Q&A: How does thyroiditis influence conception?

Hashimoto's Disease (thyroiditis) is a condition that affects optimal functioning of your thyroid gland. It is considered an autoimmune disease and is the most common form of thyroid problem in the United States, affecting more women than men. Autoimmune diseases occur when your own immune system attacks your organs, cells, tissues, or glands. In the case of Hashimoto's, the immune system targets and destroys the functioning of the thyroid gland.

Your thyroid gland is located in the lower part of your neck. It is the shape of a butterfly and wraps itself around the outside of your trachea (windpipe). The thyroid gland makes hormones (thyroxine/T3 and triiodothyronine/T4) that help with the functioning of your heart rate, blood pressure, body temperature, and the metabolism of food. It also releases a hormone (calcitonin) that helps keep your bones healthy and strong. As you can surmise, when there are issues with the thyroid gland, it can lead to some problems.

Symptoms can certainly vary; some women may have no symptoms at all. Some of the most common symptoms women may experience include the following:

• Fatigue
• Weight gain
• Weakness
• Dry skin and hair
• Cold intolerance
• Depression
• Heavy menstrual cycles

Your doctor can make a definitive diagnosis by checking your levels (with a blood test) of thyroid hormones. The test checks the levels of TSH (thyroid-stimulating hormone).

The goal is to bring the thyroid into what is called a euthyroid state—or one of balance. With Hashimoto's disease, thyroid levels are low, which causes a state of hypothyroidism. Your doctor will give you a prescription for a medication called synthroid which helps to bring your thyroid function to its normal state. You will have periodic checks of your TSH hormone to make sure your dosage is in a therapeutic range.

The bigger problem occurs when a woman is undiagnosed. Left untreated, the hypothyroid state can lead to problems with ovulation and menstruation. The good news is that your doctor has diagnosed you and you have hopefully started medication. Once you are in the euthyroid state, there should not be a problem with getting pregnant. Once you do become pregnant, your doctor will closely monitor your TSH levels, as the metabolic changes in your body during pregnancy may necessitate slight changes in your dosage. Dr. Nora Miller, of the Women's Fertility Center in Stamford, Connecticut, says, "This hormone is vital to your own body function, but also to that of your developing baby." She mentions a study in the New England Journal of Medicine that finds a correlation between a child's IQ scores and a woman's thyroid levels in pregnancy.

According to the American Thyroid Association, "the first 10 to 12 weeks of pregnancy, the baby is completely dependent on the mother for the production of thyroid hormone. By the end of the first trimester, the baby's thyroid begins to produce thyroid hormone on its own."

Be sure to keep in close contact with your doctor regarding symptoms or any trouble getting pregnant.