Pregnancy and Thyroid Disease: How to Support Your Health and Your Baby's

headshot of Dr. Linda Khoshaba on a white background

Dr. Khoshaba

September 5, 2023

Bringing a new life into the world is remarkable, but pregnancy poses unique challenges for expectant mothers with thyroid disease. So, what's the relationship between pregnancy and thyroid disease? This blog post will explore the importance of managing thyroid disease during pregnancy and discuss practical ways to support your health and your baby's development. From medication management to self-care strategies, Natural Endocrinology Specialists™ will help you explore the steps to navigate your journey successfully.

Pregnancy and Thyroid Disease

The thyroid gland helps regulate various bodily functions, including the development of the baby's brain and nervous system. Ensuring optimal thyroid function during pregnancy is very important for the well-being of both the mother and the baby. We will begin by first defining what thyroid disease is.

What is thyroid disease?

A model of a thyroid gland on a hand to illustrate Pregnacy and thyroid disease
The thyroid gland

Thyroid disease refers to a group of medical conditions that affect the thyroid gland, a small butterfly-shaped gland located in the front of the neck. The thyroid gland plays a role in regulating various bodily functions by producing and releasing thyroid hormones.

The most common types of thyroid diseases include:

  • Hypothyroidism: This condition occurs when the thyroid gland does not produce enough thyroid hormones, resulting in a slower metabolic rate.
  • Hyperthyroidism: In contrast to hypothyroidism, hyperthyroidism refers to an overactive thyroid gland that produces an excess of thyroid hormones.
  • Thyroid nodules: These are abnormal growths or lumps that form within the thyroid gland. Most thyroid nodules are benign (noncancerous) and do not cause significant symptoms. However, in some cases, they can be cancerous or affect thyroid hormone production.
  • Thyroiditis: This condition involves inflammation of the thyroid gland, which an autoimmune response, infection, or certain medications can cause. Thyroiditis may cause temporary hyperthyroidism followed by hypothyroidism or persistent thyroid dysfunction.

Thyroid cancer: Although relatively rare, thyroid cancer can develop within the cells of the thyroid gland. It may present as a lump or nodule in the neck and can be detected through imaging tests or a biopsy.

How does thyroid disease affect pregnancy?

Thyroid disease can have various effects on pregnancy and maternal health. The thyroid gland maintains hormonal balance, which is particularly important during pregnancy for the proper development of the fetus. Here's how thyroid disease can impact pregnancy:

  • Hypothyroidism: If hypothyroidism is left untreated or poorly controlled during pregnancy, it can increase the risk of complications such as miscarriage, preeclampsia (high blood pressure during pregnancy), anemia, preterm birth, and low birth weight. It may also affect the baby's brain development and cognitive function.
  • Hyperthyroidism: Uncontrolled hyperthyroidism during pregnancy can lead to an increased risk of miscarriage, preterm birth, preeclampsia, and fetal thyroid dysfunction. In some cases, hyperthyroidism may be caused by Graves' disease, an autoimmune condition affecting the baby's thyroid gland.
  • Thyroid nodules and cancer: Most thyroid nodules and thyroid cancers do not directly impact pregnancy. However, if a nodule or tumor grows significantly, it can cause compression of the surrounding structures, leading to breathing difficulties or swallowing problems.
  • Postpartum thyroiditis: Some women may develop thyroid dysfunction after giving birth, known as postpartum thyroiditis. It involves a temporary phase of hyperthyroidism followed by hypothyroidism. It can cause fatigue, mood changes, and difficulty caring for the baby.

What Are the Signs and Symptoms of Thyroid Disease?

An illustration showing signs and symptoms of thyroid disease

Thyroid disease can manifest in various ways, and the signs and symptoms can differ depending on whether the condition is hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid).

Only some people with thyroid disease will experience all the symptoms below, and the severity can vary from person to person. Additionally, some symptoms, such as fatigue or weight changes, can occur in both hypothyroidism and hyperthyroidism but may be more pronounced in one condition than the other.

Here are the common signs and symptoms associated with each:


  • Fatigue and weakness
  • Weight gain or difficulty losing weight
  • Sensitivity to cold
  • Constipation
  • Dry skin and hair
  • Hair loss
  • Muscle aches and stiffness
  • Depression or mood swings
  • Memory problems or difficulty concentrating
  • Menstrual irregularities or heavy periods
  • Hoarse voice
  • Swelling of the face, hands, or legs (edema)
  • Elevated cholesterol levels


  • Rapid or irregular heartbeat (palpitations)
  • Unexplained weight loss or increased appetite
  • Nervousness, anxiety, or irritability
  • Tremors or shaky hands
  • Heat intolerance and increased sweating
  • Fatigue or muscle weakness
  • Difficulty sleeping (insomnia)
  • Changes in menstrual patterns
  • Frequent bowel movements or diarrhea
  • Bulging eyes (in Graves' disease)
  • Swelling in the neck (enlarged thyroid gland or goiter)
  • Skin thinning or itchiness

How Is Thyroid Disease Diagnosed?

