Articles on thyroid disease in pregnancy

Thyroid and Pregnancy: Do I Need to Check

Dr. Priyanka Mehta, General Surgeon
What is the thyroid gland?The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.What are the normal changes in thyroid function associated with pregnancy?The thyroid gland can increase in size during pregnancy called goiter especially in iodine-deficient areas of the world like India.What is the interaction between the thyroid function of the mother and the baby?For the first 10-12 weeks of pregnancy, the baby is completely dependent on the mother for the production of thyroid hormone most crucial time of development. The World Health Organization recommends iodine intake of 200 micrograms/day during pregnancy to maintain adequate thyroid hormone production. What are the risks of hypothyroidism to the mother? Untreated, or inadequately treated, hypothyroidism has been associated with maternal anemia (low red blood cell count),muscle pain, weakness, heart failure, high blood pressure, placental abnormalities, low birth weight infants , heavy bleeding after deliveryWhat are the risks of maternal hypothyroidism to the baby? Thyroid hormone is critical for brain development in the baby. Children born with hypothyroidism (no thyroid function at birth) can have severe cognitive, neurological and developmental abnormalities if the condition is not recognized and treated promptly. These developmental abnormalities can largely be prevented if the disease is recognized and treated immediately after birth.It is vital to check a woman’s TSH value either before becoming pregnant (pre-pregnancy counseling) or as soon as pregnancy is confirmed. This is especially true in women at high risk for thyroid disease, such as those with prior treatment for hyperthyroidism, a positive family history of thyroid disease and those with a goiter.Clearly, woman with established hypothyroidism should have a TSH test once pregnancy is confirmed, as thyroid hormone requirements increase during pregnancy, often leading to the need to increase the levothyroxine dose. If the TSH is normal, no further monitoring is typically required. Its better to discuss with your doctor.How should a woman with hypothyroidism be treated during pregnancy? The treatment of hypothyroidism in a pregnant woman is adequate replacement of thyroid hormone in the form of thyroxine tablets.It is important to note that thyroxine requirements frequently increase during pregnancy, often times by 25 to 50 percent. Ideally, hypothyroid women should have their levothyroxine dose optimized prior to becoming pregnant. Women with known hypothyroidism should have their thyroid function tested as soon as pregnancy is detected and their dose adjusted by their physician as needed to maintain a TSH in the normal range.Thyroid function tests should be checked approximately every 6-8 weeks during pregnancy to ensure that the woman has normal thyroid function throughout pregnancy.It is also important to recognize that iron and calcium taken during pregnancy can impair the absorption of thyroid hormone from the gastrointestinal tract. Consequently, levothyroxine and prenatal vitamins should not be taken at the same time In many hospitals newborn screening for thyroid disorders is being done as a routine after first few days of birth to prevent hypothyroidism related developmental delay. 

