Schwangerschaft und Schilddrüsenunterfunktion

With known hyperthyroidism and ongoing therapy before pregnancy, it should be noted that the requirement increases during pregnancy, and that the Levothyroxine dose should therefore be increased. Thyroid hormones should preferably be checked every 4-8 weeks.

Thyroid underfunction (hypothyroidism) is not easy to recognize when it occurs during pregnancy. The symptoms are often interpreted as complaints associated with pregnancy. Precise knowledge of the symptoms can help you talk to your physician in time.

The most frequent physical complaints with hypothyroidism are:

• Fatigue, listlessness, and weakness
• Weight gain
• Low blood pressure and low pulse
• Hoarseness
• Hypersensitivity to cold
• Constipation
• Dry skin, increased hair loss, brittle nails
• Elevated blood lipids

The most frequent psychological complaints with underfunction are:

• Depression
• Memory loss
• Disinterest and apathy

Therapy:

Levothyroxine: potential complications during pregnancy can be eliminated by treatment with thyroid hormones. With existing hypofunction and ongoing hormone therapy, the requirement increases during pregnancy, and thus, particularly during the first 20 weeks, TSH should be checked at 4-week intervals. After childbirth, the requirement declines.  The patient should therefore stop taking TSH.

Iodine supply: from the 10^th to 12^th week of pregnancy, the fetal thyroid gland is able to take up iodine and produce thyroid hormones. For this reason, the iodine requirement increases during pregnancy. A sufficient daily iodine supply of 200 µg and normal metabolic status are absolutely necessary for the normal physical and mental development of the fetus.