Risks of thyroid disease for expecting women highlighted

Diseases of the thyroid gland are among the most abundant endocrine disorders worldwide, second only to diabetes. Thyroid diseases have a global prevalence of 5%-10%. In Pakistan, the hypothyroidism and hyperthyroidism prevalence are 4.1% and 5.1%, respectively.

These views and statistics were shared by Prof M. Zaman Shaikh, a consultant diabetologist & endocrinologist and former vice president of the Pakistan Endocrine Society, at a public health awareness seminar held recently in connection of World Thyroid Day 2024.

He explained that the thyroid is a small, butterfly-shaped gland in the front of your neck that makes thyroid hormones. Thyroid hormones control how your body uses energy, so they affect the way nearly every organ in your body works even the way your heart beats. Sometimes the thyroid makes too much or too little of these hormones.

Prof Zaman Shaikh further said that too much thyroid hormone is called hyperthyroidism and can cause many of your body’s functions to speed up. “Hyper” means the thyroid is overactive. Too little thyroid hormone is called hypothyroidism and can cause many of your body’s functions to slow down. “Hypo” means the thyroid is underactive.

Thyroid disease affects women of reproductive age, and when untreated during pregnancy, is associated with an increased risk of miscarriage, placental abruption, hypertensive disorders, and growth restriction, he said.

During the first few months of pregnancy, the fetus relies on the mother for thyroid hormones. Thyroid hormones play an essential part in normal brain development. Deprivation of the maternal thyroid hormone due to hypothyroidism can have irreversible effects on the fetus. Recent studies found that children born to mothers with hypothyroidism during pregnancy had lower IQ and impaired psychomotor (mental and motor) development. If properly controlled, often by increasing the amount of thyroid hormone, women with hypothyroidism can have healthy, unaffected babies, Prof Zaman Shaikh explained at the seminar, which was held in collaboration of Dr Essa Laboratory and Diagnostic Center.

“Current recommendations are to verbally screen all women at the initial prenatal visit for any history of thyroid dysfunction or thyroid hormone medication. Laboratory screening of thyroid functions and or thyroid antibodies should be considered for women at high risk of hypothyroidism. Detection and treatment of maternal hypothyroidism early in pregnancy may prevent the harmful effects of maternal hypothyroidism on the fetus. For women on thyroid hormone prior to conception, thyroid function testing should be performed regularly throughout pregnancy as it is very likely that the thyroid hormone dose will need to be increased. Women are encouraged to ask their gynaecologist for further information and clarification on this important topic,” he added.

“Uncontrolled hyperthyroidism has many effects. It may lead to preterm birth (before 37 weeks of pregnancy) and low birth weight for the baby. Some recent studies have shown an increase in pregnancy-induced hypertension (high blood pressure of pregnancy) in women with hyperthyroidism. A severe, life-threatening form of hyperthyroidism, called thyroid storm, may complicate pregnancy. This is a condition in which there are extremely high levels of thyroid hormone that can cause high fever, dehydration, diarrhea, rapid and irregular heart rate, shock and death, if not treated,” Prof. Zaman Shaikh said.

Prof. Nadia Athar, consultant physician at Sir Syed College of Medical Sciences, also spoke at the seminar. She said: “Do you have tremors, sudden weight loss or weight gain, feel bloated pretty often or have been finding it difficult to concentrate lately? Although these can be symptoms for various other conditions, these five are also indicative of thyroid disease. Hence, it is best to go for a checkup and see if you have thyroid diseases.”

She further said: “It is important to lead an active lifestyle and eat a balanced diet as the thyroid gland can affect almost every cell present in our body. They help in converting the carbohydrates, protein and fat into energy.”

“A thyroid patient needs to have proteins of high biological value like eggs, chicken, fish, milk, curd, paneer and dals. Some studies have shown that a high protein diet helps to better managehv thyroid. One should also eat diet rich in omega 3 fatty acids like nuts (almonds, walnuts), chia seeds, flax seeds and olive oil,” said Prof. Nadia Ather.

She said that all vegetables are fine including the cruciferous vegetables like cabbage, cauliflower, broccoli and Brussels sprouts, as long as they are cooked. The cooking process inactivates the goitrogens present in them which are known to be harmful for the thyroid gland. These vegetables should be eaten in moderation.

“Caffeinated drinks like tea, coffee and green tea may irritate your gland so they should be consumed in restricted amounts. Exercise reduces stress as the thyroid problem is accompanied with anxiety and depression and hence regular exercise is essential if one wants to remain in a good mood,” advised Prof. Nadia.