Thyroid

Dr. Anubha, Homeopath
HOMEOPATHY ADDRESSES MULTIPLE CAUSES ATTEMPTING TO STIMULATE YOUR THYROID GLAND.When your thyroid gland does not make enough of thyroxin hormone; you get this condition called Hypothyroidism.ABOUT THYROID GLANDThyroid gland became sluggish and does not produce enough hormones.Thyroid Gland: Size, Shape & Function The thyroid is a butterfly-shaped endocrine (hormone secreting) gland in the neck that is found on both sides of the trachea (windpipe)The thyroid weighs about 20-25 gms in an adult. It is butterfly shaped and it consists of two lobes which are connected together by a median isthmus.The function of the thyroid gland is to take up iodine from the foods that we eat and to convert it into thyroid hormones namely Thyroxine (T4) and Triiodothyronine (T3) and Calcitonin (which is involved in calcium metabolism).Causes of Under active Thyroid (Hypothyroidism)Primary Hypothyroidism or Under active Thyroid can be caused due to several reasons such as follows:Secondary hypothyroidism is commonly caused by the following:Diagnosis of Under active Thyroid (Hypothyroidism) Diagnosis of hypothyroidism can be established based on the results of tests done to measure the levels of these hormones in the blood.What is homeopathy?Homeopathy is an alternative method of treatment, based on the nature's law of Cure, namely 'Like Cures Like'Treatment or therapies for HypothyroidismThe mainstay of Allopathic system of medicine is to keep providing thyroid hormones artificially for the rest of the life of the patient Complications of Hypothyroidism If left untreated, hypothyroidism can progress and cause a multitude of complications. Homeopathic medicines act on the immune system. When a disease invades the human body, it produces some symptoms. An ultra diluted homeopathic medicine prescribed as per symptoms and diagnosis produces in the human body a drug effect that activates the immune system. The activation by the medicine produces an immunity that makes it stronger than the disease, and the person is restored to health. It is due to this mechanism of action that these medicines produce hardly any side effects and leave the body stronger than they find it. On the contrary, in conventional medicine, the medicines act directly on the disease. After pathological tests, when the infection is detected, a drug is administered, which can kill the infection. These drugs, in the process of killing infections, often kill normal body cells and produce numerous side effects, making the patient weaker. In many deficiency diseases, conventional medicine proposes to fulfill the deficiency by supplementing it throughout life. As an example, in hypothyroid cases, the deficiency of thyroxin is supplemented by the administration of orally throughout life. The homeopathic approach is different. In Homeopathy, we prescribe specific medicines which reactivate the thyroid and when this occurs, we discontinue the medicines and the patient keeps well for the rest of his/her life. We have ample proof of such cases

