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Women with symptoms or a very high TSH level, or both, are usually prescribed a course of levothyroxine. [3] Asymptomatic women with slightly elevated TSH levels who are planning subsequent pregnancies, should consider a course of treatment until completion of the family to avoid possible developmental complications in future children. [3]
Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% and 0.3-0.5% for subclinical and overt hypothyroidism respectively. [8] Endemic iodine deficiency accounts for most hypothyroidism in pregnant women worldwide while chronic autoimmune thyroiditis is the most common cause of hypothyroidism in iodine sufficient parts of the world.
Recognizing and evaluating hyperthyroidism in pregnancy is a diagnostic challenge. [58] Thyroid hormones are commonly elevated during the first trimester of pregnancy as the pregnancy hormone human chorionic gonadotropin (hCG) stimulates thyroid hormone production, in a condition known as gestational transient thyrotoxicosis. [8]
Subclinical hyperthyroidism in pregnancy is associated with an increased risk of pre-eclampsia, low birth weight, miscarriage and preterm birth. [50] Propylthiouracil is the preferred treatment of hyperthyroidism (both overt and subclinical) in the first trimester of pregnancy as it is associated with less birth defects than methimazole. [50]
Hypothyroidism is diagnosed by looking at the free thyroxine (T4) levels in people with elevated TSH levels, and comparing the ratio between them. People with high TSH and low T4 get a diagnosis ...
If the TSH is high, or the T 4 low, the infant's doctor and parents are called and a referral to a pediatric endocrinologist is recommended to confirm the diagnosis and initiate treatment. A technetium (Tc-99m pertechnetate) thyroid scan detects a structurally abnormal gland, while a radioactive iodine (RAIU) exam identifies congenital absence ...
These normal hormonal changes often make pregnancy look like a hyperthyroid state but may be within the normal range for pregnancy, so it necessary to use trimester specific ranges for TSH and free T4. [23] [24] True hyperthyroidism in pregnancy is most often caused by an autoimmune mechanism from Graves' Disease. [23]
TSH values may also be lower than normal (particularly in the first trimester) and the normal range should be adjusted for the stage of pregnancy. [ 8 ] [ 44 ] In pregnancy, subclinical hypothyroidism is defined as a TSH between 2.5 and 10 mIU/L with a normal thyroxine level, while those with TSH above 10 mIU/L are considered to be overtly ...
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