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During pregnancy, immunologic suppression occurs which induces tolerance to the presence of the fetus. [5] Without this suppression, the fetus would be rejected causing miscarriage. [ 5 ] As a result, following delivery, the immune system rebounds causing levels of thyroids antibodies to rise in susceptible women.
Thyroid hormone concentrations in blood are increased in pregnancy, partly due to the high levels of estrogen and due to the weak thyroid stimulating effects of human chorionic gonadotropin (hCG) that acts like TSH. Thyroxine (T4) levels rise from about 6–12 weeks, and peak by mid-gestation; reverse changes are seen with TSH.
Both NTIS and primary hypothyroidism may have reduced fT3 and fT4, and elevated TSH (which is common in the hospital, during the recovery phase of NTIS). [2] Prescribing thyroxine to treat this may lead to lifelong thyroid overtreatment. [2] Hyperthyroidism may be assumed due to decreased TSH and a transient fT4 increase.
The most useful marker of thyroid gland function is serum thyroid-stimulating hormone (TSH) levels. TSH levels are determined by a classic negative feedback system in which high levels of T3 and T4 suppress the production of TSH, and low levels of T3 and T4 increase the production of TSH. TSH levels are thus often used by doctors as a screening ...
The target level for TSH is the subject of debate, with factors like age, sex, individual needs and special circumstances such as pregnancy being considered. [79] Recent studies suggest that adjusting therapy based on thyroid hormone levels (T 4 and/or T 3 ) may be important.
Subclinical hypothyroidism, a milder form of hypothyroidism characterized by normal thyroxine levels and an elevated TSH level, is thought to occur in 4.3–8.5% of people in the United States. [8] Subclinical hypothyroidism has been associated with an increased risk of atrial fibrillation (AF) and is the most frequent thyroid abnormality in ...
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. [2] Gestational diabetes generally results in few symptoms ; [ 2 ] however, obesity increases the rate of pre-eclampsia, cesarean sections, and embryo macrosomia, as well as gestational diabetes. [ 2 ]
The negative effects of pregestational diabetes are due to high blood sugar and insulin levels primarily during the first trimester of pregnancy (in contrast to gestational diabetes, which can lead to fetal complications during the second and third trimester). Since this period is when many of the major internal structures and organs of the ...