An illustration explaining how thyroid disease is diagnosed for  Pregnacy and thyroid disease
How Thyroid Disease is Diagnosed

Thyroid disease is diagnosed through medical history evaluation, physical examination, and specific diagnostic tests. Here are the common methods used for diagnosing thyroid disease:

Medical history and physical examination

Your healthcare provider will start by discussing your symptoms, medical history, and family history of thyroid disease. They will also perform a physical examination, checking for signs such as an enlarged thyroid gland (goiter), nodules, or other abnormalities.

Blood tests

Thyroid function tests are commonly used to evaluate the levels of thyroid hormones in the blood. These tests typically include:

  • Thyroid-stimulating hormone (TSH) test: TSH is a hormone produced by the pituitary gland that stimulates the thyroid gland to produce thyroid hormones. Abnormal TSH levels can indicate hypothyroidism or hyperthyroidism.
  • Free thyroxine (T4) test: T4 is the primary thyroid hormone produced by the thyroid gland. Abnormal levels can indicate thyroid dysfunction.
  • Triiodothyronine (T3) test: T3 is another thyroid hormone, but it is mostly derived from the conversion of T4 in peripheral tissues. It may be measured in certain cases to assess thyroid function.

Imaging tests

In some cases, imaging studies are used to evaluate the structure and size of the thyroid gland or to detect the presence of nodules or tumors. Common imaging tests include:

  • Thyroid ultrasound: Using advanced technology, the process of transforming an image to video has become increasingly efficient, allowing for dynamic presentations of medical findings such as thyroid nodules, their size, and characteristics captured through non-invasive tests utilizing sound waves. This non-invasive test uses sound waves to create images of the thyroid gland and can help identify nodules, their size, and characteristics.
  • Thyroid scan (aka Thyroid Scintigraphy): A thyroid scan involves a radioactive tracer taken up by the thyroid gland. It can provide information about the overall function and activity of the gland.
  •  Fine-needle aspiration (FNA) biopsy: If a thyroid nodule is found, your healthcare provider may recommend an FNA biopsy. This procedure involves using a thin needle to extract a small tissue sample from the nodule, which is then examined under a microscope to determine if it is benign or cancerous.

The Importance of Managing Thyroid Disease During Pregnancy

An illustration showing how Living With Thyroid Disease During Pregnancy can be done

Managing thyroid disease during pregnancy is crucial for both the mother's well-being and the baby's healthy development. Here's why:

  • Effects on baby's development: Thyroid hormones play a vital role in the development of the baby's brain and nervous system, especially during the first trimester. Untreated or poorly managed thyroid disease can increase the risk of developmental issues, intellectual impairment, and low IQ in the baby.
  • Risk of pregnancy complications: Thyroid disease, if uncontrolled, can contribute to several pregnancy complications such as preeclampsia (high blood pressure), gestational diabetes, preterm birth, and low birth weight. These conditions can impact the baby's health and increase the risk of long-term health issues.
  •  Maternal health risks: Untreated thyroid disease during pregnancy can pose risks to the mother's health. For example, uncontrolled hyperthyroidism increases the risk of maternal heart problems, while severe hypothyroidism can lead to an increased risk of anemia and postpartum hemorrhage.

To manage thyroid disease effectively during pregnancy, consider the following:

  • Consult your healthcare provider: If you have a known thyroid condition or suspect you may have thyroid disease, inform your healthcare provider as soon as possible. They will monitor your thyroid levels and adjust treatment as needed.
  •  Medication adherence: It's essential to take your thyroid medication as prescribed by your healthcare provider. Medication helps maintain stable thyroid hormone levels, which are crucial for your well-being and your baby's development.
  • Regular checkups: Attend regular prenatal checkups throughout your pregnancy. These visits allow your healthcare provider to monitor your thyroid hormone levels, adjust medication if necessary, and assess the overall health of you and your baby.
  • Collaborative care: Your healthcare team may include an endocrinologist, obstetrician, and other specialists as needed. Collaborative care ensures that all aspects of your thyroid disease and pregnancy are properly managed.
  • Communication with your healthcare provider: Inform your healthcare provider about any changes in symptoms or concerns you may have. They can address your questions, provide guidance, and make any necessary adjustments to your treatment plan.

