What It Is
A condition in which an overactive thyroid produces too much hormone, kicking the metabolism into high gear. One common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder that tends to run in families and affects the entire thyroid gland. Another cause is so-called “hot nodules” that can form on the thyroid. The nodules contain cells that produce too much of the thyroid hormone thyroxine.
Who Gets It
The American Association of Clinical Endocrinologists estimates that as many as 27 million Americans may have overactive or underactive thyroid, more than half of them undiagnosed. Eight of 10 people with thyroid disease are women.
An overactive thyroid can cause more frequent bowel movements, weight loss, irregular periods, increased appetite, insomnia, nervousness, heat intolerance, hand tremors, and heart palpitations. Sometimes symptoms are so subtle that the condition goes unrecognized for years. Infertility or miscarriage may be the first sign that something is wrong.
How It's Diagnosed/Detected
Thyroid disorders are easily detected by simple blood tests that measure levels of the hormone thyroxine and TSH (thyroid stimulating hormone). TSH, produced by the pituitary gland, works like a thermostat to regulate thyroid function. Levels may become too high or too low as the pituitary attempts to compensate for an overactive or underactive thyroid gland.
How It Affects Fertility (And Pregnancy)
An overactive thyroid can sometimes prevent ovulation and cause infertility. When a woman with hyperthyroidism does conceive, her metabolism may be so out of balance that miscarriage or fetal death may result.
The goal is to slow down the thyroid’s secretion of hormones. This can be done with anti-thyroid drugs or with radioactive iodine that kills part of the gland. Radioactive iodine cannot be used during pregnancy, and doctors urge women to wait six months after treatment before trying to conceive.
Of the various threats to fertility, thyroid disorders are among the easiest to identify and treat. If you have symptoms that you think might be caused by an overactive thyroid, insist on testing, even if doctors have dismissed your complaints. If you are already being treated for hyperthyroidism, you can still conceive and have a healthy pregnancy with a little extra planning and vigilance. Preconception planning to manage medications is a must, and during pregnancy an endocrinologist or obstetrician familiar with thyroid disease should test your blood frequently to ensure that thyroid hormone levels are in the normal range.
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