Autoimmune thyroiditis in pregnancy

Hypothyroidism is a persistent deficiency of thyroid hormones. The term autoimmune refers to the inability of the human body to recognize cells as "self - alien", which leads to the appearance of autoantibodies to thyroid cells. So what are the risks of autoimmune thyroiditis during pregnancy? How serious is this disease and how can it affect the course of pregnancy, the body of the expectant mother and her unborn child.

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Causes of autoimmune thyroiditis during pregnancy

During the period not related to the reproductive functions of the human body, or during pregnancy, the causes of autoimmune thyroiditis are identical. The only difference is that the "interesting position of a woman" only aggravates the situation, activating and increasing the imbalance of thyroid hormones.

The disease in question is attributed to the genetic predisposition of the human body to this type of pathology. Most often, the genomic complex contains abnormalities in HLA-DR5 and/or HLA-B8. This disorder is mainly traced within one family. It is often diagnosed not in isolation, but in combination with other autoimmune pathologies.

The basis for such a conclusion is the analysis of the family history, as well as cases when identical twins are born. There are many situations when one of the born was diagnosed with the disease discussed in this article, while the body of the other was burdened, for example, with diffuse toxic goiter, which also belongs to the category of autoimmune pathologies.

Autoimmune thyroiditis is classified as a multifactorial disease. The reproduction of the program for the development of the disease is catalyzed by the confluence of certain factors that have both chemical, morphological, physical and biological nature.

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Autoimmune thyroiditis and IVF

Having failed to achieve the desired conception, some couples, not wanting to accept defeat, try to resort to in vitro fertilization (IVF), without even bothering to determine the cause of failure. Or another option: the disease is recognized, treatment is carried out, but ineffectively, which poses a threat to fertilization of the egg. If a woman has one of the above problems, autoimmune thyroiditis and IVF become incompatible. In such a situation, there will be no result from artificial insemination.

If a woman is diagnosed with this disease, which entails a decrease in the level of hormones in the blood, then, first of all, she needs to undergo an examination and consultation with a doctor - an endocrinologist, as well as planned treatment under his supervision. After this, we can talk about planning a pregnancy. Only against the background of hormonal therapy, even with the use of in vitro fertilization with subsequent transfer of embryos into the mother's uterus, the expectant mother has the opportunity not only to conceive, but also to bear the fetus.

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How does autoimmune thyroiditis affect pregnancy?

The disease in question, in the absence of a decrease in the level of hormones in the blood, does not cause much harm to a person, but not in the case of a pregnant woman. After all, pregnancy is already a stressful condition for the body, in which it begins to rebuild, changing its hormonal background, which invariably affects the severity of autoimmune thyroiditis.

As many people know, during pregnancy, many previously "dormant" pathologies in a woman's body become aggravated. This also applies to autoimmune thyroiditis, which can become active after fertilization of the egg, worsening the situation.

After conception, a woman's body requires up to 40% more substances produced by the thyroid gland. Moreover, if there were problems in this area before conception, then after fertilization the situation will only get worse.

Therefore, the answer to the question of how autoimmune thyroiditis affects pregnancy can only be one - negatively, up to and including miscarriage. This can happen in a situation where the patient does not receive the proper replacement therapy, which compensates for the lack of the substance.

Pathogenesis

If a woman has a history of the disease in question, during her pregnancy, there is a fairly high probability that additional physiological stimulation (as in the case of iodine deficiency) will not lead to the desired result. That is, the production of thyroid hormones, so necessary for the normal development of the fetus, will not increase, but will remain at the same level, or even decrease. Which will inevitably lead to an even greater shortage.

In addition, the pathogenesis of the disease, against the background of the woman’s “interesting situation”, can provoke an even greater degree of deficiency of the substance, provoking the appearance of manifestations of hypothyroidism with its pathological symptoms.

But, as practice shows, not every increase in the quantitative component of antibodies to thyroid peroxidase indicates the presence of the disease in question in the patient, it can also be, for example, hypothyroxinemia. Only a qualified specialist can understand this issue and make a correct diagnosis. In our case, an endocrinologist.

As monitoring has shown, a clear clinical picture of the disease is observed in 1 - 1.4% of the population, while doctors find the presence of antibodies to peroxidase in the blood of every tenth healthy woman. This diagnosis is established for every 30th woman.