Thyroid Diseases Causes, Diagnosis and Treatment

Dr. (Maj Gen) JK Bansal, Endocrinologist
Dr (Maj Gen) JKBansal,  Vishist Sewa Medal, ChikitsaRatan, MDWHO fellow Thyroidology, University of Southern California, USAWHO fellow Endocrinology, University of Wales U.K.Former Head thyroid department INMAS Govt of India Delhi.Thyroid Clinic 74 Mall Road, BehindD-3 Vasant Kunj, New DelhiSenior Consultant, Thyroid & Diabetes Rockland Hospital, Qutab NewDelhiMob: 9910062437, Email:generaljkbansal@gmail.com Thyroid is a small, butterfly-shaped gland located in the front ofthe neck. The thyroid takes iodine from the blood and uses it to make theactive hormones thyroxine, also called tetraiodothyronine (T4), andtriiodothyronine (T3). These thyroid hormones deliver energy to cells of the body, burn calories and control heart beats. I. Thyroid Disorders:There are several different disorders that can arise due to overactive thyroid, or hyperthyroidism, and underactive thyroid or hypothyroidism or enlargement of the thyroid gland causing goitre. Thyroid problems include:1. Hypothyroidism - when thyroid glanddoes not make enough thyroid hormones2. Hyperthyroidism - when thyroid glandmakes more thyroid hormones than body needs3. Goitre - enlargement of the thyroidgland due to thyroid nodules, thyroiditis, thyroid cancer.II. T3,T4, TSH hormone tests: Blood tests can determine the amount of hormones produced by thyroid and pituitaryglands. If thyroid is underactive, the level of thyroid hormone will be low. Atthe same time, the level of thyroid-stimulating hormone (TSH) will be elevatedbecause pituitary gland tries to stimulate thyroid gland to produce morethyroid hormone. Goitre associated with an overactive thyroid usually involvesa high level of thyroid hormone in the blood and a lower than normal TSH level.Antibodiestest:  A blood test mayconfirm the presence of antibodies indicating autoimmune thyroid disease.Ultrasonography:  The images reveal the size of thyroid gland and whether the gland contains nodules that may not have been detected clinically.Thyroid radionuclide uptake & scan:  Thyroid uptake & scans provide information about activity and size of thyroid.Fine-needle aspiration cytology (FNAC): During afine-needle aspiration biopsy, ultrasound is used to guide a needle into thyroid to obtain fluid sample for testing. FNAC is useful to indicate whether lesion is benign or malignant.III. Hypothyroidism: One of the most common causes of hypothyroidism is the autoimmune disease called Hashimoto's disease, in which  anti thyroid antibodies gradually target the thyroid and destroy its ability toproduce thyroid hormone. Causes of hypothyroidism include:1. Hashimoto's disease, an autoimmune disorder, where the body’s own immune system attacks thyroid tissue, leading to reduced thyroid hormone. Treatmentof Grave’s hyperthyroidism with radioactive iodine or by   thyroidectomy may lead to hypothyroidism.Baby,born without a thyroid gland (congenital hypothyroidism);Surgicalremoval of the thyroid gland as a treatment for thyroid cancer. Symptoms of hypothyroidism:1. Fatigue or lack of energy2. Dry, coarse skin3. Dry, coarse hair4. Sensitivity to cold temperatures5. Heavy and/or irregular periods6. Puffy tissues7. Unexplained weight gain8. Depression9. Muscle cramps, muscle pain andtenderness10. Slower than normal heart rate11. Constipation12. Infertility13. Mental lethargy14. Goitre15. Decreased libidoHypothyroidism poses a special danger to newborns and infants. A lack of thyroid hormonesin the system at an early age can result in cretinism (mental retardation) anddwarfism (stunted growth).  Infants need their thyroid levels checked routinely soon after birth. If they are found to be hypothyroid, treatment must begin immediately. In infants, hypothyroidism can be due to a pituitary disorder, defective thyroid or complete lack of the gland. A hypothyroid infant is unusually inactive and quiet, has a poor appetite and sleeps for excessively long periods of time.Sub-clinical Hypothyroidism is quite common and almost impossible to diagnose clinically. There may be no symptoms, associated with this condition. It is important to make the correct diagnosis because once treatment is started it usually continues for life as it becomes very difficult to stop treatment to determine whether the original diagnosis was correct. The measurement of TSH in the blood helps to define even minor degrees of hypothyroidism.Treating hypothyroidism: Thyroid hormone replacement with levothyroxine (Levothroid, Synthroid) will resolve the symptoms of hypothyroidism as well as slow the release of thyroid-stimulating hormone from pituitary gland.IV. Hyperthyroidism:When the thyroid gland becomes overactive and produces too much thyroid hormone, a person is said to be hyperthyroid. The most common cause of hyperthyroidism is the auto immunecondition known as Graves' disease, where thyroid antibodies target the gland and cause it to speed up hormone production. Hyperthyroidism occurs due to: Graves' disease.This is an auto-immune condition and is the commonest cause of an overactive thyroid gland.Toxic adenomas: Nodules develop in the thyroid glandand begin to secrete excessive thyroid hormones. A goitre may contain several of these nodules then it is called as multi-nodular toxic goitre.Sub acute thyroiditis: This is where inflammation of the thyroid causes the gland to ‘leak’ excess hormones, resulting in temporary hyperthyroidism. The condition generally lasts a few weeks, but it may persist for months. Hyperthyroidism- Signs and Symptoms:1. Unexplained weightloss2. Weight loss despite an increase in appetite3. Irritability and nervousness4. Muscle weakness and/or tremors5. Irregular periods6. Difficulty in sleeping7. Compromised vision oreye irritation8. Sensitivity to warmtemperatures9. Heart palpitations orrapid heart beat10. Frequent bowel movements or diarrhoea11. High blood pressure12. High heart rate13. Excessive sweating14. Excessive hair thinning When the thyroid gland becomes enlarged due to diseases or tumours, it is referred as goitre. It can be associated with hyperthyroidism or with hypothyroidism. Goitre may be associated with normal levels of thyroid hormones. When goitre becomes very large, it can sometimes cause symptoms because it presses on adjacent structures such as the oesophagus and trachea. Symptoms that can occurrelated to a large goitre include problems with swallowing, shortness of breath, hoarseness. Some of the conditions that can cause goitre include:1. Hashimoto's thyroiditis, a common autoimmune condition in which the body's immune response is directed against the thyroid gland, leading to inflammation of the thyroid2. Iodine deficiency, is major cause of goitre 3. Graves' disease,another autoimmune disease, stimulates the gland to be overly active4. Benign tumours (nodules) that may cause multi-nodular goitre 5. Thyroidcancers VI. Message: If detected and managed, in early stage of onset, thyroid disorders are treatable. It is therefore advisable to report to thyroid specialist as soon as you suspect thyroid problem.

