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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.
Not enough TRH, which is uncommon, can lead to not enough TSH and thereby to not enough thyroid hormone production. [10] Pregnancy leads to marked changes in thyroid hormone physiology. The gland is increased in size by 10%, thyroxine production is increased by 50%, and iodine requirements are increased.
Congenital iodine deficiency syndrome (CIDS), also called cretinism, [2] is a medical condition present at birth marked by impaired physical and mental development, due to insufficient thyroid hormone production (hypothyroidism) often caused by insufficient dietary iodine during pregnancy.
There are five general types of thyroid disease, each with their own symptoms. A person may have one or several different types at the same time. The five groups are: Hypothyroidism (low function) caused by not having enough free thyroid hormones [2] Hyperthyroidism (high function) caused by having too many free thyroid hormones [2]
The thyroid may enlarge slightly in healthy women during pregnancy, but not enough to be felt. These changes do not affect the pregnancy or unborn baby. Yet, untreated thyroid problems can threaten pregnancy and the growing baby. Symptoms of normal pregnancy, like fatigue, can make it easy to overlook thyroid problems in pregnancy. [1]
A low amount of thyroxine (one of the two thyroid hormones) in the blood, due to lack of dietary iodine to make it, gives rise to high levels of thyroid stimulating hormone (TSH), which stimulates the thyroid gland to increase many biochemical processes; the cellular growth and proliferation can result in the characteristic swelling or hyperplasia of the thyroid gland, or goiter.
Congenital hypothyroidism can also occur due to genetic defects of thyroxine or triiodothyronine synthesis within a structurally normal gland. Among specific defects are thyrotropin ( TSH ) resistance, iodine trapping defect, organification defect, thyroglobulin , and iodotyrosine deiodinase deficiency.
Successful pregnancy outcomes are improved when hypothyroidism is treated. [129] Levothyroxine treatment may be considered at lower TSH levels in pregnancy than in standard treatment. [15] Liothyronine does not cross the fetal blood-brain barrier, so liothyronine (T 3) only or liothyronine + levothyroxine (T 3 + T 4) therapy is not indicated in ...