Hyperthyroidism in Pregnancy - Symptoms, Effects & Treatment

When one’s thyroid gland produces excessive thyroid hormone, leading to an overactive metabolism, it is known as hyperthyroidism. While hyperthyroidism can occur in anyone, it is a particular concern during pregnancy and can lead to serious health complications for both the mother and the baby.

During pregnancy, women typically produce double the amount of thyroid hormones compared to before they were pregnant. These hormones, called triiodothyronine (T3) and thyroxine (T4), are crucial for both the mother's body and the development of the foetus. However, producing too much thyroid hormone during pregnancy can be a concern because it may affect the baby's development and increase the risk of preterm birth.

When it comes to hyperthyroidism in pregnancy, there can be several reasons that can lead to this condition. It is essential to identify the right cause of hyperthyroidism for doctors to ensure the right course of action for the treatment. Some of the most common causes of hyperthyroidism in pregnant women include:

1. Graves’ disease: Hyperthyroidism during pregnancy can be caused by several factors. One of the most common causes is Graves' disease, an autoimmune disorder where the immune system attacks the thyroid gland, causing it to produce an excessive amount of thyroid hormone.
2. Thyroid nodule: Another possible cause of hyperthyroidism in pregnancy is a thyroid nodule or goitre. These non-cancerous growths in the thyroid gland can produce excess thyroid hormone. 
3. Gestational transient thyrotoxicosis: Hyperthyroidism during pregnancy can be caused by gestational transient thyrotoxicosis. In this condition, the woman’s body produces increased human chorionic gonadotropin (hCG) hormone, leading to hyperthyroidism. This temporary condition occurs during the first trimester of pregnancy, and it usually resolves on its own without treatment. 
4. Specific Medications: In some cases, hyperthyroidism in pregnancy can be caused by medications that the mother is taking. For example, some women who take thyroid hormone replacement therapy for hypothyroidism may accidentally take too much of the medication, leading to hyperthyroidism.
5. Excess intake of iodine: Consuming high amounts of iodine can put one at a greater risk of hyperthyroidism during pregnancy. This can arise from medications or diet, resulting in an excess thyroid hormone being produced by the glands. 

These are some of the most highlighted causes of hyperthyroidism in pregnancy. It is crucial for pregnant women to get dedicated consultations and understand the cause of the condition. This helps in getting timely treatment and preventing the chances of severe complications. 

While most hyperthyroidism in pregnancy symptoms are similar to the normal conditions in pregnancy. Thus, it can sometimes be difficult to identify them right away. However, prolonged symptoms or an extreme impact on health due to these issues must be brought to your doctor’s attention. The following are the most common symptoms of hyperthyroidism in pregnancy:

1. Mood swings and tiredness
2. Shaky hands with weak muscles
3. Irregular heartbeat
4. High blood pressure
5. Diarrhoea
6. Significant weight loss
7. Increased nervousness and trouble sleeping

Hyperthyroidism is directly associated with an active metabolism, and thus, watching one’s weight changes is crucial. Women who do not gain any weight during pregnancy can also indicate the condition of hyperthyroidism.

The diagnosis of hyperthyroidism in pregnancy involves a combination of physical examination, blood tests, and thyroid function tests. The doctor will first evaluate the woman's symptoms and medical history to determine if hyperthyroidism is likely. 

1. Blood tests will then be conducted to measure levels of thyroid hormones and thyroid-stimulating hormone (TSH) in the blood. A radioactive iodine uptake test may also be used to evaluate thyroid function. 
2. If hyperthyroidism is confirmed, the doctor will work with the patient to develop a treatment plan to manage the condition and minimise the risk of complications for both the mother and baby. 

There are multiple treatments to bring down the steep increase in the thyroid hormone of women during pregnancy. The hyperthyroidism treatment in pregnancy depends on the condition's severity and the pregnancy's trimester. The two primary treatment options are medication and surgery. 

However, the course of treatment one opts for must be carefully administered to not cause any complications during childbirth. Below are the most sought-after treatments for hyperthyroidism in pregnancy:

Anti-Thyroid Drugs (ATDs)

1. Medication is usually the first-line treatment for hyperthyroidism in pregnancy, as it is the least invasive option. The most commonly prescribed medications for hyperthyroidism are antithyroid drugs (ATDs), such as propylthiouracil (PTU) and methimazole (MMI). These medications block the production of thyroid hormones in the thyroid gland.
2. It is essential to note that some of these drugs can interfere with the placenta. Thus, most doctors prescribe only a small amount of these medications. For this reason, ATDs during pregnancy are also usually reserved for cases of severe hyperthyroidism.

Surgery

1. Surgery is another option for treating hyperthyroidism in pregnancy, particularly when medication is ineffective or contraindicated. The most common surgical procedure for hyperthyroidism is a thyroidectomy, which involves the removal of part or all of the thyroid gland.
2. This procedure is generally safe for the mother and the baby, but one must speak to the doctor in detail before opting for the treatment.

Dietary Changes

1. A woman’s diet during pregnancy is yet another aspect that can help improve the condition of hyperthyroidism. Consuming cruciferous vegetables like cauliflower and broccoli can help women experiencing high amounts of thyroid hormone production. They can reduce the release of the hormone and improve the condition. 
2. It is also important to avoid eating foods that are rich in iodine. Since the mineral tends to increase the thyroid glands’ activity, avoiding them can decrease the chances of further complications. 
3. The time taken to cure the condition of hyperthyroidism in a pregnant woman is largely dependent on the underlying cause of the issue and the treatment chosen. In most cases, women can see improvement in their condition within a few weeks after starting the medications. 

Hyperthyroidism in pregnancy cannot be completely prevented, but some steps can help reduce the risk and severity of the condition. 

1. Pregnant women should maintain a healthy diet and take prenatal vitamins recommended by their doctor. 
2. Maintaining a healthy weight and consuming adequate iodine.
3. Women with a family history of thyroid disorders or other risk factors should inform their doctor to monitor their thyroid function closely during pregnancy. 
4. Avoiding smoking and excessive caffeine intake is also advisable. 
5. Managing stress.

It's important to consult a doctor if you experience symptoms of hyperthyroidism during pregnancy such as rapid heartbeat, weight loss, anxiety, or difficulty sleeping.

Additionally, if you have a history of thyroid problems or are taking medication for thyroid disorders, you should discuss this with your doctor and have regular thyroid hormone level checks during pregnancy. Prompt treatment and monitoring can help reduce the risk of complications for both the mother and baby.

Hyperthyroidism in pregnancy is a serious condition that can significantly impact the health of both mother and baby. It is crucial to contain the excess thyroid hormone production, especially during pregnancy, to ensure safe childbirth. It is also important to understand the various causes of hyperthyroidism in pregnancy, based on which you can opt for the best course of treatment. Some preventive actions like maintaining a balanced diet can help improve the condition. 

You must consult with your doctor to know the exact underlying cause of the condition and the best path forward. We at HexaHealth can help you with our expert medical assessments. Our experienced professionals diagnose your condition, carry out necessary tests and then determine the most appropriate treatment for you. 

Reach out to us today and book your consultation!