4 Healthy Tips to Cure Thyroid

Dr. Amar Deep, Homeopath
Followings are few tips for Thyroid patients:1. Slow Down Your EatingThe thyroid gland is located in your throat area, so it literally connects the mind and body. When you rush while eating, the food moves so quickly from mouth to stomach that the connection from mind to body is not strong. The mouth doesn’t know what the stomach is doing and vice versa. This is good health advice no matter what: sit down, slow down, savor, breathe and chew your food. Since the thyroid is the master of your metabolism, you want to eat slowly enough so it can record the message that food is entering the body.2. Drop the cell phoneWe already know about the connection between cell phones and brain tumors. But this little radiation machine that you hold up to your ear is awfully close to your thyroid gland as well. A good alternative is to get a headset to use while speaking on the phone.3. Find Your VoiceOnce again, if you look to the anatomy, you find the thyroid gland located in the throat, the center of our communication with the world. People with hypothyroid tend to “swallow down” what they really want to say. It’s been very healing for them to learn to speak their truth. On the flip side, it has found that people with hyperthyroid  talk too much, and can benefit by listening more.4. Do YogaYoga asanas can stimulate and support the entire endocrine system. The shoulder stand(sarvangasana) is especially beneficial for stimulating the thyroid gland.

Your Thyroid Gland - All That You Need To Know!

Dr. Prashant K Vaidya, Homeopath
Thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. Thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.What is hypothyroidism?Hypothyroidism is an under active thyroid gland. Hypothyroidism means that the thyroid gland can’t make enough thyroid hormone to keep the body running normally. People get hypothyroid if they have too little thyroid hormone in the blood. Common causes are autoimmune disease, surgical removal of thyroid, and radiation treatment.SYMPTOMSWhat are the symptoms? When thyroid hormone levels are too low, the body’s cells can't get enough thyroid hormones and the body’s process starts slowing down. As the body slows down you may notice that- You feel cold- You get tired easily- Your skin gets drier- You become forgetful and depressed- You start getting constipation- You get more sleep- Your periods become irregular- Your hair fall increases- You start gaining weightCAUSESWhat causes hypothyroidism?EMOTIONAL CAUSES Like depression, continuous grief, suppressed anger, sudden death of a closed one, continuous domination.• Autoimmune disease : In some people’s bodies, the immune system that protects the body from invading infections can mistake thyroid gland cells and their enzymes for invaders and can attack them. Then there aren’t enough thyroid cells and enzymes left to make enough thyroid hormone. This is more common in women than men. Autoimmune thyroiditis can begin suddenly or it can develop slowly over years. The most common forms are Hashimoto’s thyroiditis and atrophic thyroiditis.Surgical removal of part or all of the thyroid gland.Some people with thyroid nodules, thyroid cancer, or graves’ disease need to have part or all of their thyroid removed. if the whole thyroid is removed, people will definitely become hypothyroid. if part of the gland is left, it may be able to make enough thyroid hormone to keep blood levels normalRadiation treatment.•Congenital hypothyroidism (hypothyroidism - that a baby is born with)•Thyroiditis•Too much or too little iodine: The thyroid gland must have iodine to make thyroid hormone. iodine comes into the body in food and travels through the blood to the thyroid. Keeping thyroid hormone production in balance requires the right amount of iodine. Taking in too much iodine can cause or worsen hypothyroidism•Damage to the pituitary gland : The pituitary,“master gland,” tells the thyroid how much hormone to make. When the pituitary is damaged by a tumor, radiation, or surgery, it may no longer be able to give the thyroid instructions, and the thyroid may stop making enough hormoneHow is hypothyroidism diagnosed?The correct diagnosis of hypothyroidism depends on the following:You should tell your doctor:•About changes in your health that suggest that your body is slowing down•If you’ve ever had thyroid surgery•If you’ve ever had radiation to your neck to treat cancer•If you’re taking any of the medicines that can cause hypothyroidism— amiodarone, lithium, interferon alpha, interleukin 2, and maybe thalidomide•Whether any of your family members have thyroid disease•Physical exam. The doctor will check your thyroid gland and look for changes such as dry skin, swelling, slower reflexes, and a slower heart rateBlood testsThere are two blood tests that are used in the diagnosis of hypothyroidism - TSH AND T 4How is hypothyroidism treated In HOMEOPATHY?In almost every patient, hypothyroidism can be completely cured.It is treated in homeopathy by constitutional medications which activates thyroid gland and which initiates release of thyroid hormones i.e t4 and tsh to bring your T4 and TSH back to normal levels. Thus, constitutional homeopathic medications restore your body’s thyroid hormone levels and your body’s function.