Symptoms of autoimmune thyroiditis during pregnancy

The thyroid gland consists of connective tissue with an interweaving of nerve receptors and blood vessels. Thyroiditis is an inflammation affecting these tissues. Quite often, the pathology is asymptomatic (the stage of euthyroid or subclinical hypothyroidism). Mostly, such a clinical picture is inherent in patients with a normal amount of hormones in the patient's blood serum. Symptoms of autoimmune thyroiditis during pregnancy begin to appear only when the amount of antibodies in the blood increases, and the volume of thyroid production becomes less and less.

When the process is activated, the following symptoms may appear:

• Increased volume of the thyroid gland (goiter). In this disease, the size parameters of the gland do not show large values.
• Upon palpation, a lump can be detected, which is usually not painful.
• Minor weight loss may occur.
• Increased heart rate (tachycardia).
• Increased irritability may occur.
• Euthyroidism - multinodular goiter.

First signs

In most cases, women do not even suspect that they have the pathology in question in their medical history. They only feel minor discomfort, which they often attribute to their condition, lifestyle, and work rhythm, which leads to fatigue. The first signs of the disease can be discovered completely by accident during a routine check-up. Or if the symptoms begin to worsen, becoming more obvious.

Initially, during palpation, a person himself may feel some unnatural seals on the front side of the neck - this discovery should prompt him to go to a specialist for a consultation, since this fact is only probable and does not necessarily indicate the presence of the disease discussed in this article.

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Acute autoimmune thyroiditis during pregnancy

This form of the disease is diagnosed quite rarely. Acute autoimmune thyroiditis during pregnancy is confirmed mainly when gram-positive microorganisms enter the woman's body. They provoke an inflammatory process, which often goes away with the formation of abscesses.

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Chronic autoimmune thyroiditis during pregnancy

Lymphocytic thyroiditis, old Hashimoto's goiter, lymphomatous - all these diseases are classified as autoimmune. Chronic autoimmune thyroiditis during pregnancy progresses based on the developing leakage of T-lymphocytes into the thyroid parenchyma.

During this type of changes, the result is an increase in the number of antibodies to the cells of the thyroid gland, which pushes the organ to gradual destruction. As a result, not only a disruption in the functioning of the gland itself is observed, which invariably affects the entire body, but also the structural characteristics of the organ.

Chronic autoimmune thyroiditis during pregnancy has a genetic nature. Therefore, if there were similar diagnoses in the family, it would not be superfluous for a woman planning a pregnancy to first consult a specialist and, if necessary, take adequate replacement measures.

If such measures are not taken, either the conception itself or the bearing of the baby is at risk. There is a high probability of miscarriage.

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Postpartum autoimmune thyroiditis

Until a certain time, a woman may not even suspect that there is a malfunction in her body related to the thyroid gland. Everything can start when she enters a new status. Obstetrics is also stressful for the body, after which the mother's body is rebuilt again, since it will have to continue working in a mode without a developing fetus.

The pathology progressing in this period on postpartum signs is called postpartum autoimmune thyroiditis. The main reasons for its development are:

• Increased impact of estrogens (female sex hormones) on the lymphocyte system of the body's defenses.
• Rapid growth of immunity in the mother, which occurs after obstetric assistance. And this is against the background of their recent suppression. Doctors observe hostile activation of immune structures, which are capable of producing special antibodies that damage, among other things, the cells of their own body. The thyroid gland can also be subject to such a fate.

According to medical statistics, the probability of developing postpartum autoimmune thyroiditis increases with the onset of a new pregnancy. At the same time, the degree of expression of postpartum symptoms is more pronounced, the worse the condition of the gland was before conception.

Depending on the severity of the pathology in question, postpartum manifestations may be expressed in different ways. This may be a complex of the symptoms listed below, their isolated manifestations, or a complete absence of symptoms.

• Minor amplitude tremor in the phalanges, upper limbs or the whole body.
• Long-term, unexplained elevated body temperature readings (within 37–38 °C), with periodic spikes to 39 °C.
• The life of a young mother is usually very dynamic, as she needs to do several things at once. It is this excessive energy that can become a catalyst for the development of the disease.
• Emotional lability is an unstable emotional state of a woman in labor.
• Increased heart rate and breathing rate.
• Decreased weight readings, even with a good appetite.

If such symptoms are present, it would be a good idea to inform your doctor about them.

