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The thyroid is a butterfly-shaped endocrine gland usually located in the lower front of the neck below the larynx (the voice box). The thyroid's job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should. The main hormone made by the thyroid is thyroxine.
What is Hypothyroidism?
Hypothyroidism is a kind of thyroid disease. In people with hypothyroidism, the thyroid does not make enough thyroid hormone to keep the body running normally.
Who are at high risk for thyroid disease during pregnancy?
A personal history of thyroid dysfunction and/or thyroid surgery
A family history of thyroid disease
Symptoms that may suggest hypothyroidism
Type I diabetes
A history of either miscarriage or preterm delivery
Other autoimmune disorders that are often linked to autoimmune thyroid problems, such as: vitiligo, adrenal insufficiency, hypoparathyroidism etc
Who have previously received radiation to the head or neck area as a cancer treatment, or who have had multiple dental x-rays
Who are morbidly obese, which is defined as a body mass index (BMI) of over 40, or a body weight that is 20% or more over ideal body weight
Who are age 30 or older
Who have been treated with amiodarone for heart rhythm irregularities
Who, in the previous six weeks, have been exposed to iodine in a medical test contrast agent
In such patients screening is required for hypothyroidism.
What is the interaction between the thyroid function of the mother and the baby?
Baby is dependent on mother for the production of its own thyroid hormones. Hence hypothyroidism in mother can effect baby growth.
Treatment for hypothyroidism during pregnancy.
It involves adequate replacement of thyroid hormone in the form of 'thyroxine'. Thyroxine requirement increase during pregnancy often by 25-50%.
When to contact your doctor?
You should contact your doctor if:
You are losing weight without trying.
You have a fever.
You have chills, a cough, or feel weak and achy.
You have pain, redness, and swelling in your muscles and joints.
Your skin is itchy, swollen, or has a rash.
You do not have any more thyroid medicine, or you stopped taking it without your caregiver's advice.
Your doctor may order one of the blood tests as follows, on a regular basis - Every 6-8 weeks during pregnancy
TSH (Thyroid Stimulating Hormone) Test
After a change in your thyroxine dose, you will need to have your TSH checked after 4 weeks. You may need tests more often if you are taking a medicine that interferes with your body's ability to use thyroxine (like vitamin tablets containing calcium or iron supplements, or antacids that contain either calcium or aluminum hydroxide). Consequently, levothyroxine and pre-natal vitamins should not be taken at same time and should be separated by 2-3 hours.
The goal of treatment for hypothyroidism is to get your TSH in the normal range and keep it there.
These tips may help you take your pills every day:
Take your pill at the same time every day - first thing in the morning or last thing at night works well for many people - and make it part of your daily routine.
For many people, it is easy to forget whether they have taken their daily pill. To keep better track of your pills, store them in a container that has a box marked for each day of the week. Whatever container you use, keep it tightly closed so your pills stay dry.
Store your pills in the room where you will best remember to take them. As with all medicines, keep thyroxine out of the reach of children.
You can take your pill with any liquid except soy milk. Cow's milk is probably fine.
Grapefruit juice and coffee should be avoided. Do not try to swallow your pill without liquid; if it dissolves in your mouth or throat, not enough medicine will be absorbed into your blood.
It does not matter whether you take your pill on an empty stomach or with food, as long as you always do the same thing. That is because foods and medicines can interfere with the body's ability to absorb thyroxine.
Wait 4 hours after taking thyroxine before you eat foods that contain soy (including soy formula for babies), take calcium supplements, iron supplements, or antacids that contain either calcium or aluminum hydroxide (see labels of antacid which you take).
Take same brand of thyroxine always.
IF YOU MISS A PILL:
It is not serious to miss just one pill because thyroxine stays in your blood for a long time. For example, if you remember this afternoon that you did not take your pill this morning, take it now. If today you remember that you did not take yesterday's pill, you can take two pills in one day - if possible, take one of the pills in the morning and the other one in the evening.
If you are sick and vomit up a pill, do not take an extra pill. Wait and take your next regular dose tomorrow. However, if you vomit up a pill because you are pregnant and having morning sickness, take another pill at bedtime when you are less likely to feel sick.
Everyone should try to eat a balanced diet of nutritional foods from the basic food groups: fruits and vegetables, whole grains, low-fat dairy products, lean meats, beans, and essential fats. However, if you have thyroid problems, certain foods within those groups should be avoided.
Two categories of foods have been associated with irregular thyroid hormone production.
The first category is soybean-related foods.
The second category is cruciferous vegetables including broccoli, cabbage, cauliflower, and turnips.
Some other foods can also interfere with proper function of the thyroid gland. These foods include peaches, strawberries, peanuts, radishes, tofu, and spinach.
These foods should NOT be included in your diet if you have thyroid disease. If you have hypothyroidism, you should also avoid iodine-containing foods including red food dyes, and iodine in dairy products, shellfish, multivitamins, and metabolic boosters.
Choosing iodized salt - salt supplemented with iodine - over plain salt and prenatal vitamins containing iodine will ensure this need is met.