Hypertension in Pregnancy

Dr. Pallavi Vasal, Gynecologist/Obstetrician
                                                                      Hypertension is defined as high blood pressure (B.P). A person has high blood pressure when the systolic pressure (the top number in BP reading) is greater than 140mmHg and the diastolic pressure (the bottom number) is greater than 90mm Hg.Hypertension can lead to many health problems. During pregnancy severe and uncontrolled hypertension can cause complications to both mother and baby.Causes of high blood pressure in pregnancy -1. Chronic hypertension - is high blood pressure that is present before the lady is pregnant or that occurs in first 20 weeks of pregnancy.2. Gestational hypertension – is high blood pressure that occurs during the second half of pregnancy that is after 20 weeks of pregnancy.3. Pre-eclampsia - is high blood pressure after 20 weeks of pregnancy associated with proteinuria (an abnormal amount of protein in the urine) . Pre-eclampsia is a serious BP disorder which can affect all the organs of a lady.The woman can present with complaints of severe headache, swelling over face and hands, changes in vision, vomiting, pain in upper abdomen or decrease urine output.The RISK of developing pre-eclampsia are more in women who -Are pregnant for the first timeHave had pre-eclampsia in previous pregnancy or have family history of pre-eclampsia.Are 40 years or olderHave multiple pregnancy (more than 1 baby in utero)Have history of chronic hypertension, kidney disease or both.Are obese IVF conceptionHave medical conditions such as diabetes, thrombophilias or lupus.RISKS  of high BP for baby -Growth restrictionPreterm deliveryPlacental abruption that is premature detachment of placenta (afterbirth) from the wall of uterusCaesarean deliveryIntra uterine deathHence it is very important for the lady who is planning to conceive or is pregnant to keep her BP within normal limits.PRECAUTIONS TO BE TAKEN FOR HIGH BP DURING PREGNANCY - Before Pregnancy-Keep the blood pressure under control. Reduce salt intake and do physical exercise. Loose weight if overweight .Lady needs to discuss with her doctor that she wants to become pregnant so that the doctor may change the medication to one which are safe in pregnancy or change the dose of medication if she is trying to conceive. 2) During Pregnancy-Take care of your diet that is a diet which is low in salts (avoid processed foods, pickles, pappad etc) and eat food rich in vitamin C, D and antioxidants.Lifestyle modifications that is exercise regularly .Walk and practice yoga if possible and keep weight gain under control.Avoid alcohol and tobaccoGo for antenatal check ups with your obstetrician and make sure that BP and urine are examined in each checkup. If the lady is feeling unwell any time during pregnancy , consult the doctor immediately.Being proactive and taking care of herself, going for regular prenatal and antenatal check ups, the lady with hypertension can deliver a healthy baby.

Is Thyroid Making You Fat?