Consequences

To assess the danger of a particular disease, it is worth getting acquainted with the consequences of ignoring the problem. If such a patient does not undergo replacement therapy, she may face:

• Depletion of cells of the central and peripheral nervous systems, which is accompanied by the appearance of corresponding symptoms:
  • Periodic depressions.
  • Unreasonable mood swings.
  • Irritability.
  • The emergence of panic attacks.
  • And others.
• Problems with the heart and blood system:
  • Increased cholesterol levels in the blood.
  • Tachycardia (increased heart rate) or, conversely, bradycardia (decreased heart rate).
  • Heart failure.
• The larger the size of the goiter, the greater the compression directed at neighboring organs and systems.
  • Breathing problems.
  • Voice change.
  • Difficulty swallowing.
• Changes affecting the functioning of female organs:
  • Irregularity or complete cessation of the menstrual cycle.
  • Infertility.
  • Polycystic ovary syndrome.
• There is a risk of the nodes degenerating into cancerous structures with further metastasis.

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Complications

If we talk about the period when a woman is expecting a baby, then the most dangerous complications that can await a woman are miscarriage. But not only this development of pregnancy can threaten the expectant mother, who ignores the specialist's prescription for taking hormone replacement drugs. If she refuses treatment, she can expect other troubles, for example, in the form of placental insufficiency, which does not bode well for the fetus, or gestosis - toxicosis of late pregnancy. Such complications include: the manifestation of edema, convulsions (eclampsia), increased blood pressure, loss of protein in the urine.

Antibodies to thyroglobulin and thyroperoxidase produced against the background of the disease freely overcome the placental barrier, which cannot adversely affect the developing embryo (namely, the cells of its thyroid gland). As a result of all the above - the woman loses the child - miscarriage and miscarriage.

In the most unfavorable course of the pathology, the functioning of all organs and systems of the body can be disrupted, which invariably leads to disability.

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Diagnosis of autoimmune thyroiditis during pregnancy

Sometimes the only indication that a woman has a history of the disease discussed in this article may be the presence of this pathology in one of the pregnant woman's close relatives. Diagnosis of autoimmune thyroiditis during pregnancy involves a comprehensive approach to examination:

• Physical examination by a specialist: the thyroid gland is enlarged, palpation reveals the presence of a lump.
• Examination and consultation with an endocrinologist.
• Laboratory blood tests: increased amount of antibodies to thyroid peroxidase, increased level of thyroid-stimulating hormones.

Considering that a woman does not always feel obvious manifestations of pathology, it is advisable to screen for the disease no later than the 12th week of pregnancy.

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Tests

One of the most indicative diagnostic methods in this case is laboratory testing. A woman's blood tests allow us to identify the presence of antibodies to thyroglobulin and/or thyroid peroxidase. The presence of antibodies to both substances is a serious fact indicating the presence of autoimmune thyroiditis in a woman's body, or a high risk of its development in the near future.

As a rule, the presence or absence of T4 and TSH in the serum of a pregnant woman depends on the stage of the pathology. The level of thyroid stimulating hormones (TSH) is also analyzed. If this indicator is less than 2 mIU/L, no corrective therapy is prescribed, if this indicator is more than 2 mIU/L, but less than 4 mIU/L, the presence of pathology has a high index, which already requires medical intervention. If the TSH level is higher than 4 mIU/L, the risk of diagnosing autoimmune thyroiditis is high.

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Instrumental diagnostics

In recent years, new research methods have come to the aid of doctors. In light of the pathology under consideration, instrumental diagnostics that can facilitate diagnosis also exist. The following may be useful here:

• Echography is an ultrasound diagnostics, which is caused by obtaining an image by recording an ultrasound wave reflected from an object. The information content of this method is determined by the figure of 80–85%.
• Fine-needle aspiration biopsy - taking samples of the cellular composition of a "suspicious" formation of the adrenal gland. Allows to differentiate autoimmune thyroiditis from diseases with similar clinical symptoms.

Differential diagnostics

If laboratory and instrumental examination results are available, an experienced specialist is needed to ensure that differential diagnostics result in a correct diagnosis of the disease.

The difference between the hypertrophic manifestation of autoimmune thyroiditis and diffuse nontoxic goiter is the different density of the formation. This diagnosis is confirmed by different clinical presentation and the presence of autoantibodies in the serum.

The first pathology shows a weakly expressed clinical picture, and no eye symptoms are observed.

Autoimmune thyroiditis is not a benign neoplasm, so its degeneration into malignant forms is very unlikely. It can be lymphoma quite rarely.

