The relationship between thyroid function and pregnancy.

The thyroid gland is an endocrine organ in the human body that controls the speed of energy usage, protein production, and regulates the body's sensitivity to other hormones. Its dysfunction mainly includes hyperthyroidism, hypothyroidism, and subclinical hypothyroidism, which are common conditions in the population, especially prevalent among pregnant women. Among these, hypothyroidism has the closest relationship with pregnancy and has the greatest impact on the fetus. In clinical practice, the main tests related to thyroid function include: 1. Free T3 and Free T4: These are not affected by thyroid hormone binding proteins and directly reflect the state of thyroid function. Elevated levels are seen in hyperthyroidism; decreased levels are seen in hypothyroidism and pituitary dysfunction.

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The thyroid gland is an endocrine organ in the human body that controls the speed of energy use, protein production, and the body's sensitivity to other hormones. Its dysfunction mainly includes hyperthyroidism, hypothyroidism, and subclinical hypothyroidism, which are common conditions in the population, especially among pregnant women. Among these, hypothyroidism has the closest relationship with pregnancy and has the greatest impact on the fetus.

The main laboratory tests related to thyroid function in clinical practice include:

1. Free T3 and Free T4: These are not affected by thyroid hormone binding proteins and directly reflect the functional status of the thyroid gland. Elevated levels are seen in hyperthyroidism, while decreased levels are observed in hypothyroidism, pituitary dysfunction, and severe systemic diseases.

2. Total Thyroxine (TT4): This is the most basic screening test for assessing thyroid function.

3. Total Triiodothyronine (TT3): Elevated serum TT3 and TT4 concentrations are mainly seen in hyperthyroidism. Together with FT3 and FT4, they can be used in the diagnosis, assessment, and monitoring of treatment efficacy for hyperthyroidism and hypothyroidism.

4. Thyroid-Stimulating Hormone (TSH) measurement: TSH is secreted by the anterior pituitary, and serum TSH is a sensitive test reflecting the function of the hypothalamic-pituitary-thyroid axis, especially significant for diagnosing subclinical hyperthyroidism and subclinical hypothyroidism.

5. Thyroglobulin Antibody (TGA) and Thyroid Microsomal Antibody (TMA): TGA and TMA are two main specific thyroid autoantibodies found in serum. In autoimmune thyroid diseases, TGA and TMA levels are elevated. They can also be detected in other thyroid diseases and healthy individuals. TGA is a specific diagnostic marker for chronic lymphocytic thyroiditis and is often significantly elevated. Abnormal levels of both are also related to recurrent miscarriage.

In early pregnancy, due to changes in hormone levels, some pregnant women may show a tendency towards hyperthyroidism in their thyroid function tests. If a follow-up test after one month shows normal function, there is no need for concern; however, if hyperthyroidism is still indicated, endocrine consultation is necessary. If hypothyroidism is suggested, it should be taken seriously. Once diagnosed, treatment is required, with levothyroxine being the most common replacement medication for hypothyroidism. Untreated hypothyroid pregnant women may have an increased risk of miscarriage, abnormal brain development in the fetus, and congenital hypothyroidism after birth. If only antibodies (TPOAb, TGAb) are positive and the three thyroid function tests (FT3, FT4, and TSH) are negative, levothyroxine may be used as a preventive measure for hypothyroidism, with regular follow-ups. Patients with isolated positive antibodies should avoid high-iodine diets, as excessive iodine intake can further increase antibody levels and raise the incidence of hyperthyroidism or hypothyroidism.

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The relationship between thyroid function and pregnancy.

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