thyroid gland It is a butterfly-like organ located in the front of the neck. Basic function; which play a role in our development, such as metabolism, heat balance and many other vital functions. thyroid hormones It produces it and adds it to the bloodstream when needed.
from the thyroid gland T3 and T4 Two important thyroid hormones are produced: and. Released from the pituitary located at the bottom of our brain TSH Thyroid hormone level is adjusted by the hormone called. taken from outside in the cells of the thyroid gland iodineIt is combined with amino acids and converted into thyroid hormones. Underactivity or overactivity of the thyroid gland causes metabolic diseases. Low work status Hypothyroidism, hyperthyroidism in case of overwork is called. Like all other hormonal diseases, it is more common in women than men. during pregnancy in need of iodine there will be a slight increase. Iodine excretion through the kidneys also increases during pregnancy. Increased iodine need of the fetus also increases iodine intake. Enlargement of the thyroid gland goiter It is called. During pregnancy, the thyroid gland normally grows slightly. Sometimes, this growth may be in the form of a growth that includes nodules rather than a general growth. to this nodular goiter is called.
During pregnancy, there is also an increase in the level of a carrier protein called thyroid hormone binding globulin. This can be up to 2.5 times. The hormone increase may continue to peak until the 20th week of pregnancy. In case of pregnancy, it is therefore more important that we measure free T3 and T4 levels. During pregnancy, TSH is suppressed, and T3 and T4 hormone levels increase because they are bound to proteins. Free T3 and T4 values also increase, sometimes this increase may slightly exceed the normal limit.
The thyroid gland is one of the places where diseases caused by deteriorations in the body's immune system, which we call autoimmune diseases, are most commonly seen. These diseases affecting the thyroid gland areautoimmune thyroid diseases It is said. One of the most common among these is It is Hashimoto's thyroiditis.
High thyroid hormone during pregnancy (hyperthyroidism) can be observed. Hyperthyroidism causes risks such as miscarriage, preeclampsia and heart failure in the mother; In the child, it may cause problems such as low gestational age, miscarriage, prematurity, and heart disorders.In hyperthyroidism TSH levels may be at the lower limit of normal or even more suppressed. HCG levels may be high. Free T4 levels may be borderline high or even slightly higher than the limit. Weight loss and unexplained palpitations may also occur during pregnancy. Hyperemesis Gravidarum(excessive nausea and vomiting of pregnancy). In addition to TSH, free T4 and free T3 levels, thyroid antibodies should be checked and thyroid ultrasonography should be performed if necessary.Thyroid scintigraphy It is dangerous for pregnant women and cannot be taken.
In pregnancy-related high thyroid hormone levels, thyroid antibodies are not detected, goiter is generally absent and resolves spontaneously by the 20th week of pregnancy at the latest. Thyroid hormone suppressive therapy is generally not recommended. If the condition of Hyperemesis Gravidarum is very severe and the elevation continues after the 20th week of pregnancy, low doses of thyroid hormone suppressive treatment may be given. Patients in this picture generally have a moderate graves disease Graves' disease may occur throughout pregnancy. It is a disease that can also flare up during pregnancy. If there is long-term well-being in patients with previous Graves' Disease, pregnancy should be recommended. In those who have received radioactive iodine treatment, pregnancy should be postponed for at least 1 year.
When Graves' Disease occurs during pregnancy, it is generally more severe than pregnancy-related thyroid hormone elevation. Hormone levels are much higher than pregnancy-related increases. Thyroid antibodies are significantly high. Heart rate can be detected as 120 or more per minute. The pregnant woman should be monitored very closely. follow up one by endocrinologistmust be provided. During pregnancy, the patient may develop hyperthyroidism by producing hormones from a pre-existing hot nodule. If there is nodule formation and hyperthyroidism is related to it, surgical intervention may be necessary. Surgical intervention does not harm the child. Radioactive iodine treatment can never be given or recommended during pregnancy.
Thyroid diseases during pregnancy It is also seen during and after pregnancy. Since pregnancy itself is an event that affects the immune system, there are also pregnancy-specific thyroid diseases (such as postpartum thyroiditis).
Hypothyroidism during pregnancy - Underactive thyroid gland:
Since hypothyroidism symptoms can actually be confused with normal pregnancy symptoms, it is not easy to make the diagnosis based on clinical findings. Weight gain, sleepiness, decreased exercise capacity and intolerance to cold are observed in these patients. In more severe patients, constipation, deepening of the voice, hair loss, broken nails, dry skin and goiter are observed.
Laboratory findings show that TSH increases and thyroid hormone levels are normal or decreased.
The most common cause of hypothyroidism is iodine deficiency. If the mother does not get enough iodine before the baby's thyroid gland develops (the first 3 months), the baby may even experience mental retardation. If iodine deficiency occurs again after the fetal thyroid gland develops, the baby's brain development may be impaired because the baby will not synthesize enough thyroid hormone. Thyroid hormone requirement increases in pregnant patients. As soon as pregnancy is detected, hormone levels should be checked and the appropriate drug dose should be adjusted. During pregnancy, medication dosage should be adjusted by checking hormone levels, usually every two months. It should be kept in mind that iron taken during pregnancy may reduce the absorption of thyroid hormone from the intestine. Therefore, iron medications and thyroid medications should be taken at least 4 hours apart.