Your Healthy Pregnancy with Thyroid Disease
by Dana Trentini and Mary Shoman (2016, Da Capo Life Long publisher)
The niece of my friend John had a miscarriage, and John wondered if it had anything to do with hypothyroidism/Hashimoto’s, so he ordered this book—and shared it with me.
“During pregnancy, the thyroid gland expands its function to meet the needs of mother and baby. Thyroid hormone is an essential part of the neurological and brain development of the fetus, most significantly during the first trimester. The baby’s thyroid gland does not produce thyroid hormone until around 12-weeks gestation”—so it is dependent on maternal thyroid in first trimester. In a woman with healthy thyroid function, the thyroid gland increases about ten percent in size to meet the increased demand for production of the hormone begins as soon as she is pregnant. But, in women who are iodine deficient, the thyroid increases 20 to 40 percent. After the first trimester, the fetus receives thyroid hormone from the mother and its own thyroid gland.
As you can see, pre-conception and first trimester thyroid health is important. Routine early prenatal screening for hypothyroidism is not routine, but a patient with a family history or history of miscarriages can request for it to be done.
In plain language, Your Healthy Pregnancy with Thyroid Disease, explains how the thyroid works and what happens when it doesn’t, in particular in fertility and pregnancy. “Undiagnosed, untreated, or improperly treated thyroid disease: increases risk of infertility; miscarriage, stillbirth; a range of birth-related problems; breastfeeding difficulties; and postpartum depression.
One would think that practitioners providing obstetric care would know and follow the latest treatment guidelines, but the authors say, “that is not the case. In a study published in Thyroid in 2010, three waves a mail surveys were distributed to 1,601 Wisconsin health-care providers who were members of ACOG or American Academy of Family Physicians who provided obstetric care. Of the 575 providers who completed the survey, only 11.5 percent (66/575) had actually read the Endocrine Society’s 2007 clinical guidelines. In another survey. . .only 23 percent had read the guidelines.” Thus, the need for women and childbirth mentors to be informed on this matter to participate more fully in getting the right lab tests and management.
How common is hypothyroidism? For every 1000 Americans, 8 have hypothyroidism; its five to ten times more common in women; women 50 and older have the highest incidence. The incidence in pregnancy for overt hypothyroidism is 0.3 to 0.5 percent, andd2 to 3 percent for subclinical hypothyroidism.
In this informative 328-page book, the authors explain pre-pregnancy planning, understanding the results of thyroid-related lab tests, the influence of diet, and recognizing postpartum thyroid-related symptoms.