The classic morphological criterion of the pathology in question is the place of its development or progression of thyroid infiltrates by lymphocytes. A typical factor of such a disease is also the presence of large oxyphilic cells.

With the help of magnifying equipment, it is possible to recognize dense formations of immune complex deposits. It is possible to detect such structures as fibroblasts (connective tissue cells of the body that synthesize the extracellular matrix).

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Treatment of autoimmune thyroiditis during pregnancy

To date, a typical therapy suitable for any case of relief has not yet been developed. Modern methods are not able to effectively influence the autoimmune processes progressing in the thyroid gland, leading to complete recovery and return of its normal functioning.

As with other patients, during pregnancy, treatment of autoimmune thyroiditis is carried out using the method of replacement therapy. The essence of such measures is the selection of the appropriate medication and its dosage, which would maintain the level of hormone production in the body necessary for the normal functioning of the entire body as a whole.

In light of the condition of the pregnant woman, the goal of all manipulations is to prevent the development of hypothyroidism. There are no special features in stopping the problem in pregnant women. The disease is stopped according to the general rules that are prescribed for the treatment of any patient.

The first trimester after conception is the most important. At this time, all organs and systems of the developing organism are laid down. Therefore, the probability of miscarriage is high, especially if the body of the expectant mother is burdened with pathology. This fact also concerns autoimmune thyroiditis. As a replacement therapy, against the background of the first trimester, the pregnant woman usually receives hormonal drugs, sedatives and anti-stress medications.

If the manifestations of the disease in question affect the period of the second and/or third trimester, the treatment protocol includes drugs that regulate the functioning of the central nervous system, diuretics, and hypotensive drugs. Such a patient is prescribed a drug that can normalize the rheological and coagulation characteristics of the blood, hepatoprotectors, antioxidants, immunomodulators, drugs that improve uteroplacental blood flow, vitamin and mineral complexes, drugs that affect metabolism, and, if necessary, detoxification therapy is also carried out.

Medicines

As already noted in the previous paragraph, depending on the trimester of pregnancy and the clinical picture of the pathology, the protocol of replacement therapy may contain a different set of diverse medical products. But one thing is constant, it necessarily includes medications of the thyroid hormone group, designed to compensate for their deficiency in the body. These can be such drugs as thyroxine, levothyroxine, euthyrox, novotiral, bagotirox, thyreotom, L-thyrox and others.

Levothyroxine is started with minimal daily doses – from 0.0125 to 0.025 g. The drug is taken once a day. On average, daily administration is allowed in the amount of 0.025 to 0.2 g. For the greatest effect, levothyroxine should be administered 20-30 minutes before meals.

For small patients, this dosage is selected depending on their age: newborns up to six months of age - 0.025 - 0.050 g, up to one year - up to 0.06 g. If the patient's age falls within the period from one to five years - up to 0.1 g, from six to twelve - 0.1 to 0.15 g. For children over twelve - up to 0.2 g per day.

During the therapy, the patient is subject to constant medical supervision. The TSH content in the blood should be checked monthly. If this indicator exceeds the control 2 mIU/l, the dosage of levothyroxine is increased by 0.025 g.

At the same time, the pregnant woman receives sedatives: motherwort, valerian, Novo-Passit.

Immunostimulants: Eleutherococcus (but not in alcohol). You should be very careful with the medicinal forms of this group and take only those prescribed by a specialist. Self-medication is unacceptable, especially during this period. After all, a woman is responsible not only for herself, but also for the life and health of her unborn baby.

Medicines that improve uteroplacental blood flow: dipyridamole, xanthinol, penselin, curantil and others.

Folk remedies

Many pregnant women, fearing harm to the fetus, do not want to use pharmacological drugs to relieve the problem, considering them harmful to the baby's health. They prefer folk remedies, perceiving them as harmless effective therapy. But this is fundamentally wrong. Most remedies have a general effect on the body, treating one problem and neutrally affecting another (or pathologically). Therefore, in order not to harm yourself, if you want to use one of the methods of folk therapy, you should consult with your doctor and obstetrician-gynecologist who is monitoring the pregnancy. Only with their consent is this treatment permissible.

We would like to offer you several recipes that really show effective results.

