Part 2: Treatment for Hypothyroidism During Pregnancy

HRPC staff looking at ultrasound picture on computer Maintaining optimum thyroid levels is key to a healthy pregnancy

Do you know how you can avoid or manage risks effectively once you’re diagnosed with hypothyroidism? If you have reason to believe you have low thyroid, it’s important to discuss this with your primary care doctor or obstetrician before you become pregnant or as soon as you conceive. If you’ve been diagnosed with hypothyroidism, make sure that your medication is properly adjusted for pregnancy to avoid potential complications.

Blood tests can confirm the health of your thyroid gland

Diagnosing hypothyroidism is not easy to do without testing since many symptoms are common to other conditions or may not be perceived as problems, especially if you’ve lived with them for a long time. Your doctor can discuss your medical history and look for changes in your health that could indicate a problem. If there is reason for concern, blood tests can confirm whether your thyroid gland is producing the right amount of the thyroid hormone thyroxine (T4). If you’re diagnosed with hypothyroidism, you will be treated with thyroxine replacement therapy.

Periodic testing is critical throughout pregnancy for hypothyroid women

The amount of T4 in your body will change during a normal pregnancy and it’s important that the doctor evaluating your test results measures it against trimester-specific reference ranges and not against normal ranges for a non-pregnant woman. Regular testing allows your doctor to adjust your medication dosage as needed. We recommend testing every four weeks throughout the first half of your pregnancy and less often in the second, unless your dosage requirements change.

Pregnancy requires a higher dosage of thyroid medication

Throughout your first trimester, your body is producing thyroid hormone for two: you and your developing baby. Thereafter, the baby’s own thyroid function kicks in. So it’s critical that your own levels are optimum from the moment you conceive. We recommend that women with preexisting hypothyroidism who become pregnant immediately increase their medication dosage by 30% until they can have their thyroid levels measured and get professional guidance from their primary care provider, obstetrician or high risk pregnancy specialist. You can safely add two additional doses per week by taking a double dose on two days. Thereafter, throughout your pregnancy, your medication dosage will be guided by frequent testing. The newest research indicates that it may need to increase by as much as 50% to meet your and your baby’s increasing demand for the hormone. When you have hypothyroidism, don’t take a chance with your medication. Make sure you are working with a specialist who has the latest knowledge about thyroid replacement therapy during pregnancy. Then follow recommendations for testing and medication dosage. With proper care, you can avoid or minimize any complications and enjoy a healthy pregnancy and delivery. Read Part 1 of this series on pregnancy and hypothyroidism.