Dr. Vinod Kumar

It is important for you to know how pregnancy affects your thyroid gland. The thyroid hormone plays an important role during pregnancy in the development of the baby and also regarding the health of the mother. If you suffer from thyroid problems during pregnancy, you should take medicines and certain thyroid function tests.

How pregnancy affects normal thyroid function?
The pregnancy hormones known as human chorionic gonadotropin or hCG and estrogen lead to increased thyroid hormone levels in your blood. The hCG made by the placenta stimulates the thyroid to produce excessive hormones. Increased estrogen leads to higher levels of the thyroxine binding globulin, which transports the thyroid hormone in the blood.

Because of these normal hormonal changes, thyroid function tests are difficult to perceive during pregnancy. The thyroid hormone is very important for the normal development of a baby’s nervous system and brain. During the first trimester of pregnancy, the foetus depends on the supply of thyroid from the mother via the placenta.

In healthy women, the thyroid enlarges during pregnancy. An enlarged thyroid can indicate a thyroid disease, which should be diagnosed immediately. Thyroid problems are difficult to diagnose during pregnancy because of the increased hormone levels, increased thyroid size, fatigue and other factors.

Hyperthyroidism in pregnancy
Hyperthyroidism may occur in pregnancy because of Graves’ disease where enough thyroid hormones are not produced. Graves’ disease is an autoimmune disorder in which the immune system attacks the cells and organs of the body instead of fighting bacteria or viruses. With Graves’ disease, an antibody is released by the immune system called the thyroid stimulating immunoglobulin or TSI. This causes the thyroid gland to produce excess thyroid hormone. In many cases, the antibody is also associated with eye problems like bulging, irritation and puffiness. Graves’ disease commonly appears during pregnancy, but women with this disease from before may actually observe improvements in the symptoms during the second and third pregnancy trimesters. The remission or the disappearance of the symptoms of Graves’ disease may occur due to the general suppression of the immune system, which occurs during early pregnancy. The disease is likely to recur and worsen in a few months after the delivery. It is important for pregnant women with Graves’ disease to be monitored carefully.

Hypothyroidism during pregnancy may lead to a developmental delay in the child. Sometimes, hormone therapy is given to women who are at the borderline stage in thyroid function during pregnancy or just before pregnancy. The treatment of the condition aims at maintaining a proper and balanced thyroid hormone level in the body.

The body functions are controlled by hormones which are produced by various endocrine glands (named so because these glands secrete hormones directly into the body). There are various endocrine glands, and these are controlled by the master endocrine gland which is the pituitary gland.

The pituitary gland is attached to the base of the brain. It also produces prolactin which helps regulate milk production when a woman is breast-feeding. To a smaller extent, it also has some effect on other hormones.
Prolactinoma is a benign tumour of the pituitary gland which produces large amount of prolactin. The cells in the pituitary gland multiply to produce large amounts of prolactin. In people with prolactinoma, there are reduced amounts of oestrogen in females and testosterones in males.

Causes: Though the cause is unknown, a genetic connection believed to exist. Also, people who are hypothyroidic, pregnant, and/or breast-feeding have a higher chance of developing this condition. They can develop in men as well. Interestingly, this is the most common form of pituitary gland tumour.

Types: Depending on the size of the tumour, the tumour is of two main types—microprolactinoma (when the tumour measures less than 10 mm) and macroprolactinoma (when the tumour measures more than 10 mm).

Signs and symptoms: Though the most important function of prolactin is the regulation of breast milk production, it also has various other functions in both men and women. The symptoms, therefore, would depend on the gender and the age group.

Men: Reduced libido, erectile dysfunction, reduced fertility, and gynecomastia and sometimes even production of milk.

Women: Menstrual disorders, including lack of periods or irregular periods, reduced fertility, reduced libido, increased facial hair, and spontaneous leakage of milk from the breasts.

If teenagers are affected, there could be reduced growth and delayed puberty.
In addition to the above symptoms, as the tumour continues to grow, there could be pressure on the surrounding nerves, leading to headaches, blurred of vision, and even double vision. As the tumour grows, the normal pituitary functioning may be affected, and other hormones may not be produced and accordingly the symptoms would appear.

Treatment: One of the main reasons it gets diagnosed is infertility. When ruling out causes for infertility, prolactinoma is suspected and to rule this out blood tests are done. Increased amounts of the hormone would lead to undergoing MRI scans and other tests to confirm the diagnosis.

Once confirmed, the treatment would depend on the symptoms and the patient. It causes reduced amounts of oestrogen and testosterone, which is usually harmless. Unless required, some people can choose to go without any treatment. Hormone supplements can be used to restore the normal hormone levels. Dopamine antagonists can be used to suppress the production of prolactin from the pituitary gland.