Ms. Swati Kapoor, Dietitian/Nutritionist
A tiny sized butterfly-shaped thyroid gland placed in the lower front of your neck that produces the thyroid hormones T3, T4 and TSH has a huge impact on almost every aspect of our health, from weight to mood to heart rate to energy level. The thyroid hormones control the metabolism of the body i.e. how the food is metabolized and used up. So when the gland's hormone output goes out of gear, it can stop or slow down the process of weight loss.There are two ways your thyroid can get out of whack. Over activity of thyroid leads to hyperthyroidism showing the symptoms of weight loss, anxiety or irregular heart beat. The other condition is under active thyroid causing hypothyroidism which shows the symptoms of weight gain, hair loss, constipation, lack of energy. Risk of hypothyroidism increases in women after the age of 50 when the estrogen production goes down in the body.An under active thyroid leads to slow metabolism due to the fact that there is constant tiredness irrespective of how much you rest. An under active thyroid also means deficiency of iodine in the diet which is very essential for a healthy thyroid. A daily recommended amount of iodine can be incorporated in the diet but it should not go in excess as it leads to acne, allergic reactions and goiter.  Hence there is no motivation to workout, which in ways hinders the weight loss process. The other reason is joint problems and a feeling of depression that is observed during hypothyroidism, Joint immobility or pain makes the workout and hence making weight loss a difficult phenomenon. Depression makes you feel demotivated to achieve your targets.There are three major hurdles to weight loss in an under active thyroid. One is the sluggish metabolism. The low production of the thyroid hormones is unable to keep up your metabolic rate and makes you unable to burn calories you are consuming. The best way to keep up your fat burning is to exercise. Exercise will not only help you burn your excess fat but it also helps build muscles and boosts your metabolism. Low thyroid activity alters the brain chemistry by releasing certain chemicals that makes you feel hungry and increases their cravings for carbs even when the body does not require them. This builds on the excess calories that are converted into fat leading to weight gain. Hypothyroidism may reduce the levels of serotonin, which prevents you from feeling satisfied even after having eaten. Exercise will help you to regulate your chemicals to a more normal level. The result of overeating makes your pancreas secrete insulin excessively to absorb the carbs into the cells. The overworking of this endocrine gland causes insulin resistance.  The best remedy for insulin resistance is a low carbs, low fat diet that is rich in fresh produces and lean protein.Hence to counteract the problem of hypothyroidism which poses major hassle in losing weight is to keep you motivated. Monitoring your diet and exercise are the best two ways to defeat your disease. Most importantly, take the medications regularly as advised by the physician and keep yourself updated on the new advancements in treatment and information on the disease.

Is Your Thyroid Pill/OC Pill Really Helping You?

Dr. Disha Sridhar, Gynecologist/Obstetrician
Hormones are an important and often confusing topic. They can literally make or break how we feel. Hormones relate to stress, anxiety, joy, happiness, energy, metabolism, digestion, sleep, sexual function, fertility and almost every other human function. These days we have taken extreme steps to balance our hormones by taking synthetic hormone supplements.We have gone the route of synthetic chemicals, synthroid or elthroxine(synthetic thyroid hormone), birth control pills, Hormone Replacement Therapy ( synthetic estrogen, progesterone and testosterone) and now to the confusing world of “bio-identical” and “natural” hormones.The problem with using synthetic hormones externally is that it will suppress the natural function of the gland. It’s like telling the body that it does not need to produce the hormone anymore and the gland shuts down and atrophies. USE IT OR LOSE IT. That’s why people taking a synthetic thyroid supplement have to keep on increasing dosage as their thyroid gland gets weaker and weaker.Hormone replacement therapy offers a quick temporary relief, but at a cost. Merely masking symptoms that are associated with decreased hormone production has potential side effects. Just keeping the symptoms at bay by introducing extra hormones without removing the reasons why hormone production is unbalanced, can have happy wheels demo long-term consequences.One often ignored area is the emotional aspect of hormones. Hormones are the physical messengers of our thoughts and feelings. For every thought we think, we make a neurotransmitter (hormone) in the brain that informs every cell of our body what we were thinking. Emotional states, withheld anger, frustration, fear, not feeling worthy enough, are thoughts that have a physical aspect (e-motion, or energy in motion). The endocrine hormones fluctuate according to how we feel about our self and our world. They are less physically controlled than most people assume or believe.Our bodies are wonderful and Mother Nature has given us many amazing gifts to heal our hormones. Nourishing the body with real food is important but we often forget about peace, deep breathing, exercise, loving others, kind words, saying no to negativity, nature walks, prayer, going to bed on time, unplugging the electronics, lighting candles, vacations on the beach, sunshine and playtime. All these things are very powerful in healing our hormones but are sadly forgotten in our busy lives.Life is all about choices we make. May this year we choose nature, May this year we choose rejuvenation and healing!To a healthier and hormonally balanced you!

