**Hyperthyroidism in pregnancy** Hormonal changes during pregnancy are normal and lead to important physiological and hormonal changes that affect thyroid function. These changes mean that thyroid tests should be interpreted with caution during pregnancy. **What are the normal changes in thyroid function associated with pregnancy?** Thyroid function tests change during pregnancy due to the effects of two main hormones: human chorionic gonadotropin (hCG), the hormone measured in pregnancy tests, and estrogen, the main female hormone. HCG can weaken the thyroid, and high levels of circulating hCG in the first trimester may lead to lower blood TSH during pregnancy. Total thyroid hormone is in the blood....because more than 99% of thyroid hormones in the blood are bound to these proteins....however, measurement of free hormone (which is not bound to protein and represents the active form of the hormone) is usually normal....if it remains within the normal range as long as TSH and free T4 are within normal range during pregnancy..normally....the size of the thyroid gland can increase during pregnancy. (Enlarged thyroid = goiter)....however pregnancy-related goitre is much more common in iodine deficient areas of the world....goitre is relatively rare in the US....an enlarged thyroid can be detected if very accurate imaging techniques (ultrasound) are used..some women do..this change in size is usually only a 10-15% increase in size and is not usually detected by a physical exam by a doctor...but sometimes it can Goiter becomes significant and the doctor decides to prescribe more tests for thyroid function... ### Pregnancy?. ** Some people have hyperthyroidism before pregnancy....these people should control their hyperthyroidism more during pregnancy....but others develop this disease after pregnancy....in general, the most common cause of hyperthyroidism in women of reproductive age is Graves' disease, which is seen in 0.2% of pregnant patients....in addition to other common causes of hyperthyroidism, very high levels of hyperthyroidism may also cause causing nausea in the morning... Transient hyperthyroidism in early pregnancy... The correct diagnosis is based on detailed history, physical examination and tests.... ### ** What are the risks of hyperthyroidism for the mother?** Graves' disease may initially appear in the first trimester or it may worsen during this period for a woman who has this disorder and has already been diagnosed with this disorder. In addition to the common symptoms associated with hyperthyroidism, improper treatment and lack of control of maternal hyperthyroidism can lead to premature birth and a serious complication called preeclampsia. Pregnancy improves but may worsen in the postpartum period... ### **Is hyperthyroidism dangerous in pregnancy?** Uncontrolled hyperthyroidism of the mother is associated with a rapid heart rate of the fetus, lack of proper growth of the baby, prematurity of the baby, miscarriage and congenital anomalies (congenital defects). For this reason, the diagnosis and treatment of hyperthyroidism during pregnancy is recommended. Graves' disease is an autoimmune disorder caused by the production of antibodies that stimulate the thyroid gland called thyroid-stimulating immunoglobulins (TSI). These antibodies cross the placenta and can affect the newborn's thyroid. High TSI levels in the mother have been shown to cause hyperthyroidism in the fetus or infant. Weeks 18 to 22 are recommended.... Fetal hyperthyroidism rarely occurs when a mother with Graves' disease requires treatment with antithyroid drugs during pregnancy. If you have been treated for Graves' disease in the past, be sure to inform your doctor. - Preeclampsia - Heart failure - Fetal loss - Premature delivery - Birth of a low birth weight baby These complications are significantly reduced in pregnant women whose hyperthyroidism is under control... Fetal death has been observed in 249 uncontrolled pregnancies, and another 5% have had other fetal and neonatal abnormalities... Women who are resistant to thyroid hormone (where thyroid hormone and thyrotrophin concentrations are inappropriately high - i.e. not due to autoimmunity) also have a high rate of miscarriage, indicating the effect of Thyroid hormones are directly toxic to the fetus. If this disease is not treated, it can have the following consequences for the fetus: - Fetal abnormality in case of poor control in the first trimester - Abortion - Goiter - Heart failure Intrauterine growth restriction - Being premature - Fetal hydrops - Intrauterine death - Convulsive disorders / neurobehavioral disorders in the later stages of life ### **Conclusion** Before trying to get pregnant, make sure to include thyroid tests among your mandatory measures.... You may have unknown symptoms and have not gone to the doctor for treatment.... After pregnancy, be sure to be under the supervision of a thyroid doctor and do the necessary tests.... In case of hyperthyroidism or hypothyroidism, be sure to start control and treatment without stress... Also consult with thyroid **... Thyroid and Paratium Dr. Ahmadi and Parasite.. A member of the forum American Thyroid (ATA), which performs its surgeries with the most up-to-date technology in the world... He is known as Iran's Golden Paw thyroid surgeon and has a history of more than 5000 successful thyroid operations.... To make an appointment, you can use the listed numbers or complete the appointment reservation form... Click on the link to learn about 3 ways to treat Graves' disease..

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