Thyroid Medication Reduces Pregnancy Complications

The thyroid gland is an endocrine organ that is located at the base of the neck and it produces hormones that are essential in controlling certain functions such as the body’s metabolic rate. Thyroid hormones are essential for the neurological development of the fetus, but these babies cannot produce their own thyroid hormones during the first trimester of pregnancy. They therefore have to rely on the mother's source of thyroid hormones until the second trimester when they do start producing their own hormones. 

Up to 3% of pregnant women have reduced levels of thyroid hormones and are therefore regarded as having mild hypothyroidism which can be treated with a synthetic replacement hormone called levothyroxine.

Reduced thyroid function in pregnancy is associated with negative obstetric outcomes, but it isn't clear whether treatment with levothyroxine, initiated during pregnancy, is beneficial for expectant mothers. A recent study that was done has made some relevant discoveries that will be discussed further in this article.

The study

Researchers from the University of Cardiff explored whether pregnant women who were diagnosed with mild hypothyroidism, together with their babies, would benefit from treatment with levothyroxine.

These researchers analyzed the clinical data of 13,224 women at 12-16 weeks of pregnancy. 518 of the expectant mothers had mild hypothyroidism, of which 263 of these women received the treatment levothyroxine and the rest received no medication. The women’s pregnancy outcomes were assessed by measuring data on preterm deliveries, stillbirth rates, fetal birth weights, the number of early caesarean sections that were performed and hospital length of stay.

The findings

The following findings were made in this study:

• Women diagnosed with mild hypothyroidism, and who were treated with levothyroxine, had a decreased risk of giving birth to babies with a low weight and were also less likely to have an early caesarean section performed on them.
• Women with mild hypothyroidism, who didn't receive treatment with levothyroxine, were more likely to have a stillbirth than women with a normal thyroid function.
• The mentioned group that received treatment never experienced any stillbirths.
• No significant difference between the other obstetric outcomes was found.

Clinical significance

Clearly, by treating pregnant women, even with mildly impaired thyroid functions, with thyroid supplementation can offer a better obstetric outcome for the unborn fetus. Essentially, this management helps to supplement the mother's thyroid hormones that are being utilised by the developing baby during the first trimester of pregnancy.

READ Thyroid Symptoms and Problems in Women

Thyroid screening is therefore essential in the ante-natal workup of a pregnant women in order to assess serum thyroid hormone levels and to decide if treatment is warranted in these patients.

Further research

It has been suggested that further clinical trials are needed to confirm the mentioned findings, and pregnant women may even discover more substantial benefits if they are treated with levothyroxine at an earlier stage than used in this study.

Overview Of Hypothyroidism

Hypothyroidism is defined as having a reduced level of thyroid hormones in the bloodstream due to the thyroid gland becoming underactive and therefore not producing enough of the mentioned hormones. Thyroid hormones are very important as they regulate the body's metabolic rate.

If hypothyroidism is left untreated, it can result in the development of numerous health-related conditions such as peripheral neuropathy, heart conditions such as atrial fibrillation and heart failure as well as mental health issues such as depression.

Causes

There are numerous conditions and scenarios that can result in hypothyroidism and they include the following:

• Autoimmune diseases -  The most common autoimmune condition that results in hypothyroidism is known as Hashimoto's thyroiditis. An autoimmune condition is one where the body's own immune system produces antibodies that attacks normal tissue, in this case the thyroid gland. Essentially, this condition causes the thyroid gland to become underactive and results in a reduced amount of thyroid hormones in the body.
• Radioactive iodine therapy - this oral nuclear medicine therapy is used to treat patients who are diagnosed with hyperthyroidism, where too much thyroid hormone is produced by the thyroid gland. In some cases, though, this form of treatment can work too well and therefore result in permanent hypothyroidism.
• Thyroid surgery - removing a portion or large section of the thyroid gland can result in a reduction of thyroid hormone production. 
• Radiation therapy - radiation therapy that is used to treat certain cancers involving the head and neck can negatively affect the thyroid gland which may lead to hypothyroidism.
• Medications - certain medications such as lithium, which is used to manage mental health conditions such as bipolar mood disorder, can cause hypothyroidism.

Symptoms

Patients in different age groups who are diagnosed with hypothyroidism tend to display different signs and symptoms of this condition. They are as follows:

Adults

• Increased sensitivity to cold.
• Fatigue.
• Impaired memory.
• Decreased appetite.
• Weight gain.
• Dry skin.
• Puffy face.
• Thinning hair.
• Depression.
• Decreased heart rate.
• Muscle and/or joint aches, tenderness, stiffness and weakness.
• Hoarseness.
• Constipation.
• Irregular or heavy menstrual periods.
• Elevated blood cholesterol levels.

READ Thyroid Hormones, Iodine Deficiency and Hypothyroidism

Infants

Hypothyroidism can develop in newborns and infants. The signs and symptoms in this age group include the following:

• Jaundice.
• A large, protruding tongue.
• Frequent choking, especially when feeding.
• A puffy appearance to the face.
• Failure to grow and develop normally.
• Poor muscle tone.
• Constipation.
• Excessive sleepiness.
• If left untreated, hypothyroidism can result in severe mental and physical restrictions.

Children and teenagers

The signs and symptoms of hypothyroidism in this age group is the same as in adults do, but they can also experience the following issues:

• Delayed development of permanent teeth.
• Poor growth that results in developing a short stature.
• Poor mental development.
• Delayed puberty which can affect fertility.