Symptoms during pregnancy
During pregnancy there are many changes in metabolic processes. An underactive thyroid also leads to a number of different symptoms during pregnancy. On the one hand, hypothyroidism during pregnancy is characterized by the general symptoms of hormone deficiency.
These include fatigue, disorders of the skin, hair and nails, as well as weight gain and a feeling of cold. The symptoms of hypothyroidism in pregnancy can be masked or intensified by other changes in the body. Thus a pregnant woman gains weight even with a healthy thyroid gland.
Water retention is increased by a simultaneous underactive thyroid during pregnancy. An underactive thyroid gland is of particular importance during pregnancy for the unborn child. This is supplied by the mother with thyroid hormones.
If this is not possible, serious damage to the baby can occur. These include mental and physical developmental disorders. Therefore, the control of the thyroid gland during pregnancy is extremely important.
Symptoms in the child
Untreated hypothyroidism in children can have extremely serious consequences, as thyroid hormones are essential for the physical and mental development of the child. Here, especially the congenital hypothyroidism is dangerous. In the womb, the unborn child is supplied with thyroid hormones by the mother.
This disappears after delivery. Immediately after birth, babies are conspicuous for their weakness, laziness in drinking and listlessness. If the hypothyroidism persists, further considerable symptoms will appear in the course of the birth.
Thriving disorders, which manifest themselves as dwarfism, can occur. A too large tongue is often noticeable in children. In addition, general symptoms of hypothyroidism, such as constipation, brittle hair and nails and doughy, dry skin, are also seen in children.A reduction in performance and a lack of drive also indicate an underactive thyroid in children.
Mental development is also impaired by a lack of thyroid hormones. Reduced intelligence, concentration and memory disorders can be corresponding symptoms. In the worst case, considerable mental retardation can occur in the child.
This is also known as cretinism. If the hypothyroidism in the child occurs relatively late, i.e. towards teenage age, similar symptoms to those in adults are more prominent. Physical and mental disorders occur mainly in early childhood in the developmental phase.
The thyroid hormone levels in the blood are determined. In latent (subclinical = without symptoms) hypothyroidism, the free thyroid hormones T3 and T4 in the blood are normal, but the brain hormone that increases TSH. In a manifest (with symptoms) hypothyroidism, a distinction is made depending on the location of the cause.
If it is in the thyroid gland itself, then the thyroid hormones are lowered, but the hormone of the brain, which increases TSH, is increased. If the cause is in the pituitary gland, then both the brain hormones and the thyroid hormones are lowered. In autoimmune thyroiditis, antibodies can be detected in the blood.
In congenital hypothyroidism, the thyroglobin in the blood and iodine in the urine are also determined. An ultrasound of the thyroid gland is then performed. In unclear cases, a scintigraphy may be useful.
In the case of congenital hypothyroidism, a lifelong intake of thyroid hormones (synthetic T4 = L-thyroxine) and control examinations of the blood level are necessary. The same applies to manifest hypothyroidism. The substitution therapy must be started slowly and at a low level.
The final dose depends on the patient’s individual well-being and the TSH values. This should be in the normal range between 0.5 – 2.0 mU/l. The latent hypofunction should be treated with hormones in patients <70 years of age and in patients who wish to have children, as there is an increased risk of calcification of the vessels (=early arteriosclerosis).