Treatment Options for Thyroid Disease During Pregnancy

pregnancy and thyroid disease
Thyroid disease

During pregnancy, the treatment options for thyroid disease aim to maintain thyroid hormone levels within the normal range while considering the safety of the developing baby.

It's important to note that the specific treatment approach will depend on the type and severity of thyroid disease, as well as the individual's unique circumstances.

Healthcare providers with expertise in managing thyroid conditions during pregnancy will guide treatment decisions and closely monitor thyroid hormone levels to ensure the best outcomes for both the mother and the baby. Here are the commonly used treatment options for thyroid disease during pregnancy:

Levothyroxine (Synthroid)

This medication is a synthetic form of the thyroid hormone T4 and is the standard treatment for hypothyroidism during pregnancy. It helps to restore and maintain normal thyroid hormone levels.

The dosage may need to be adjusted during pregnancy, and regular monitoring of thyroid hormone levels is necessary to ensure optimal thyroid function.

Anti-thyroid medications (Propylthiouracil or Methimazole)

These medications are used to treat hyperthyroidism during pregnancy. They work by reducing the production of thyroid hormones. 

Propylthiouracil (PTU) is typically preferred during the first trimester due to a lower risk of congenital disabilities, while Methimazole may be used in the later stages of pregnancy. Close monitoring of thyroid hormone levels and liver function is necessary when taking these medications.


In rare cases where hyperthyroidism does not respond to medication or is severe, a thyroidectomy (surgical removal of the thyroid gland) may be considered during pregnancy.

This option is generally reserved for cases where other treatments are ineffective or contraindicated. Surgery is typically delayed until the second trimester when the risk to the developing baby is reduced.

Living With Thyroid Disease During Pregnancy

An illustration showing how Living With Thyroid Disease During Pregnancy can be done

Living with thyroid disease during pregnancy can present unique challenges, but with proper management and support, it is possible to have a healthy pregnancy.

Remember, every pregnancy and every individual's experience with thyroid disease is unique. What works for one person may not work for another.

Focus on maintaining good communication with your healthcare provider, adhering to your treatment plan, and seeking support when needed. With proper management and support, you can navigate pregnancy while effectively managing your thyroid disease.

Here are some considerations and strategies to help you navigate this experience:

Pregnancy expectations

Pregnancy itself can impact thyroid hormone levels, so it's important to monitor your thyroid function closely. Your healthcare provider will regularly check your hormone levels and adjust your medication dosage as needed.

Be prepared for more frequent blood tests and checkups compared to pregnancy without thyroid disease.

Symptom management

Some symptoms of thyroid disease, such as fatigue, mood swings, and weight changes, can overlap with normal pregnancy symptoms. Properly managing your thyroid condition can help alleviate these symptoms.

Follow your healthcare provider's recommendations for medication adherence and communicate any changes in symptoms promptly.

Communication with your healthcare provider

Maintain open and honest communication with your healthcare provider. Discuss any concerns or changes in symptoms, and don't hesitate to ask questions.

Your healthcare team is there to support you throughout your pregnancy and can provide guidance and reassurance.

Seek emotional support

Dealing with thyroid disease and pregnancy can be emotionally challenging. Reach out to your partner, family, or friends for support.

You may also consider joining support groups or seeking counseling services to help cope with the stress and emotions associated with the condition.


Prioritize self-care during pregnancy. Get enough rest, eat a balanced diet, engage in gentle exercise if approved by your healthcare provider, and practice stress management techniques like relaxation exercises or prenatal yoga.

Taking care of your physical and mental well-being can help alleviate some of the stress associated with thyroid disease.

Educate yourself

Learn more about your condition and how it may affect pregnancy. Understanding the impact of thyroid disease can empower you to participate in your treatment and make informed decisions actively.

Reliable sources of information include reputable medical websites, books, and discussions with your healthcare provider.

Does Fasting Hurt Your Thyroid?

Fasting, especially prolonged or extreme fasting, can potentially have negative effects on thyroid health.

It is recommended to consult with healthcare professionals, like Natural Endocrinology Specialists™, to determine the best approach for managing thyroid disease during pregnancy.

We will provide valuable insights on incorporating a balanced and nourishing diet that supports thyroid function while considering any specific dietary restrictions or requirements. Prioritizing thyroid health through proper nutrition is essential for optimal outcomes.

How to take care of your thyroid during pregnancy

Take the first step towards getting your thyroid back on track:

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Dr. Linda Khoshaba is the Leading Integrative Health and Hormone Doctor in Scottsdale, Arizona. She has extensive experience working in the field as a Hormone Specialist and Natural Endocrinologist.

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