
Looking for thyroid problems in women
Some women ask their doctors to test their thyroid function as soon as they decide to try to get pregnant or conceive. Don’t hesitate a minute if you have type 1 diabetes, any other autoimmune problem, or a personal or family history of thyroid disease. It’s also a good idea if you haven’t been feeling well, with unexplained symptoms: Many women fall in a gray in-between with common issues like weight gain, fatigue, and trouble conceiving. Up to 60 percent of Americans may suffer from a thyroid condition without knowing it, the American Thyroid Association reports. As your pregnancy progresses, thyroid symptoms can easily seem like normal side effects of pregnancy. That’s one reason to get tested early.
Symptoms of thyroid problems
If you are hypothyroid, the gland doesn’t produce enough hormones. You may be constipated, sensitive to heat or cold, have dry skin, gain weight, feel sore in your muscles or joints, suffer from heavy or irregular periods or find your hair thinning. You may feel continually fatigued and depressed or become forgetful.
Untreated hypothyroidism increases the risk of not just miscarriage, but premature birth, preeclampsia, bleeding after birth, and anemia.
The good news is that the condition responds to medication, which is safe to take while pregnant and dramatically lowers the risks. You should take your pills separately from any iron or calcium supplements, which can interfere with their action. Levothyroxine sodium (you might see the brand names Synthroid, Levoxyl, or Levothroid) is a synthetic version of “T4,” thyroxine. The drugs Cytomel, Triostat, and Thryrolar contain other thyroid hormones. You’ll get your “TSH” levels checked every six weeks or so, once it falls into a normal range.
If you are hyperthyroid, the gland overproduces. You may also lose weight and feel weak, but are more likely to be irritable or anxious than depressed. You may have vision problems or eye irritation. You might feel a heart flutter or suddenly become short of breath. Those symptoms can be normal in pregnancy, but you might want to check them out, especially if you’ve had two confirmed miscarriages.
About one percent of Americans have Graves’ disease, an autoimmune condition that causes too much thyroid hormone. It may emerge for the first time during your first trimester of pregnancy, and then often improves in the second and third trimesters and flares up again after delivery.
A mild case of hyperthyroidism should be monitored to see that it doesn’t get worse, since it is dangerous for you and the fetus. “Anti-thyroid” drugs, if needed, should stabilize your hormones. They do present some risk to the baby. To prevent them from affecting the baby’s own thyroid gland, your doctors will use the lowest possible dose and most likely cut the dose once your tests show that you’ve reached a desirable level.
The test itself won’t hurt you, but if it’s going to cause you inconvenience or anxiety, isn’t mandatory. In a 2015 review, the prestigious Cochrane group analyzed results from two high-quality trials and concluded that testing all pregnant women didn’t reduce pregnancy complications, though more women were treated. If you do get tested, you’ll need at least two kinds of tests for an accurate diagnosis, and there’s some controversy about how they should be interpreted. Don’t stress out about this; that’s not good for you either.
March 22, 2017
Janet O’Dell, RN