Awareness Wednesday: January is Thyroid Awareness month. Here is what we think you should know about thyroid tests when you are trying to conceive.
In addition to producing hormones that regulate metabolism, heart and digestive function, the thyroid hormones are important in brain development.
Thyroid Stimulating Hormone (TSH) is produced in the brain and stimulates the thyroid gland to make hormones.
- When thyroid hormones are high, the brain makes less TSH
- When thyroid hormones are low, the brain makes more TSH
- Babies do not produce thyroid hormones in the first trimester of pregnancy, so it is important for women to have normal thyroid hormones in early pregnancy
Hyperthyroidism (Low TSH, High thyroid hormones) can lead to infertility, severe nausea/vomiting in pregnancy, pre-eclampsia, prematurity, birth defects, and fetal death.
Overt hypothyroidism (High TSH, Low thyroid hormones) can lead to infertility, miscarriage, premature rupture of membranes, placental abruption, preterm birth, poor fetal brain development, and fetal death.
Subclinical hypothyroidism refers to elevated TSH levels with normal thyroid hormone levels. It occurs in 4-8% of women of reproductive age.
Your fertility doctor may order thyroid tests as part of your initial evaluation:
- If you have risk factors for thyroid disease, or
- As part of preconception/prenatal lab testing
Your fertility doctor may order multiple thyroid tests, including TSH, thyroid hormones, or thyroid antibody studies. Or you doctor may order the TSH as a screening test and only order additional tests if they see an abnormal TSH.
If you have hyperthyroidism or severe hypothyroidism, your doctor may refer you to a thyroid specialist.
The threshold of “normal” TSH changes in pregnancy. If you have subclinical hypothyroidism, your doctor may:
- Recommend treatment for thyroid values that are normal for non-pregnant women, but abnormal for pregnant women
- Recommend treatment only for for certain levels of TSH
- Recommend treatment if you have thyroid antibodies.
- Thyroid antibodies are not used for the diagnosis of subclinical hypothyroid, but elevated levels are associated with an increased chance of developing hypothyroidism
To learn more about the tests that may be ordered at your first fertility visit, check out our post here: https://askaneggspert.com/what-are-all-these-tests/
We hope we met your Eggspectations—An Eggspert
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Disclaimer: All of the comments on this page are for basic information only. They are based on the opinions and expertise of the authors and are not meant to provide a substitute for medical care or specific treatment recommendations. Each person is unique and requires individualized diagnosis and treatment plans. Any specific questions should be directed to your personal healthcare provider.