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Monday, 26 August 2013

Hypothyroidism in Pregnancy

This condition is important to diagnose early in the pregnancy, and ideally before pregnancy begins. Even a mildly underactive thyroid may lead to conditions which affect the baby's brain development. It has been shown that low levels particularly those in the lower 5th percentile may lead to lower IQ's and autism.
Anyone with symptoms or a family history of Hashimoto's Disease ( an autoimmune disorder of the thyroid) should be treated before getting pregnant. I recently had a patient in her early pregnancy with this condition. She had been rightly treated by her GP with replacement therapy. However it is also important to have regular blood tests to monitor the thyroid levels as too high a thyroid hormone level may result in its own set of complications. The best tests would be the T4 and TSH, the latter of which should be kept to <2mIU/ml.
An underactive thyroid may be caused by a lack of iodine in the diet. Selenium taken before pregnancy may help in those who have mild hypothyoidism.

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