Accompanying symptoms of hyperthyroidism during pregnancy

During pregnancy, the need for thyroid hormones and therefore the hormone level is increased in many pregnant women. If, however, the overactive thyroid is caused by thyroid autonomy or Graves’ disease, drug therapy must be carried out, otherwise there is a risk of health consequences for mother and child. These risks can be greatly reduced with a proper therapy.

It is important to use the correct dosage and to take the medication according to the schedule recommended by the doctor, otherwise the reverse metabolic situation, i.e. hypothyroidism in the fetus or the newborn, may follow. In the case of pregnancy-associated hyperthyroidism it is usually not necessary to take any medication. This so-called gestational hyperthyroidism usually disappears on its own during the second trimester of pregnancy.

Only regular checks of the thyroid gland values should be performed. During the first trimester of pregnancy, the active substance propylthiouracil (PTU) is the drug of choice. It is only used for a limited period of time, as the risk of PTU-induced liver failure is increased with prolonged use.

Only in the second and third trimester can the active ingredients carbimazole or thiamazole, which are standard in common hyperthyroidism, be used, as these substances carry an increased risk of malformation in early pregnancy. The drugs used are usually aimed at achieving thyroid hormone levels in the upper reference range. In the hCG-dependent form of hyperfunction, beta-blockers can be used.

What are the consequences of hyperthyroidism in pregnancy?

The consequences of untreated hyperthyroidism begin even before pregnancy. Often the readiness to conceive is reduced and women who suffer from hyperthyroidism try in vain for a long time to become pregnant. Therefore, women who plan to become pregnant should undergo appropriate therapy.

This is all the more important because if a pregnancy then occurs, it can go unnoticed for a period of two to three months or even longer, as is the case with most women. However, an optimal supply of thyroid hormones is especially important in the first weeks of pregnancy in order to support a proper development of the child and to minimize health risks for mother and child. Another possible consequence of untreated hyperthyroidism can also occur after pregnancy and is directly related to it.

It can lead to so-called postpartum thyroiditis of the mother, i.e. an inflammation of the thyroid gland during the puerperium, which develops about 4-24 weeks after delivery. This disease usually progresses in two phases. After the initial worsening of the hyperthyroid metabolic situation, there is a drop in thyroid hormones with a subsequent (sometimes permanent) hypothyroidism. However, hyper- or hypothyroidism can also occur in the course of the inflammation.