Even women who have had a thyroidectomy and live without a thyroid can have a peaceful pregnancy and have a child. Of course, fertility and a successful pregnancy inevitably require more commitment and attention than any other mother. Even immediately after birth they will have to follow specific instructions. Here is a guide for you who probably already know a lot about the thyroid because it is a problem that belongs to you, but you hope to find yourself pregnant as soon as possible and to carry out the pregnancy without thyroid and without nasty surprises.
Let’s start with the basics.
The thyroid is a butterfly-shaped gland that rests in the front of the neck. But what are the glands (like the thyroid gland)? By definition, they are organs that produce a secretion, in particular they secrete hormones. Hormones are messengers that as soon as they are produced go to their “target organs” and modulate their functions.
In practice, you can imagine our whole organism as a great highway where hormones of all kinds run with countless tasks to complete. Their functions are all essential to our well-being and our survival.
The thyroidis a gland that produces two different thyroid hormones (their names are triiodiothyronine and tetraiodiothyronine). Thyroid hormones have no real target organs, but they act on the whole organism in many ways. In particular, they work on the basal metabolism, that is the waste of “vital” energies that an organism has even when it is at rest. In fact, although we do not move, we are still breathing, digesting and we have active the blood circulatory system and the nervous system. Here, the thyroid excites this metabolism and accelerates it. Not surprisingly, a low production of these hormones (we talk about hypothyroidism) leads to drowsiness, mental numbness, chronic fatigue and makes you fat. The thyroid also serves to grow large.
Thyroid hormones are produced thanks to cells called thyrocytes that generate and release these substances under the stimulus of the thyroid-stimulating hormone, TSH , produced by the pituitary, in turn secreted by order of the TRH which is produced by the hypothalamus … In short, a long chain of command for a very important hormonal function.
When is the thyroid removed?
There are numerous pathologies (some congenital at birth and others acquired in life) that can damage the thyroid. In some cases it is necessary to remove the entire gland as a whole through an operation called a thyroidectomy .
However, this should not scare you, in fact for decades there have been drugs that lead to a replenishment of deficient thyroid hormones, in particular L-thyroxine.
The therapy with replacement hormones has shown excellent results on the whole organism, rebalancing its functioning.
The thyroidectomy may be partial, rather than total. In this case we can speak of isthmectomy when the removed part is the central one, that is the isthmus (where the butterfly’s wings are “fastened”) or hemithyroidectomy, when half of the gland is removed (with or without the isthmus included).
The “synthetic” hormones of the pharmacological treatments that will be prescribed will help all women undergoing these operations to live in normal conditions.
Of course, however, there is a particularly important moment in the life of a thyroidectomized woman: when she decides she wants to get pregnant . The research period of a baby, as well as the entire duration of pregnancy , require some precautions. It will be necessary to pay great attention to the optimal balance of the therapy that is followed in this period, both to ensure the mother’s fertility and the health of the baby.
Getting pregnant is difficult, but not impossible.
First, we explain that a lack of thyroid means a clinical picture of hypothyroidism (the same definition that is given to having a thyroid that “works little”). Difficulty conceiving is common in hypothyroid women who may have frequent irregular cycles , poor and without ovulation (called anovulators). We all women have anovulatory cycles from time to time, but in those who have thyroid problems or have undergone thyroid removal they are frequent.
Is there a risk of miscarriage?
If anti-thyroid antibodies are present , as in the case of Hashimoto’s thyroiditis, the inflammatory situation that arises could interfere with the mechanisms of embryo implantation and placenta formation . For this reason, some specialists believe that thyroid diseases may be implicated in a greater risk of abortion , but beware, it does not mean that all women who have some thyroid dysfunction will suffer from abortion (repeated episodes): many of them will still be able to have pregnancies. very normal.
Fertility problems
Another mechanism by which the woman with thyroid disorders may have fertility problems concerns the premature aging of the ovaries . Again, this does not mean that all women with thyroid dysfunction go through early menopause , also because the age of menopause is highly dependent on genetic and hereditary factors.
I’m pregnant, now what? Once the pregnancy is established, the mother will have to continue to remain under control throughout the pregnancy . A thyroid hormone deficiency during fetal formation or early childhood can produce a condition called cretinism characterized by incomplete central nervous system development and mental retardation. In this regard, we remind you how the increased need for thyroxine can become evident already in the first 4 weeks from conception. Precisely for this reason it is advisable to measure TSH values immediately.
In thyroidectomised women it will be necessary to constantly and precisely monitor the TSH and the concentration of thyroxine in circulation, this to adapt the therapy whenever necessary, setting it to measure at each stage of pregnancy and for each single future mother.
In this picture there is a positive side: the treatments will not be new and you will be well followed by a medical team. The fact that you have already been diagnosed, that you have already started therapy after a thyroidectomy some time ago (as well as in the case of thyroid deficiency specific treatments are already being followed), puts you in a position to be well monitored . On the other hand, the situation of women who suffer without knowing it from disorders of the functionality of the thyroid gland (a condition that is called subclinical or unknown dysthyroidism) is much more dangerous and who without understanding the reasons find themselves unable to get pregnant, racking their brains on their infertility . The same as during pregnancythey could then find themselves protagonists of unpleasant abortion events and all because they are unaware of having problems with hypothyroidism. Of course, sooner or later it will be discovered that the problem lies in this gland, but the time it takes to make a diagnosis and dictate adequate therapy causes a waste of time and precious opportunities in order to have a child.
Speaking of which, here’s one thing to keep in mind! It is important to add – to the tests that every woman is periodically recommended – the evaluation of the TSH reflex , a simple blood chemistry test that removes many doubts and helps to solve problems in time.
What does the thyroid gland do in a “normal” pregnancy?
For all women, during pregnancy, the thyroid is in a period of extra work: it has a great functional load and is forced to increase the synthesis of thyroid hormones for many different causes. Let’s give you just one example: during pregnancy our blood changes, an increase in plasma volume is generated with an increase in the amount of circulating blood and the consequence is that the substances circulating in the blood are more diluted – including thyroid hormones – and therefore consequently they must be synthesized in larger quantities to keep the plasma concentration stable. In short, the thyroid in pregnancy is a topic to pay attention to even for those who have one, and it works well too.
If until today you have believed that living without a thyroid gland was irreconcilable with pregnancy , know that instead you may be destined to be a very special (and attentive) super-mom and for this you deserve all our best wishes!
