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Screening for Thyroid Disorders Before Pregnancy

The Thyroid Foundation of Canada recommends all women get screened for thyroid disorders BEFORE pregnancy.  I agree for a whole lot of reasons besides just overall health and symptom relief – here are some of the pregnancy-specific reasons I would INSIST on proper thyroid screening before pregnancy:

1) thyroid disorders can become exacerbated during pregnancy

2) miscarriage and infertility have been linked to thyroid disorders

3) the developing baby relies solely on the mother’s thyroid function for the first 10 – 12 weeks when it begins to produce it’s own thyroid hormone

3) thyroid-autism connection – yes I’ve been reading a lot lately about this possible connection.  The rates of autism are sky-rocketing and some researchers are questioning whether maternal thyroid disorders could be playing a role.  Dr. Raphael Kellman’s article is a good place to start if you want to learn more.

4) pregnancy-induced hypertension

5) preterm delivery

6) placental abruption

In North America there is no such thing as universal screening for pregnant mothers – in fact it’s controversial partially due to whether it’s cost effective, also a suggestion that concern over malpractice could also be at play, and some say that there’s not enough research to support universal screening.

 This NEEDS to change!

In the meantime – ADVOCATE for yourself & INSIST on screening.  If your doctor says no then be prepared to tell him/her about your research:

  • Take a list of the possible outcomes of not treating thyroid disorders in pregnancy that I mentioned above to your doctor’s appointment
  • Learn about the 300+ symptoms.
  • Tell your doctor that American Academy of Clinical Endocrinologists and National Academy of Clinical Biochemistry (NACB) endorsed universal screening of pregnant women for thyroid dysfunction.
  • Ask your doctor if he or she is aware of the Endocrine Society’s new guidelines as of August, 2012 There’s a good chance that your doctor isn’t aware of this.  The Endocrine Society admits that they can’t come to a consensus about pre-pregnancy or prenatal screening for thyroid disorders and came out with this written release:

 “The committee did not reach a consensus on screening recommendations for all newly pregnant women. “Some members recommend screening of all pregnant women for serum TSH abnormalities by the ninth week or at the time of their first visit. Other members recommend neither for nor against universal screening of pregnant women at the time of their first visit and support aggressive case finding to identify and test high-risk women. In some situations, ascertainment of an individual’s risk status may not be feasible and in such cases, testing of all women by 9 weeks of pregnancy or at the first prenatal visit is reasonable.”

It’s your body – It’s your baby!

Both Dr. Norman Wong from University of Calgary and Dr. Richard Lewanczuk, an Endocrinologist from the University of Alberta were interviewed and stated that they believe ALL women should be screened before pregnancy.

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  1. Dana Trentini

    Excellent article Sonya! Bravo to Canada for thyroid testing prior to pregnancy Bravo! All countries of the world should do the same. I am determined to make that happen with my blog Hypothyroid Mom!

    1. Sonya

      Thanks Dana – unfortunately it may sound better than it is – while the Thyroid Foundation of Canada may support thyroid testing for women but that doesn’t mean it’s being done, as I know you are well aware. 79% of women were not told by their doctors about their thyroid health while they were pregnant & only 15% had any thyroid testing done. We have such a long way to go. I believe we will get there – especially with you reaching out to women on your wonderful blog http://www.hypothyroidmom.com

      Here’s a link to an article you may find interesting: http://www.lfpress.com/life/healthandfitness/2012/03/01/19445926.html

  2. Dana Trentini

    Of course I wish that thyroid testing was MANDATORY before pregnancy and not just recommended and I hope to see the day that happens! Great article.

    1. Sonya

      I wish it was mandatory before pregnancy too! One of the challenges is that not everyone visits their doctor before they decide to get pregnant. But because the first 10 – 12 weeks are so crucial it is important. I think a major education campaign is key. Most doctors don’t tell their patients – even their thyroid patients – how important thyroid hormones are in pregnancy!

  3. Courtney Rundell

    Woot woot! Canada is so progressive. Although it does seem they are just checking TSH & they need to run the full panel…

    1. Sonya

      Check out my comment to Dana. It’s still just a recommendation by an association but at least they’re putting it out there right. And I too, doubt that the full thyroid panel is being done. It’s why I believe so strongly in being an e-Patient – empowerment changes outcomes!

  4. Courtney Rundell

    And now I’m thinking I should get my son’s thyroid levels tested. My thyroid wasn’t even close to optimum levels when I was pregnant and they knew I had Hashi’s. thyroid treatment must be improved!

    1. Sonya

      You’re so right – Thyroid Treatment MUST be improved! It is likely that your son’s TSH was tested at birth. You know the heel prick blood test that they do on newborn babies? One of the things they are screening for in Canada and the US is congenital thyroid disorder. It’s probably only TSH tested and we as mothers are not really given the information or test results are we? If you talk with your son’s pediatrician/doctor to see what tests they did – let me know what you find out – I’d be curious to know. I’m researching thyroid disorders in children.

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