• A mixture of beetroot and carrot juices has proven itself to be quite effective in treating symptoms of autoimmune thyroiditis. It is necessary to obtain freshly squeezed juices of these tubers. Mix them in a ratio of one part beetroot and three carrot juices. To increase the effectiveness, you can add a tablespoon of flaxseed oil to the medicinal liquid (any with a therapeutic effect will do). This will allow the mixture to be better absorbed. Take a glass of juice two or three times a day.
• You can similarly prepare an assortment of lemon and cabbage juices.
• A decoction made from seaweed, which is rich in iodine, will also help.
• Fresh juice prepared from the juices of vegetables such as cabbage (25 ml), spinach (50 ml), carrots (100 ml) and beets (25 ml) is also effective. Take a glass of juice two to three times a day.
• An effective result is shown by taking a tincture of pine buds. Grind a couple of boxes of the herbal product purchased at the pharmacy and place them in a vessel. Fill the vessel with forty-degree vodka. Cork it and put it in a warm place for three weeks. After the expiration of the term, strain the contents. Treat the thyroid gland area daily with the resulting brownish liquid. If the treatment is constant, then after a certain period of time the disease will recede.
• A good result of therapy is shown by the treatment of autoimmune thyroiditis with bear bile. First, prepare an infusion of 50 g of celandine, 50 g of parsley and half a liter of vodka. In this form, the composition is infused for a week, after which 20-25 g of bear bile is added to it. The medicine is left to infuse for another week. In this case, it should be shaken periodically. The medicinal liquid is taken 20-25 drops three times a day for a month. A week's break and the course of treatment is repeated until the medicine runs out.

Taking these medications will invariably have a positive effect on the patient's health.

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Herbal treatment

Herbal preparations also play an important role in the treatment of autoimmune thyroiditis. Herbal treatment is very effective, but a preliminary consultation with a specialist is necessary. If permission is received, let us recall a number of recipes that are easy to prepare at home.

• Celandine infusion is very effective. However, this plant is considered poisonous, so you should follow the dosage recommendations very precisely. Take a jar, fill it with flowers and leaves of the previously crushed plant. Fill the remaining space with 40-degree vodka. Leave the resulting container to infuse for two weeks. Then strain the mixture. Drink 25 g of the liquid on an empty stomach in the morning. The initial introduction begins with two drops diluted with a quarter of a glass of water (approximately 25 ml). We systematically increase the volume by two drops every day, bringing it to 16 drops per day. After this, the course of treatment is a month. Then a ten-day break and the course is repeated. The full cycle of therapy consists of four such courses with intervals of rest from treatment.
• Place elecampane flowers in a jar filled with vodka. Seal and leave for two weeks. After the time has elapsed, strain the mixture and squeeze out the pulp. Gargle with the resulting medicine once a day just before bedtime. It is not advisable to swallow. There is no specific duration of therapy. Long-term, constant procedures usually lead to the disease receding.
• You can also offer a herbal tincture. First, make a collection, taking in equal proportions (50 g each) homeopathic tincture of fucus, plantain, field ivy, seaweed (double weight - 100 g), pine buds, walnut partitions. All ingredients should be chopped and mixed well. Place in a container and pour boiling water. Place this combination on low heat, bring to a boil and hold for 15 minutes. Remove from heat and add 50 g of honey and one finely chopped lemon. Put it back on the fire for a quarter of an hour. After the time has elapsed, cool the decoction and strain. Take a tablespoon immediately before the main meal, three times a day.

Homeopathy

Today, traditional medicine does not allow the presence of homeopathic drugs in the replacement therapy of the disease in question. But recently, homeopathy has expanded its range and is ready to offer effective means in the fight against the disease of interest to us.

But it is worth noting that there are practically no highly qualified specialists in this field of medicine in our country. The only country where homeopathy is at a high level is China. Therefore, if you want to be treated with these methods, it is better to take such a course in this country with the assistance of experienced homeopaths. If this is not possible, we advise you not to risk your health and the health of your baby by taking questionable drugs. At best, you can lose a certain amount of money, at worst - your health or the life of your baby.

Surgical treatment

In principle, doctors do not resort to non-drug methods of treating autoimmune thyroiditis. Surgical treatment of the disease in question is also prescribed quite rarely.

The attending physician may take such a step if the size of the thyroid gland acquires large parameters. Such volumes begin to shift neighboring organs and structures from their normal place, putting pressure on them.

Mostly, thyroid resection is performed either before conception or after childbirth.

Detailed information on all treatment options for autoimmune thyroiditis can be found here.

