DISCLAIMER: The following post outlines the writer’s personal journey with Graves disease + her thyroid. It is not intended to act as medical advice. As always, please consult your doctor with any questions about your thyroid and/or thyroid diseases.

When I was nearly ten weeks pregnant with my first child, my husband and I received an alarming call from an endocrinologist, a specialist doctor I had never met or thought I would need to meet. My OB/GYN had been very concerned with my routine prenatal blood work and had reached out for her expert opinion.

My thyroid levels were dangerously high. So high, in fact, that they were worried about me going into cardiac arrest and possibly losing the pregnancy. We drove over four hours from the vacation home we were staying at in upper Michigan to a Metro Detroit hospital emergency room, where I was immediately assessed.  

My pregnancy, and every day after that, would never be the same. I was diagnosed with Graves disease, a thyroid condition. It had gone undiagnosed during my first pregnancy and is believed to have caused my miscarriage. At that point, it was inflicting a host of symptoms my previous OB/GYN had initially dismissed. I was treated and, after giving birth, had my thyroid removed so that it wouldn’t go haywire during subsequent pregnancies. 

Thyroid Awareness Month happens every January. But it often doesn’t get as much attention as other awareness months, and many continue to be unaware of the statistics. Women are at higher risk for thyroid issues than men, with one in eight women developing problems during their lifetime, according to the Office on Women’s Health. Still, testing isn’t always routine during pregnancy, postpartum, or beyond. 

What is your thyroid?

According to the Cleveland Clinic, the thyroid is a butterfly-shaped gland in the base of your neck that regulates a host of bodily functions–namely, metabolism and growth, through hormone secretion. On a smaller level, it helps control your heart rate, promotes digestion, and keeps your bones healthy and strong. To keep your body running smoothly, your thyroid hormone releases two important hormones–Triiodothyronine (T3) and Thyroxine (T4). How much of each hormone is released depends on the thyroid-stimulating hormone (TSH) secreted from the pituitary gland. You would be correct if you think it sounds like a delicate balancing act! 

Too much or too little thyroid hormones can significantly impact the body.

What thyroid conditions can affect women?

In general, most women are affected by hyperthyroidism or hypothyroidism. These are umbrella terms that can occur due to other thyroid-related conditions, like Graves disease or Hashimoto’s thyroiditis. 

Hyperthyroidism

Hyperthyroidism, according to the Mayo Clinic, is when too much thyroid hormone is secreted. Too much T4 and T3 and too little TSH usually indicate an overactive thyroid. These hormones can cause your body to burn through energy very quickly. As a result, you may experience:

• Fatigue
• Constant hunger
• Anxiety 
• Hand tremors
• Hair loss
• Inability to concentrate
• Trouble sleeping
• Heat intolerance
• Increased sweating
• Restlessness 
• Weight loss
• Flushed skin or a rash
• Irregular menstrual periods 
• Goiter (a swollen thyroid gland that protrudes from the neck) 

If not treated, a thyroid crisis could occur, in which an abnormal heart rate could lead to heart failure. Prolonged hyperthyroidism can also lead to weak bones (osteoporosis). Graves disease, a hereditary autoimmune disease, is the most common cause. 

Hypothyroidism

Hypothyroidism, according to the Mayo Clinic, is the opposite, in which too little thyroid hormone is produced. An underactive thyroid means your body can’t receive the energy it needs, caused by your metabolism and digestive processes slowing down. 

Symptoms can include: 

• Fatigue
• Feeling cold all the time
• Weight gain
• Thinning hair
• Dry skin
• Joint and muscle pain
• Depression
• Slow heart rate
• Difficulty conceiving 
• Heavy and irregular menstrual periods 

If not treated, it can lead to dangerous conditions, such as heart disease or nerve damage. Hashimoto’s disease, an autoimmune condition, is the most common cause. 

Thyroid Conditions + Womanhood

Thyroid conditions aren’t always extreme, and their side effects can make them easily misdiagnosed. Symptoms like brain fog or irregular menstrual cycles could have various other causes, like menopause or the chaotic experience of postpartum. Therefore, blood tests of all three hormone levels (T3, T4, and TSH) can go a long way in finding out whether or not your thyroid is to blame. For women, getting your thyroid levels checked can be very important. 

Thyroid problems can affect menstruation, causing cycle irregularity and very heavy or light periods. If a woman is trying to conceive, thyroid conditions can make it extremely difficult. According to the National Library of Medicine, thyroid hormones may be a cause of anovulation (when ovulation doesn’t occur at all). Additionally, those with hypothyroidism may be more at risk of developing cysts on their ovaries, reports the National Institute on Health. 

When pregnancy occurs, the mother’s thyroid hormones support the baby for the first few months. If her body is producing too little or too much thyroid hormone, there can be negative effects for both the mom and her baby, such as miscarriage, preterm labor, or stillbirth. Even women who are post-childbearing age can feel the effects of an abnormally functioning thyroid. They might struggle to lose weight, experience hair loss, have trouble concentrating, or have difficulty sleeping–all symptoms that can be attributed to motherhood in general when you’re just trying to survive raising little ones while juggling everything else! 

As a woman ages, thyroid issues could trigger early-onset menopause. If hyperthyroidism is not addressed, it could exacerbate problems that affect older women, like osteoporosis. 

Should you get your thyroid checked?

Typically, thyroid labs aren’t completed unless a woman has a family history of thyroid conditions or reports symptoms. Even in pregnancy, thyroid hormone levels may not be a part of prenatal screening. The March of Dimes states that most providers don’t check thyroid levels during prenatal or postnatal health visits unless there is an indication to do so; however, as many as 21 in 100 women can develop postpartum thyroiditis in which they become hypothyroid or hyperthyroid (or even both) in the first year after childbirth. 

Therefore, according to the American Thyroid Association, all adults beginning at age 35 and every five years thereafter should get their thyroid checked. You may not need to request blood labs immediately. However, medical professionals encourage women to monitor themselves for thyroid disorder symptoms. Being conscientious of thyroid symptoms becomes even more important for women who are pregnant or hoping to become pregnant.  

Fortunately, once a thyroid condition is diagnosed, it can often be easily treated. This includes during pregnancy. I was lucky to have an amazing endocrinologist and fetal-maternal medicine team who closely monitored me and my baby. Though I will have to take medication daily for the rest of my life, I credit my endo with preventing another miscarriage and helping me to go on to have three happy and healthy children without complications during or after pregnancy.

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