Why Is There Even Debate Over Female Thyroid Testing? Patient Advocate Says Pregnant Women -- and Their Babies -- Deserve Proper Thyroid Diagnosis and Treatment

While researchers recruit women for a new clinical trial looking at pregnancy and thyroid disease -- and the implications for babies -- the nation's leading thyroid patient advocate, Mary Shomon, asks why the trial is even necessary, when research already shows the dangers of failing to treat thyroid conditions in pregnancy. Shomon shares some important warnings for women who might consider participating in the study, and offers guidelines that will help all women deal with thyroid and hormonal conditions and have a healthy pregnancy and baby.

Kensington, MD (PRWeb) February 8, 2007 -- The launch of a new clinical trial looking at pregnancy and thyroid disease -- and the implications for babies -- has focused debate on the value of screening and treating pregnant women for thyroid conditions. The nation's leading thyroid patient advocate, Mary Shomon, urges women to think twice, however, about participating in the study, and to be aware of important guidelines when it comes to thyroid disease and pregnancy, and the birth and health of their babies.

Why would women participate in a study that will deny some of them hypothyroidism treatment while pregnant, especially given what we already know about how treatment may reduce the risk of miscarriage, pre-term labor, stillbirth, and developmental problems in our children?

The clinical trial announced this week is titled, "Thyroid Therapy for Mild Thyroid Deficiency in Pregnancy," and is being conducted by the National Institute of Child Health and Human Development.(1) NICHD will work with university researchers at various centers around the country to enroll 1,000 pregnant women with mild hypothyroidism. Half the women will receive a thyroid hormone replacement drug treatment, and half will be untreated, receiving instead an inactive placebo pill.

The women participating in the trial will have a monthly thyroid evaluation during pregnancy. Researchers will evaluate each baby's intellectual development annually, from birth until age five. The researchers are examining the effects of failing to treat mild hypothyroidism on pregnancy and a child's intellectual development. The results of this study are supposed to finally resolve a controversial, ongoing question: should thyroid screening and treatment be universal for all pregnant women?

Thyroid patient advocate Mary Shomon, has major concerns about the study. "For years, significant research has already shown that untreated hypothyroidism -- including mild, subclinical forms of the condition -- is linked to problems in pregnancy and to developmental concerns such as lower IQ in children," says Shomon. "Why would researchers now ask pregnant women to participate in a trial where half of them won't even receive treatment? I'm afraid that this study could endanger the health of pregnant women, and put their unborn babies needlessly at risk."

Proper thyroid function is especially important during pregnancy, because the mother's gland must, at times, produce "thyroid hormone for two." Especially critical are the first 13 weeks, when the baby's developing thyroid can't produce any hormone at all, yet the hormone is necessary for proper brain development. Babies born to hypothyroid mothers, those who are not treated, are at increased risk of developmental problems, including a lower IQ, and in severe cases, even mental retardation and cretinism.

Untreated hypothyroidism in pregnancy can also contribute to infertility, early and recurrent miscarriages, pre-term labor and stillbirth.

According to Shomon, "Almost three years ago, the American Thyroid Association came out with a public health statement that said 'Pregnant mothers with overt or subclinical hypothyroidism are at an increased risk for premature delivery.' That same statement also made it clear that children born to women who were hypothyroid during pregnancy are at risk of impaired intellectual and motor skills." (2)

"Why would women participate in a study that will deny some of them hypothyroidism treatment while pregnant, especially given what we already know about how treatment may reduce the risk of miscarriage, pre-term labor, stillbirth, and developmental problems in our children?" asks Shomon.

Mary Shomon has the following practical, patient-oriented recommendations for women related to pregnancy and thyroid disease:

1. If you're planning a pregnancy, get a pre-conception thyroid test, and take a good pre-natal vitamin. "Many women are so careful when they're trying to get pregnant.," says Shomon. "We stop drinking coffee, avoid medications, and get our immunizations. But women who want to ensure the best possible outcome for themselves and their babies baby should also get a thyroid test, and make sure to take a pre-natal vitamin that includes both iodine and folic acid."

