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Q: I am 34 years old, have hypothyroidism, and am approimately 2 months pregnant. I am taking synthroid. Are there additional precautions I should take to make sure the baby is healthy? Is it necessary to see some type of specialist - my gynecologist diagnosed the hypothyroidism approximately 4 months ago.
A: Hypothyroidism is the condition in which the thyroid gland does not produce enough thyroid hormone to circulate in the organism. This is a benign condition, and can be easily treated. The treatment of this condition consists in merely giving sufficient thyroid hormone so that there is enough circulating hormone concentration. However, in particular during pregnancy, it is extremely important that the condition is properly treated since it may otherwise lead to miscarriage. In order to follow whether the hypothyroidism is being properly treated, it suffices to do a blood test to measure thyroid function and, in particular, the so called TSH (thyroid stimulating hormone). There is usually a negative relationship between the measured value of this quantity and thyroid function. Therefore, for example, when TSH is elevated, the thyroid is functioning below normal level. In such a case, the condition is not being properly treated and additional hormone is needed.
In answer to your question, all you have to do for this condition is to make sure you are being properly treated. Any well qualified physician should be in the position to establish this and no additional precautions are needed except for, of course, the standard precautions to be followed during pregnancy. In particular, as it also should be usually the case during pregnancy even in absence of hypothyroidism, you should be periodically followed up by your gynecologist. It should be emphasized, however, that it is particularly important to make sure that hypothyroidism is being appropriately treated during pregnancy since inadequate treatment could be harmful to the fetus.
Updated: 09/12/99
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