Pregnancy after thyroidectomy – what you need to know
Pregnancy is a life-changing experience for a parent. But if you’ve undergone a thyroidectomy or survived thyroid cancer, there are some challenges you may face on your journey.
Whether you’ve had a partial or total thyroidectomy, the removal of thyroid tissue means that you need to closely monitor your thyroid hormone levels throughout the pregnancy.
But if you’re armed with the following tips, you’ll find it much easier to navigate your pregnancy and ensure that both you and your little one are healthy.
Pregnant post-thyroidectomy – why does it matter?
In women with a normally functioning thyroid, there are several shifts in thyroid function. This is a result of the hormonal changes, along with the baby utilising thyroid hormones from the mother. Some of the that are experienced include:
Increased thyroid-binding globulin (TBG)
Higher T4 and T3
Increased free T4 and lower TSH in first trimester due to hCG levels
Degradation of T4 and T3 thanks to the placenta, increasing demand on the thyroid
Increased excretion of iodine, which can reduce the production of thyroid hormones
But when you are reliant on thyroid hormone replacement, some of these may not be compensated for. After all, your body can’t tell your thyroid to adjust levels! That’s why it’s critical that you support your thyroid hormone conversion and monitor your hormones throughout pregnancy.
Tips for a healthy pregnancy after a thyroidectomy/thyroid cancer
Now that you know why your body needs a little extra TLC on the journey to parenthood, let’s look at how you can make that happen!
Get your levels checked frequently
The number one priority during your pregnancy should be your thyroid hormone levels.
When it comes to thyroid hormones, the most important trimester is first trimester. Why? Because your baby’s thyroid is not developed until 12 weeks, so your thyroid is doing all of the work before then.
Ideally, even while you’re trying to conceive, you’ll be getting regular thyroid testing. But as soon as you know you are pregnant, it’s time to go get your levels checked. You may even like to ask your doctor for a test slip so you can get your bloods done as soon as you’ve confirmed your pregnancy.
But don’t just think it’s the first 3 months that you need to monitor! Any significant changes in thyroid levels in the second and third trimesters can still be a concern. So get tested regularly as recommended by your doctor – the usual is every 4 weeks for 1st trimester and every 6-8 weeks for the remainder of pregnancy.
One thing to keep in mind – if your TSH is on the lower side in the first trimester, don’t panic. Around 5% of women have a TSH below 0.1mIU/L by week 11 of pregnancy. It’s far more important that your T3 and T4 are adequate to support your pregnancy.
Support your thyroid hormone conversion
This is a tip you want to implement for life, not just during pregnancy! But it’s particularly important during both preconception and pregnancy if you’re reliant on thyroid hormone replacement.
Not sure how to make sure you’re converting your thyroid hormones? I’ve covered some tips in this article. While it discusses T4 conversion, the tips are also relevant if you’re on combination T4/T3 therapy!
Don’t neglect the drivers
Whether your thyroidectomy is partial or total, whether it was due to nodules, Graves’ or cancer – the drivers don’t disappear when your treatment finishes up! So you want to make sure you have healthy habits in place that reduce the effects of whatever caused the initial illness.
That includes:
Optimising your nutrient levels, especially those involved in thyroid hormone conversion
Ensuring you get plenty of iodine – while you might not need it for your own thyroid, your little one will develop their own
Eating a nutrient-dense wholefood diet as much as possible (while still keeping to a pregnancy-safe diet, of course!)
Reducing known flare triggers, antibodies (in the case of Graves’) and inflammation
THE POWER IS IN YOUR HANDS
When you receive a thyroid disease diagnosis, there’s a good chance you’ll feel overwhelmed and powerless. It could even be that you’re not clear on what’s driving it or where it came from!
But even if you’re still uncovering the cause, it doesn’t mean you need to suffer the symptoms forever! Your daily habits can make a massive difference – all you need to do is learn about your condition and empower yourself.