Patients with diabetes are likely to suffer from nerve damage. This condition is known as diabetic neuropathy. An increase in the blood-sugar level can damage nerve fibres, especially in the legs and feet. Diabetic neuropathy is a common complication for people suffering from diabetes.

Types of neuropathy

1. Peripheral neuropathy: This is the most frequently occurring form of diabetic neuropathy. It can affect the legs, feet, hands and arms of a person. Some of the common symptoms include numbness in the leg or arm, cramps, reduced reflexes and muscle weakness. This is accompanied by other problems such as joint pain, ulcers, and deformities.
2. Autonomic neuropathy: This part of the nervous system controls the intestines, heart, stomach, lungs, eyes and sex organs. Diabetes can wreak havoc in these vital organs. Some of the common symptoms include bladder problems, vomiting, nausea, erectile malfunction, fluctuation in body temperature, decreased or increased sweating, and irregular heart rate.
3. Radiculoplexus neuropathy: This form of neuropathy affects the nerves in areas such as the thighs, legs, buttocks, etc. This condition is mostly witnessed in people suffering from type 2 diabetes. The symptoms are often observed on one side of the body, which includes abdominal swelling, pain in the thigh, hip and buttock, weight loss, difficulty in getting up from a particular position.
4. Mononeuropathy: This form of neuropathy attacks a particular nerve and is mostly found in older adults. It doesn’t have any long-term implications. Some of the symptoms include paralysis of the face, pain in the chest, difficulty in focusing the eye, and pain in the foot.

Risk factors of diabetic neuropathy

1. Being overweight: An increase in body weight increases the chances of diabetic neuropathy. A body mass index (BMI) of greater than 24 is considered to be alarming for a patient suffering with diabetes.
2. Smoking: Smoking narrows the arteries, thereby reducing the flow of blood to the feet and the legs. This increases the chance of diabetic neuropathy.
3. Kidney disease: Diabetes can cause great damage to the kidneys, which increases the level of toxins in the body. This situation can aggravate to diabetic neuropathy.
4. Poor control of blood-sugar levels: A poor control of blood-sugar levels is the biggest risk factor of diabetic neuropathy. Keeping the blood-sugar level under control helps the nerves to maintain a healthy condition.

Common complications of diabetic neuropathy

1. Digestive problems: Nerve damage can lead to diseases such as diarrhoea, bloating, nausea, vomiting and a loss of appetite. It can also result in a disease called gastroparesis; this is a disease which doesn’t let the stomach empty at its usual rate.
2. Limb loss: Gradual nerve damage can affect the limbs of the body. Diabetic neuropathy slowly damages the soft tissues and the skin, which eventually results in the loss of a limb.

Are you suffering from diabetes and are looking for ideal at home management remedies? Diabetes is a health condition, which occurs when the blood sugar level of the body rises. There are several ways following which you will be successfully able to manage your diabetes. They are as follows:

1. Exercise regularly and track your workout patterns. Exercise is the most important lifestyle choice for a diabetic patient, which allows you to maintain a good shape. It boosts your body's metabolism rate and insulin uptake process. By taking notes on your exercising habits, you will be able to make timely and required changes. 
2. Stop consuming fast food. Try to abstain from eating outside food and reduce your intake of sugar, salt and high calorie food. Meal should be prepared at home using light ingredients and less amount of salt and sugar.
3. Quit smoking as it is very harmful, especially if you are a diabetic. Smoking narrows your blood vessels, as a result of which, your blood circulation gets disrupted.
4. Increase your fiber intake. Fiber is beneficial for all diabetic patients and helps in smooth functioning of your digestive processes. It also help in reducing your cholesterol and blood sugar levels.
5. Take care and pay attention to your feet properly. You should wash your feet in lukewarm water regularly and dry them gently. You should moisturize your feet with a lotion. Check on your feet for cuts, sores, redness, swelling and blisters and consult a doctor in case of an unusual foot sore.
6. Get your eyes checked frequently as diabetes affects your vision in serious ways, which may also lead to blindness. Regular eye checkups will help you to prevent retinopathy.
7. Take proper care of your teeth which includes brushing and flossing at least two times every day. This is because diabetes makes you prone to several serious gum infections. Go for regular dental checkups if you have type 1 or type 2 diabetes and in case you observe swollen, red gums, consult your doctor immediately.
8. Avoid stress and adapt ways to eliminate stress. Your body hormones, which are produced in relation to intense stress, prevent insulin from working efficiently, which increases your blood sugar levels and stress levels further. Relaxation techniques are effective for dealing with stress. 
9. Opt for several small meals instead of a few large meals every day. This helps in keeping your digestive processes active, which in turn increase insulin sensitivity.

In case you have a concern or query you can always consult an expert & get answers to your questions!