2. If you're pregnant, have your thyroid tested during your first trimester. According to Shomon, "Pregnancy is a time when thyroid problems are more common. But symptoms like fatigue, weight gain and depression are often assumed to be related to the pregnancy, instead of an underactive thyroid, so it can be harder to detect. There are enough studies that suggest even low-level hypothyroidism can contribute to miscarriage, pre-term labor, stillbirth, and cognitive problems in children. Given how hard it is to pick up on the symptoms, the millions of women who are undiagnosed, and the implications for children when a mother is not treated, I am in favor of universal screening for all pregnant women early in the first trimester."

3. If you have any family history of thyroid or autoimmune disease, pay particular attention to your thyroid. "Thyroid and autoimmune disease can run in families, so if you have any history, you want to be especially sure, at minimum, to have pre-conception and first-trimester thyroid testing," says Shomon.

4. Women who already are hypothyroid should ensure that their thyroid levels are optimized before pregnancy. Then, confirm the pregnancy as early as possible, and get frequently tested during the first trimester and throughout the pregnancy. "Research shows that most hypothyroid women require a 50% to 85% increase in their thyroid medication dosage during early pregnancy, especially in the first 8 weeks," says Shomon. "You need to begin pregnancy at a sufficient dose, and then get in to the doctor as early as possible after conception to test and readjust your medication, and continue to be monitored frequently during your pregnancy."

Having a healthy pregnancy with a thyroid condition is the focus of several key chapters of Mary Shomon's latest book, "The Thyroid Hormone Breakthrough: Overcoming Sexual and Hormonal Problems at Every Age." Shomon is the New York Times bestselling author of a number of thyroid and health books, including "Living Well With Hypothyroidism," and "The Thyroid Diet.

In addition to information on how to manage thyroid disease during pregnancy, "The Thyroid Hormone Breakthrough" offers step-by-step guidance on how to differentiate thyroid symptoms from women's hormonal problems. The book arms women with the knowledge and practical tools they need to find the right practitioner, get properly diagnosed, and effectively relieve conditions and symptoms with approaches chosen from among the best conventional and holistic therapies.

In addition to pregnancy, "The Thyroid Hormone Breakthrough" provides practical, hands-on advice to help women harness the power of proper thyroid function to resolve:

• Early or late puberty
    
• PMS, and irregular, heavy or painful periods
    
• Low sex drive
    
• Infertility and recurrent miscarriage
    
• Severe morning sickness
    
• Post-partum depression and weight gain
    
• Difficulty breastfeeding, low milk supply
    
• Perimenopause and menopause symptoms

Shomon's book has an accompanying website -- http://www.thyroidbreakthrough.com -- where women can take an interactive quiz to help learn whether their symptoms may be thyroid-related. A free downloadable ebook provides an overview of the thyroid/hormone connection. A free chapter from "Thyroid Hormone Breakthrough" is also available online.

Mary Shomon was diagnosed with the thyroid condition Hashimoto's thyroiditis in 1995, and has transformed her health challenges into leadership as America's leading thyroid patient advocate. She has worked for more than 25 years in writing and grassroots communications and is the founder and editor-in-chief of several thyroid, autoimmune, and nutrition newsletters, as well as the Internet's most popular independent thyroid website, http://www.thyroid-info.com. Shomon's 2004 book "The Thyroid Diet" was a New York Times bestseller, and a Quills Award semi-finalist. She is also author of a number of recent bestselling books, including "Living Well With Hypothyroidism," "Living Well with Graves' Disease and Hyperthyroidism," "Living Well With Autoimmune Disease," and "Living Well With Chronic Fatigue Syndrome and Fibromyalgia," all published with HarperCollins. Since 1997, Shomon has also served as guide for the About.com Thyroid site at http://thyroid.about.com . Mary Shomon is one of the first patient members of the American Academy on Communication in Healthcare and is a member of the Endocrine Society.

"The Thyroid Hormone Breakthrough" is available in bookstores and online, and is published by Collins, an imprint of HarperCollins Publishers. ISBN: 0-06-079865-3. Retail price: $14.95. http://www.thyroidbreakthrough.com

Sources:

(1) NIH Clinical Trial Description
http://www.clinicaltrials.gov/ct/show/NCT00388297;jsessionidBF64497FA0B249A88F223EA

(2) American Thyroid Association, Public Statement on Early Maternal Thyroidal Insufficiency: Recognition, Clinical Management and Research Directions http://www.thyroid.org/professionals/publications/statements/04_04_26_maternalthyroidal.html

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