Prevention

Since the disease in question is classified as a genetic pathology, it is practically impossible to give any recommendations that can prevent the occurrence of this disease. But it is entirely within human power to smooth out the symptoms and prevent its progression. Therefore, prevention of pathology in such a situation may include:

• Maintaining a healthy lifestyle.
  • Giving up bad habits.
  • Hardening.
  • Walks in the fresh air.
  • Moderate physical and emotional stress.
  • Vaccination.
• Healthy, nutritious nutrition. The diet should contain enough foods rich in iodine.
• Immediately before planning a pregnancy, it would be a good idea to undergo a full examination and, if necessary, a course of treatment.
• Prevention of infectious and viral diseases.
• Timely and comprehensive treatment of various diseases.
• Maintaining the body's defenses at the proper level.
• Don't ignore preventive examinations.
• Avoid contact with radioactive and toxic substances, prolonged exposure to the sun, and reduce the time spent in the solarium.
• If autoimmune thyroiditis is detected during pregnancy, it is necessary to promptly contact a specialist and follow all his instructions to relieve the problem.
• Prevention of sexually transmitted diseases.
• No self-medication.

Forecast

In principle, if the imbalance in the thyroid gland is associated with pregnancy, it is quite possible that after childbirth the hormonal background will normalize, and the problem will resolve itself.

But in some cases the disease becomes chronic, and then the prognosis for the pathology is a lifelong need for maintenance therapy.

Therefore, in light of this clinical development, the attending physician practices monitoring the thyroid gland function, starting from the early stages of pregnancy. Such a patient undergoes a control examination a year after the birth of the child. If the pathological manifestations have gone away, she is removed from the dispensary register, but if not, then she will have to undergo periodic examinations and take courses of hormone replacement drugs for the rest of her life.

If pregnancy is planned or conception has already occurred, negligence in relation to one's health is unacceptable. Autoimmune thyroiditis during pregnancy is not a death sentence, but the problem cannot be ignored either. A full examination, control of TSH in the blood and supportive therapy are what will allow a woman to successfully bear and give birth to a healthy baby. The problem that has arisen can only be solved together with qualified medical personnel. Self-medication is unacceptable here, because it is a threat not only to the health of the woman and the fetus, but also to the outcome of the pregnancy itself!

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ICD-10 code

According to the International Classification of Diseases, Tenth Revision (ICD-10 code), the disease known in medicine as autoimmune thyroiditis has another name - Hashimoto's thyroiditis Hashitoxicosis. This pathology is assigned the code E 06. The only exception is the postpartum manifestation of the disease, designated by the code O 90.5. Within the framework of E 06, differentiation is made by the genesis of the problem:

• E06.1 Subacute thyroiditis.
• E06.2 Chronic thyroiditis with transient thyrotoxicosis.
• E06.3 Autoimmune thyroiditis.
• E06.4 Drug-induced thyroiditis.
• E06.5 Thyroiditis.
• E06.9 Thyroiditis, unspecified

Planning a pregnancy

Any gland works in the body to synthesize the substance necessary for its full functioning. The thyroid gland is an organ of internal secretion, since its product goes not into the external, but into the internal environment, being absorbed into the blood. In case of failure, the body begins to produce antibodies to thyroid peroxidase and thyroglobulin, which gradually leads to the destruction of thyroid cells.

If a woman has already had to face this problem and is planning a pregnancy, the expectant mother begins to show increased anxiety, which is understandable. And the first thing she is interested in is how the disease will affect the course of pregnancy, the health of her and the future baby?

It is worth noting that the pathology in question is not an obstacle to conception if the disease occurs without a decrease in the hormonal level in the blood. The woman feels only slight discomfort. In such a situation, the pathology can be detected accidentally during a full examination, which the woman undergoes when she registers with the antenatal clinic.

Statistics show that one in five patients diagnosed with autoimmune thyroiditis still have a hormone deficiency. In this situation, conception is problematic, but can still happen if the patient receives effective replacement therapy.

At the same time, the attending physician must remember that the pregnant woman’s body’s need for thyroid products grows, increasing by forty percent, which should invariably be reflected in the doses of the medications taken.

It is worth advising women who are planning a pregnancy to undergo a full examination of the body before conception, especially if there are any prerequisites for this. In particular, a consultation with an endocrinologist is necessary. If necessary, he will conduct an additional examination and prescribe adequate replacement therapy. In no case should you resort to uncontrolled drug intake or self-medication with folk remedies.