Balancing and Navigating Thyroid Imbalance During Pregnancy

Pregnancy is a challenging time for women that causes significant changes in their bodies. Among the many changes is the fluctuation in hormone levels. The thyroid is a butterfly-shaped gland located at the base of the neck that produces thyroid-stimulating hormone (TSH).

Thyroid hormones control how your body uses energy, affecting how nearly every organ in your body works—even how your heart beats. Due to the increased demand for this hormone by both the mother and baby during pregnancy, it leads to the overproduction or underproduction of TSH, called gestational thyroid imbalance.

Types of Thyroid Imbalance

This overproduction and underproduction of TSH hormones is called Hyperthyroidism and Hypothyroidism.

  • Hyperthyroidism: Hyperthyroidism is an overactive thyroid gland that produces too much thyroid hormone.
  • Hypothyroidism: Hypothyroidism occurs when the thyroid gland is underactive and produces too little thyroid hormone.

Both hyperthyroidism and hypothyroidism can have significant health impacts if not appropriately managed. Pregnant women with thyroid disorders need to receive regular medical attention to manage their hormones.

Diagnosis and Symptoms of Gestational Thyroid Imbalance

Your healthcare provider conducts a physical exam and a blood test to check for thyroid conditions. The blood test measures the levels of thyroid hormones and thyroid-stimulating hormone (TSH) in your body. TSH is a hormone that signals your thyroid gland to produce thyroid hormones.

Some of the common symptoms of Gestational thyroid imbalance are:

  • Hoarse voice
  • Low tolerance to cold temperatures
  • Dry skin and hair
  • Carpal tunnel syndrome
  • Fatigue

Sometimes, these symptoms overlap with typical pregnancy symptoms, so detecting them as early as possible is vital. Additional signs to watch for are:

  • Weight gain
  • Constipation
  • Muscle weakness

Risks of Hypothyroidism and Hyperthyroidism to the mother

  • Mild hypothyroidism in most expecting mothers might be unaffected and have no symptoms at the onset of pregnancy. If left undiagnosed, severe hypothyroidism can lead to anaemia, lack of thyroid function, risks of miscarriages, stillbirth or preterm birth, underweight babies and other significant concerns due to this condition.
  • Hyperthyroidism in pregnancy may be present initially but might be diagnosed later, around the second trimester. Inadequately treated hyperthyroidism leads to premature labour and preeclampsia.

Risks of maternal Hypothyroidism and Hyperthyroidism to the baby

Thyroid hormones are an integral source for the overall development of a growing fetus. It mainly facilitates the development of the brain and the spinal cord. Hypothyroidism and hyperthyroidism must be diagnosed early in your pregnancy, and once diagnosed, it is crucial to follow the treatment plan and medication suggested by your endocrinologist.

Treatment and Prevention

  • Medical Care: Your obstetrician will refer you to an endocrinologist, who will recommend supplements or medications, treatment plans, and regular follow-ups.
  • Dietary recommendations: Your doctor will advise you on specific dietary changes. It is essential to eat a variety of nutritious foods and stay well-hydrated. Regular physical activity and proper meal planning can also support your thyroid health.

Postpartum

Postpartum thyroid hormone levels tend to fluctuate and might worsen later, usually three months after the birth of your baby, due to discontinued prescribed thyroid supplementation and neglect in monitoring thyroid function. Hence, your endocrinologist will advise a high dosage of thyroid medications or supplements and serum TSH tests in such cases.

Regular monitoring and treatment, guided by an endocrinologist, are essential to ensure a healthy pregnancy and postpartum period. With proper care, women with gestational thyroid imbalances can effectively support their health and the development of their growing baby.

Safe Eats for Mom-to-Be:
Eating Out During Pregnancy

Craving a plate of steaming Pad Thai or a juicy Paneer Burger during pregnancy? Don’t put those cravings on hold! With a little preparation and some smart choices, venturing out to your favourite restaurants can be a delightful and satisfying dining experience for both you and your growing baby.

husband feeding pregnant wife

Many women crave restaurant meals during pregnancy, but concerns about food safety can dampen those desires. The good news is that with a little planning and awareness, enjoying a night out doesn’t have to be risky. Here’s how to navigate restaurant menus and buffets while keeping you and your baby healthy.

