What It Is
A condition in which the thyroid gland becomes overactive (hyperthyroidism) or underactive (hypothyroidism), producing either too much or too little of the hormones that regulate the body’s metabolism.
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.
Signs of an overactive thyroid include frequent bowel movements, weight loss, irregular periods, increased appetite, insomnia, nervousness, heat intolerance, hand tremors, and heart palpitations. An underactive thyroid can cause constipation, heavier periods, weight gain, decrease in appetite, lethargy, depression, cognitive problems, fatigue, dry skin, intolerance to cold, and muscle aches. Symptoms of both hyper- and hypothyroidism are sometimes 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 underactive or overactive thyroid gland.
How It Affects Fertility (And Pregnancy)
Both overactive and underactive thyroid can cause infertility by preventing ovulation. When a woman with thyroid disease does conceive, she may have an increased risk of miscarriage.
In hyperthyroidism, production of hormones is slowed down 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. Hypothyroidism is treated with a synthetic version of the hormone thyroxine, which the body responds to as it would to the real thing.
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 cause by an overactive or underactive thyroid, insist on testing, even if doctors have dismissed your complaints. If you already are being treated for thyroid disease, you can still conceive and have a healthy pregnancy with a little extra planning and vigilance. During pregnancy, your doctor should monitor blood levels closely to ensure that thyroid hormone levels are in the normal range.
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