The thyroid is a small gland that helps regulate a person's metabolism by producing hormones.Problems can occur if the thyroid overproduces hormones, when it is known as hyperthyroidism, or under produces hormones, which is called hypothyroidism.

 

Hypothyroidism

Hypothyroidism is when a person's thyroid does not produce enough thyroid hormone.Not having enough thyroid hormone can slow down a person's metabolism. Hypothyroidism is especially common in women.

 

Symptoms:

Hypothyroid symptoms can vary, but may include:

● Feeling cold

● Tiring more easily

● Dry skin

● Forgetfulness

● Depression

● Constipation

 

Treatment:

A person can easily manage hypothyroidism with thyroid hormone replacement.A person typically takes thyroid hormone replacement orally, once a day as a pill, for the rest of their life.

Screening:

The universal screening for abnormal TSH concentrations in early pregnancy is not recommended. But in our population subclinical hypothyroidism is very common. So, its worth checking your thyroid function.

 

Diagnosis:

The hypothyroidism during pregnancy is diagnosed by measuring serum TSH and serum FT4.

Primary overt maternal hypothyroidism is defined as the presence of an elevated serum TSH and a decreased serum FT4 (Free Thyroxine).

Subclinical hypothyroidismis defined as presence of an elevated serum TSH and normal serum FT4 concentration during gestation.

 

Treatment:

The oral Levothyroxine (LT4) is the drug of choice for treatment of hypothyroidism in pregnancy.The dose of LT4 is increased by 20 %-30% in hypothyroid patients receiving LT4 treatment with confirmed pregnancy.

 

Hypothyroidism and Infertility:

Evaluation of serum TSH concentration is recommended for all women seeking care for infertility. LT4 treatment is recommended for infertile women with overt hypothyroidism who desire pregnancy.

The prevalence of thyroid autoimmunity is higher among infertile patients, especially when infertility is caused by endometriosis or ovulatory dysfunction. There is fair evidence that thyroid autoimmunity is associated with infertility. LT4 may improve pregnancy outcomes in female with positive thyroid antibodies especially if serum TSH is > 2.5 mIU/L.

The overt hypothyroidism affects the semen parameters as well as sexual behavior.

 

Hyperthyroidism:

Hyperthyroidism is when a person has too much thyroid hormone in their body, which speeds up their metabolic processes.Someone with hyperthyroidism may initially have more energy, but their body will break down more quickly, which can cause various issues, especially fatigue.

 

Symptoms:

● Rapid pulse

● Tremors in the hands

● Anxiety

● Problems sleeping

● Irritability

● Muscle weakness

● Unintended weight loss

 

Treatment:

● Anti-thyroid drugs

● Radioactive iodine tablets

● Surgery