Hypothyroidism and reproductive problems

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Grandmother: Dr. Abdul Hafeez Yahya Khoja *

The thyroid gland is one of the most important endocrine glands in the human body. The endocrine glands are the glands that secrete their hormones directly into the blood without the need for special channels to transport them.
Thyroid hormones are involved in all metabolic processes that take place in the body, promoting the growth of the body from all mental and physical aspects, regulating the cardiovascular system and preventing heart rhythm disturbances, for example, it maintains the integrity of the digestive system, works on the health of the skin and freshness of the skin, in addition to Other positive psychological effects for humans. Among the most important functions of the thyroid gland is its important role in reproduction, pregnancy safety, and the health of the mother and the fetus. We will learn here about the role of hypothyroidism or hypothyroidism, as it is the most common and widespread among women, when planning pregnancy and during pregnancy, and its effects on the health of both the mother and the fetus.

The importance of the thyroid gland
I spoke to “your health”, Dr. Abeer Muhammad bin Khamis, a consultant in internal diseases, endocrinology and diabetes at King Abdul Aziz University, and she explained at the beginning that the thyroid gland resembles a small butterfly, its size does not exceed 20 cubic centimeters, and weighs 60 grams, and is located in the neck in front of the windpipe. It consists of two lobes, each of which contains cells responsible for synthesizing and secreting thyroid hormones, and iodine is the primary component for the production of these hormones. Dr. added. The fact that the thyroid hormone (thyroxine) plays a major role in the metabolism process, in addition to regulating many body functions such as heart and digestive functions, brain development, bone and muscle health, in addition to regulating the woman’s ovulation process, that is, it affects all body systems Roughly speaking, this means that a normal level of thyroid hormones in the blood is essential for health. Any defect or disorder in the activity of this gland will affect the entire body’s functions, and make it difficult for a person to perform many tasks; Because of the fatigue caused by this defect.

Hypothyroidism and childbearing
> causes and symptoms of hypothyroidism. Hypothyroidism occurs when the gland does not produce enough hormones, which leads to a slowdown in some of the body’s functions. Or incidence of thyroid cancer, or in the event that radiation therapy has been used in the treatment of tumors of the head and neck, as well as diseases of the pituitary gland, or some medications or a lack of iodine in food.
Common symptoms of hypothyroidism include lethargy and fatigue, depression, muscle and joint pain, tingling sensations in the fingers and toes, dry skin, weight gain despite poor appetite and irregular menstruation.
> The laziness of the thyroid gland and its effect on reproduction and pregnancy. Dr. Abeer bin Khamis explained that thyroid disorders are more common in women than men, and due to the importance of this gland and its role in regulating the woman’s menstrual cycle and in the occurrence of ovulation and thus the occurrence of pregnancy, any deficiency or imbalance in the secretion of hormones in this gland may cause a delay in the menstrual cycle. And its irregularity and thus delayed pregnancy and childbearing.
And Dr. Abeer adds that it has been found in many studies that about 25% of women who suffer from inability to conceive have hypothyroidism, and that treating this deficiency improves their ability to have children. On the other hand, hypothyroidism may also affect the safety of pregnancy and the health of the fetus, such as the occurrence of miscarriage, premature labor, the effect on the mental development of the fetus and high blood pressure during pregnancy. Treating hypothyroidism with levothyroxine greatly reduces this risk.

Analysis and treatment
> Gland hormones analysis. All the previous considerations, the American Thyroid Association advises that thyroid hormones be analyzed for those who have a desire to become pregnant or even early in pregnancy, and for women at risk of developing thyroid diseases, such as:
– A previous history of thyroid disease or having symptoms of thyroid disorders.
Previous surgery on the thyroid gland.
An enlarged thyroid gland or an increase in the level of antibodies to the thyroid gland.
Diabetes mellitus type 1 or the presence of any other immune diseases.
Previous history of miscarriage, premature labor, or infertility.
A family history of thyroid disorders.
Obesity, meaning that the body mass index is above 40 kg / m2.
– If she is over 30 years old.

Treatment of hypothyroidism
Dr. Abeer bin Khamis explained that the treatment of hypothyroidism includes daily use of levothyroxine, a drug that is similar to the hormone that the thyroid gland secretes naturally. It is taken orally in different doses determined by the attending physician based on the patient’s need. In order to get good results from the use of the thyroxine-like hormone, it is very necessary to follow the following instructions:
> That the treatment be taken 30 – 60 minutes before breakfast on an empty stomach because the presence of food may affect the absorption of the treatment.
> The patient should be spaced at least 4 hours between the time of taking Levothyroxine from the times of taking the medicines containing iron and calcium or the medicines intended for the treatment of heartburn by at least 4 hours because it may affect absorption as well.
> After starting the treatment, the patient is monitored and the level of thyroid stimulating hormone (TSH) is analyzed periodically until the appropriate dose is adjusted, and it is best for those who wish to become pregnant that the level of TSH in the blood is in the lower half of the normal range, i.e. less than 2.5 mIU, as this is linked to a reduced risk of miscarriage.

Pregnancy and childbirth
treatment> Treatment during pregnancy. Due to the importance of the thyroid hormone (thyroxine) in the safety of pregnancy and the development of the brain and nervous system of the fetus, the production of thyroid hormones naturally increases during pregnancy. As the fetus in the first months of pregnancy depends on the thyroid hormone delivered by the mother through the placenta. And the thyroid gland in a healthy woman is able to increase this production naturally, unlike women who already suffer from hypothyroidism, who often needs to increase the dose of levothyroxine by 20-30 per cent when making sure the presence of pregnancy is to meet that need. And she must follow up with the specialist doctor periodically (monthly) during pregnancy, as carefully monitoring the level of thyroid hormone in the blood leads to promoting the normal growth of the fetus and reducing the risk of miscarriage.
After birth. A woman can return to the previous dose that she was taking before pregnancy and do a hormone analysis six weeks after giving birth.
In the event that hypothyroidism is discovered during pregnancy, it must be treated immediately to avoid any complications for the mother or the fetus. You may need to continue treatment after childbirth as well, but this varies from case to case, and it is necessary to consult a specialist to determine this. Knowing that taking levothyroxine is completely safe during pregnancy and lactation. It is possible that low levels of thyroid hormones affect ovulation, which may impede fertility. Moreover, some causes of hypothyroidism, such as autoimmune disorders, may impair fertility as well. While using thyroxine-like hormone to treat hypothyroidism, it is advisable to set a schedule for follow-up visits with the attending physician, as recommended. In the beginning, it is important to ensure that you receive the correct dose of medication, and to anticipate that the dose will change as needed over time.
It is also advised to be careful not to miss or not take doses, even when feeling better, so leaving the drug exposes the symptoms of hypothyroidism to gradually return. In general, a woman, and also, a man should consult a doctor when feeling tired for no reason, or when there are any other signs or symptoms of hypothyroidism, such as dry skin, paleness, swollen face, constipation or a hoarse voice.
* Consultant in community medicine

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