What Is Hashimoto's Thyroiditis - How It Affects Pregnancy?

What Is Hashimoto's Thyroiditis - How It Affects Pregnancy?

The human body has several wonderful systems that run on their own and effectively manages the body. One such is immune system which is responsible for defending any internal or external attack. But what when this defensive shield goes crooked or confused and starts attacking against your own body? These attacks are often referred to as autoimmune attacks.

Hashimoto’s Thyroiditis

The name Hashimoto’s thyroiditis was named after Dr. Hakaru Hashimoto, a Japanese physician who first described about the condition. The condition is also known with the names Hashimoto’s disease, lymphocytic thyroiditis or chronic thyroiditis. It’s an auto-immune condition of the thyroid gland.

In autoimmune disorders, the immune system which is supposed to protect the body, turns against the organs, cells or tissues. The reason behind most of the auto-immune disease is not known.

What causes Hashimoto’s Thyroditis?

As mentioned, scientists don’t know the cause behind many autoimmune conditions including Hashimoto’s thyroiditis. In this condition, the immune system creates antibodies and attacks the thyroid gland. Experts believe that presence of a virus or bacterium might trigger the immune system response. Some other believes that it’s related to certain genetic flaw as Hashimoto’s thyroiditis usually runs in families.

Who is at risk of developing Hashimoto’s Thyroditis?

Till date, several risk factors have been identified that triggers the disease. Women are 7 times more likely to get Hashimoto’s thyroiditis, especially those who are pregnant. Other risk factors include:

  • Age - It can occur in teenagers and young people but it is more common in the middle age.
  • Hereditary - Family history of Hashimoto’s thyroiditis or other autoimmune disease makes you vulnerable to the disease.
  • Other autoimmune disease - If you have other autoimmune disease such as rheumatoid arthritis, type 1 diabetes, celiac disease, vitiligo and lupus.
  • Grave’s disease - A condition which causes the thyroid gland to produce too much thyroid hormone.
  • Radiation exposure - People who are exposed to environmental radiation are more vulnerable to Hashimoto’s thyroiditis.
  • Nutritional factors - Studies have suggested a link between thyroiditis and deficiency of iodine, selenium, vitamin D and iron.

Also Read



What Are The Risk Factors Of Thyroid Disease?Who Can Get Thyroid Disease?

Symptoms

Many people with Hashimoto’s thyroiditis will not experience any symptoms, especially when the condition is in its earlier stage. And in fact, the symptoms are not unique for the disease, the signs may resemble typical thyroid problems such as hypothyroidism. The symptoms may include:

  • Sensitivity to cold
  • Sluggishness and fatigue
  • Constipation
  • Dry, pale skin
  • A swollen face
  • Brittle nails
  • Thinning or loss of Hair
  • Tongue enlargement
  • Unexplained weight gain
  • Muscle aches, tenderness and stiffness
  • Muscle weakness
  • Joint pain
  • Abnormal menstrual bleeding (menorrhagia)
  • Depression
  • Memory problems

Hashimoto’s Thyroiditis and Pregnancy

Pregnancy usually affects the thyroid gland. It enlarges slightly during pregnancy with increase in hormone levels. Some women experience thyroid problems after the birth of their babies, usually in the first year. This is known as postpartum thyroiditis. This problem is temporary and usually goes away but 20 percent of these women are prone to thyroid problems later in their life.

  • Thyroid hormone is crucial during pregnancy as baby’s brain and nervous system need this hormone, especially in the first trimester. After 10-12 weeks of pregnancy, the thyroid of baby begins to work on its own. But the growing baby would still depend on mother for iodine which is used by thyroid gland to make hormone. The baby would need about 250 microgram of iodine daily. But some women may not be able to derive required iodine from the food they eat. These women should consult a doctor and get pre-natal vitamins which also contain iodine.
  • The good news is women with Hashimoto’s disease can become pregnant. And if the pregnancy is planned, the thyroid function should be well under control before you become pregnant.
  • Untreated or poorly treated thyroid disease might lead to preeclampsia, postpartum bleeding, placental abruption, anemia and miscarriage. In severe cases, it may lead to low birth weight of the baby, preterm birth, birth defects or even stillbirth.
  • Women with Hashimoto’s disease or those with underactive thyroid should maintain their normal thyroid function. These women usually take levothyroxine to keep thyroid functioning in pace but it might not be enough and they may need higher dose.
  • Thyroid functioning in pregnancy should be checked every 6-8 weeks. But routine screening is not recommended for women with no known thyroid disorders.

Complications of Hashimoto’s Thyroiditis

Untreated Hashimoto’s thyroiditis can get worse and lead to several complications such as:

  • Infertility in woman
  • Delivering a baby with birth defects
  • High cholesterol
  • Heart problems due to high level of cholesterol
  • Goiter (enlarged thyroid)
  • Mental health issues such as depression, confusion and seizures
  • Decreased in sexual urge (libido)

How Hashimoto’s Thyroditis is diagnosed?

Generally, doctor check for few symptoms before going for tests. These include hoarseness in voice, sluggishness or tiredness, constipation or history of previous thyroid disorders such as goiter. After checking for these symptoms, the doctor may order blood test that would examine following things:

  1. Levels of hormone - If your thyroid is underactive, the thyroid hormone level will be low. At the same time, the TSH (thyroid stimulating hormone) level will be high as well. What this means is that the pituitary gland will be stimulating your thyroid gland to produce more thyroid hormones.
  2. Presence of antibodies - The blood test may also confirm the presence of abnormal antibodies that attacks thyroid peroxidase (TPO antibodies), an enzyme found in the thyroid gland that plays a crucial role in the production of thyroid hormones.

Treatment of Hashimoto’s Thyroditis

As per the conventional medical opinion, there is no specific treatment for Hashimoto’s thyroiditis unless it is accompanied by some abnormalities in thyroid blood levels such as TSH. Treatment may include just observation and certain medication. If your thyroid is working properly, your doctor will put you on wait and watch mode.

If you need medication, you would be advised to take levothyroxine, which is a synthetic thyroid hormone. You would be required to take this medicine for the rest of your life.

Glossary:
Pituitary Gland - The master gland of the endocrine system; located at the base of the brain

Sources

1. Hashimoto's Disease(2017, September). read more
2. Detecting and Treating Hypothyroidism Before, During, and After Pregnancy(2012, October). 
read more
3. Hashimoto’s Disease(2014). NIH read more