The Relation Between Thyroid and Reproduction

Dr. Sujoy Dasgupta, Gynecologist/Obstetrician
25th May is the World Thyroid Day. Thyroid disorders are one of the most common disorders of hormones in our body. Thyroid is a small gland situated in front of the neck and secretes hormones like thyroxine (T4) and tri-iodo-thyronine (T3). These hormones control various functions of our body like heart, blood pressure, digestion, metabolism, growth, blood formation, brain function etc. But one of the most important function is its association with reproduction.In both sexes, T3 and T4 are needed for sexual development during puberty so that full maturation from a child to adult occurs. That means development of hair (pubic and axillary hair), beard and moustache in boys, breast in girls, genital organ development in both sexes and menstrual function are dependent on thyroid gland. Finally production of eggs (rather maturation and release) and sperms are also related to it. In adults, thyroid function is needed to maintain the functions of sex glands particularly ovaries and testes. Desire for sex (libido) and performance of sex are also related to thyroid function. The thyroid glands in turn is regulated by a hormone secreted from pituitary gland, located inside the brain. That hormone- TSH (thyroid stimulating hormone) controls secretion of T3 and T4., Thyroid gland may be affected by various diseases like autoimmune diseases (body itself destroys its organs), deficiency of iodine, radiation, tumour, congenital causes (cause present from birth) and certain drugs. The result is that thyroid hormone secretion may be reduced (hypothyroidism) or increased (hyperthyroidism). As a result, blood tests for TSH, T3 and T4 are commonly done to detect abnormalities of thyroid gland. If abnormalities are detected, further tests may be advised, e.g., ultrasound and scanning of thyroid gland. So what can happen to reproduction if thyroid function is affected? Thyroid disorders are particularly common in females. Menstrual cycle may be irregular (coming every 2 or 3 months) or may be scanty in amount or more commonly very excessive flow. These respond well to correction of thyroid hormone levels by drugs. Thyroid disorder is a common cause of anovlation- That is women cannot release eggs in each month. The result is irregular menstruation and infertility- the inability to conceive a child. Often correction of thyroid hormone levels result in pregnancy. Please remember if you are trying for pregnancy, then your TSH value should not be the same like other people. We usually treat such women, if TSH is more than 2.5 (this may be normal for labaoratory standards for other people but not for those who plan for preganancy and who are pregnant). It can cause low libido, vaginal dryness, reduced orgasm and painful intercourse.In case of male, the thyroid disease is not very common but is not rare. It can affect sperm production leading to infertility. Apart from that it can affect sexual performance leading to low libido, easy fatigue and erectile dysfunction (ED). All these resolve after proper treatment.Never ignore checking thyroid status for adolescent boys and girls. It may be responsible for delayed puberty (delay in appearance of male like features in boys and female like features in girls) or precocious puberty (early onset of menstruation or breast development in girls; or early development of beard and moustache in boys). These may be associated with serious disorders and need proper attention.Pregnancy is a condition where there is tremendous pressure on thyroid gland and it is needed to help in proper development of baby inside uterus. Women with thyroid disorders can have miscarriage, premature delivery, death of baby inside uterus or poor growth of the baby. She can experience bleeding in pregnancy, high blood pressure (preeclampsia) and even heart failure. In initial periods babies depend on mother's thyroid gland for its development. If baby does not get proper amount of thyroid hormones, its brain and body development can be hampered. The brain development can be affected leading to birth of a disabled baby, as it may not be corrected even after treatment. So proper diagnosis and treatment of thyroid diseases in pregnancy are essential. After birth, baby should be tested for thyroid disease and appropriate treatment should be started without any delay.So, if you feel any of the above problems, please do not hesitate to consult your doctor and request testing of thyroid functions. If drug treatment is started, do not stop the drug without consulting doctor. Uncontrolled thyroid disease can lead to heart attack, stroke and emergency situations like thyrotoxicosis or myxoedema- which can be potentially life threatening if not treated in time.