Choosing the Right Restaurant

Look for Certifications: Opt for restaurants with certifications from local health authorities and good online reviews regarding cleanliness.

Freshness is Key: Order dishes made to order and served hot. Avoid buffets where food may have been sitting out for extended periods.

Making Savvy Menu Choices

Cooked Foods: Order dishes that are freshly cooked and served hot. Avoid raw or undercooked meats, seafood, and eggs, as they may contain harmful bacteria and parasites.

Fruits and Vegetables: Avoid pre-cut raw fruits and vegetables unless you wash and peel them yourself or you trust the restaurant’s hygiene standards. Opt for cooked vegetables instead.

Dairy Products: Ensure all dairy products, including milk, cheese, and yoghurt, are pasteurised. Unpasteurised products can carry harmful bacteria like Listeria.

Seafood: Avoid raw seafood like sushi and sashimi. Ensure all seafood is well-cooked to avoid bacterial contamination. Be cautious with shellfish as they are prone to toxins and bacteria.

Avoid Pre-Packaged Salads

Avoid pre-packaged salads from stores or buffets. They may have been sitting out for a long time and are more prone to bacterial contamination.

Avoid salads with unpasteurised cheese (such as feta, Brie, Camembert, and blue cheese) and dressings made with raw eggs or unpasteurised milk.

Avoid salads containing processed meats, such as deli meats, hot dogs, and smoked seafood, which can harbour Listeria.

Homemade Salads: Prefer salads made at home where you can control the washing and preparation process. If making dressings at home, use pasteurised eggs or avoid raw eggs altogether. Consider using vinegar or lemon juice-based dressings, which are safer options.

Temperature Control: Keep salads cold until ready to be eaten. If transporting salads, use ice packs or a cooler.

Women eating

Water and Beverages

Water: Drink only bottled water with intact seals or boiled water.

Ice: Avoid ice in drinks, as it may be made from unfiltered water. Opt for beverages served without ice or ensure the ice is made from safe, filtered water.

Beverages: Avoid unpasteurised juices and beverages.

Handling Buffets

Freshness: Ensure buffet items are freshly prepared and not left out for extended periods. Hot items should be steaming, and cold items should be properly refrigerated.

Serving Utensils: Use the serving utensils provided and avoid cross-contamination between different dishes.

group of women eating

General Precautions

Hand Hygiene: Wash hands thoroughly with soap and water before eating. If soap and water are not available, use a hand sanitiser containing at least 60% alcohol.

Food Temperature: Consume food while it is still hot. Avoid food that has been left out at room temperature for more than two hours.

Street Food: Street food often lacks proper hygiene standards and poses a higher risk of contamination. When eating outside, avoid all raw foods or drinks (like pani puri water, jal jeera, sugarcane juice, sprouts, etc.). Also, avoid eating and drinking from roadside stalls.

Prefer to have your favourite chats made at home.

Leftovers at home

Avoid eating leftovers, especially if they have not been stored and reheated properly. Maintaining the right food temperature during pregnancy is crucial to preventing foodborne illnesses –

Hot Foods: hot foods at 60°C (140°F) or above to prevent bacterial growth.

Cold foods: Keep cold foods at 4°C (40°F) or below.

Ask About Food Preparation: When in doubt, ask restaurant staff about how food is prepared and stored.

Seek out restaurants that display certifications from local health authorities. This signifies their commitment to food safety protocols.

By following these simple yet effective tips, you can transform your next restaurant outing into a delightful and safe experience. Remember, a healthy and happy mom-to-be translates into a healthy and happy baby! So, go forth, explore new culinary delights, and embrace the joys of dining out during your pregnancy journey!

Dr Latha Sashi
Chief Nutritionist & Head,

Dept of Clinical Nutrition & Dietetics, Fernandez Hospital