Who should be tested for a thyroid disorder?

In this article below, distinguished consultant endocrinologist, Dr Teng-Teng Chung, discusses thyroid disorders during pregnancy, before also detailing what hypothyroidism is.

How important is it to get treatment for a thyroid disorder during pregnancy?

An uncontrolled or undiagnosed thyroid disorder will impair women’s fertility and potentially cause problems during pregnancy.

Who should be tested?

There are certain patients who should definitely be tested for a thyroid disorder. For example, someone who should be tested is someone who is planning for fertility and who has a history of thyroid disease such as:

• hypothyroidism
• subclinical hypothyroidism
• previous history of radioactive iodine
• previous history of thyroid surgery
• hyperthyroidism or Graves’ disease
• thyroiditis or positive TPO antibodies

What is hypothyroidism?

The most common type of thyroid disorder in child-bearing women is hypothyroidism. Hypothyroidism means an underactive thyroid gland. The thyroid gland sits at the front of your neck and is a butterfly shaped gland.

It produces thyroid hormone. Thyroid hormone (thyroxine) is required to keep your metabolism normal, and therefore cells require it to function normally. In hypothyroidism, you do not produce enough thyroid hormone, and as a result, your metabolism and cells slow down. It is a very common condition that affects one in 50 women.

What are the symptoms of hypothyroidism?

There are a host of related symptoms. The main ones include the following:

• weight gain
• constipation
• dry skin
• dry and thinning hair
• muscle pains or pins and needles
• heavy periods/ fertility problems
• poor concentration and poor memory
• low mood
• fatigue and tiredness

What are the main causes?

The most common causes of hypothyroidism are:

• autoimmune (the most common): the immune system does not recognise your thyroid cells and destroys them
• radioactive iodine (treatment used for overactive thyroid
• thyroid removal via surgery
• head and neck radiotherapy for cancer
• problems to your pituitary gland (the hormone centre in the brain)

How is it diagnosed?

It is easily diagnosed through a simple blood test called a thyroid function test (TFT). Normally, when your thyroid is underactive, your thyroid stimulating hormone (TSH) level is increased (above the reference range) and thyroxine (T4) is low (below the reference range).

How is hypothyroidism treated?

Treatment involves the replacement of thyroxine in tablet form which has to be taken every day and usually for a long period of time. Thyroxine tablets should usually be taken first thing in the morning approximately 30-60 minutes before food, hot beverages, such as coffee and multivitamin tablets (including iron, calcium and anti-reflux tablets).

To consult with Dr Teng-Teng Chung, visit her Top Doctors profile today.