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Thyroid problems in pregnancy: Treatment, symptoms, advice and help

 Thyroid problems are generally more common in women and therefore thyrotoxicosis or hypothyroidism may complicate pregnancy. Please read the sections on thyrotoxicosis and hypothyroidism before reading this page.

The most common thyroid problems in pregnancy are firstly, thyrotoxicosis due to autoimmune thyroid disease such as Graves disease or Hashimoto’s thyroiditis, and secondly, thyrotoxicosis related to ‘morning sickness’, which is a special form of thyroid disease in pregnancy. During pregnancy, the body immune system is somewhat depressed and this means that activity of autoimmune diseases including Graves disease is somewhat slowed down. Nevertheless, it is necessary to treat the overactive thyroid gland with anti-thyroid drugs as in the non-pregnant state. These drugs do go across the placental barrier and maybe dangerous to the baby if given in large doses. It is therefore important that treatment is monitored carefully by a physician with experience in thyroid disease. Propylthiouracil (PTU) in particular has been shown to be safe in pregnancy but has to be taken three times a day. Carbimazole tablets may also be used in pregnancy. Radioactive iodine therapy is not an option during pregnancy and thyroid surgery is generally avoided is possible. If necessary, surgery maybe carried out in the middle third of the pregnancy.