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Hypothyroidism in Pregnancy: Symptoms & Complications

By Dr. Parinita Kalita in Obstetrics And Gynaecology , Robotic Surgery , Gynaecologic Laparoscopy

Mar 06 , 2025 | 3 min read

Managing Hypothyroidism During Pregnancy: What You Need to Know

Hypothyroidism in pregnancy occurs when the thyroid gland does not produce enough thyroid hormones, affecting both the mother and baby. Thyroid hormones are crucial for metabolism, energy regulation, and fetal development. Untreated hypothyroidism in pregnancy can lead to complications such as miscarriage, premature birth, and developmental issues in the baby.

What is a Normal TSH Level for a Pregnant Woman?

TSH (Thyroid Stimulating Hormone) levels fluctuate during pregnancy, and maintaining an optimal range is essential for maternal and fetal health.

First trimester: 0.1 - 2.5 mIU/L
Second trimester: 0.2 - 3.0 mIU/L
Third trimester: 0.3 - 3.5 mIU/L

High TSH levels indicate hypothyroidism, requiring immediate management to prevent complications.

Signs and Symptoms of Hypothyroidism During Pregnancy

Recognising hypothyroid symptoms in pregnancy is essential for early intervention. Common signs include:

Fatigue: Extreme tiredness despite adequate rest
Intolerance to cold: Feeling unusually cold, even in warm temperatures
Constipation: Slow digestion and difficulty passing stool
Weight gain: Unexplained weight gain despite a balanced diet
Swollen face: Puffiness, especially around the eyes
Hoarseness: Changes in voice due to thyroid dysfunction
Depression: Mood swings, anxiety, or persistent sadness
Muscle weakness: Weakness or cramps in the muscles

Risks and Complications

If left untreated, hypothyroidism in pregnancy can lead to severe complications, including:

Miscarriage: Increased risk of pregnancy loss in early stages
Premature birth: Baby born before 37 weeks, leading to health issues
Low birth weight: Poor fetal growth resulting in underweight newborns
Preeclampsia: High blood pressure during pregnancy, endangering both mother and baby
Developmental delays in the baby: Impaired brain development, cognitive delays, and learning disabilities

Diagnosis of Hypothyroidism During Pregnancy

Blood Tests

A simple blood test measures:

TSH levels: Higher-than-normal levels indicate hypothyroidism.
Free T4 levels: Low levels confirm an underactive thyroid.

Physical Examination

Doctors assess thyroid function by checking for symptoms like swelling, dry skin, slow heart rate, and excessive fatigue.

Importance of Thyroid Hormones During Pregnancy

Thyroid hormones play a crucial role in pregnancy by:

Fetal brain development: Essential for neurological growth and cognitive function
Placental health: Supports healthy blood flow and nutrient supply to the baby
Metabolism regulation: Maintains energy levels and prevents excessive weight gain
Energy levels: Reduces fatigue and improves overall well-being during pregnancy

Tips for Managing Hypothyroidism During Pregnancy

Proper management of hypothyroidism in pregnancy ensures a healthy pregnancy and baby. Here are some key tips:

Regular Monitoring

Frequent TSH level tests help doctors adjust medication dosage as needed.

Adhere to the Treatment Plan

Levothyroxine is the most commonly prescribed medication for treating hypothyroidism during pregnancy.
Always take medicines as directed and avoid skipping doses.

Maintain a Healthy Diet

A thyroid-friendly diet during pregnancy includes:

Iodine-rich foods (dairy, fish, eggs) to support thyroid hormone production
Selenium-rich foods (nuts, seeds) to aid thyroid function
Iron-rich foods (leafy greens, lentils) for optimal oxygen supply

Regular Exercise

Engage in moderate physical activity like walking, prenatal yoga, or swimming.
Exercise helps maintain weight and improve metabolism.

Stress Management

Practice relaxation techniques like meditation, deep breathing, and prenatal massage.
Chronic stress can worsen hypothyroid symptoms in pregnancy.

Get Enough Sleep

Aim for at least 7-9 hours of sleep each night.
Proper rest boosts metabolism and supports hormonal balance.

Conclusion

Managing hypothyroidism during pregnancy is crucial for the health of both mother and baby. Regular monitoring, medication adherence, a balanced diet, and a healthy lifestyle can help control the condition and ensure a smooth pregnancy. If you experience hypothyroid symptoms during pregnancy, consult your doctor for personalised care and treatment.