How to Regulate Thyroid Function Before Pregnancy

Mar 19, 2025 Source: Cainiu Health

Dr. Zhang Lu

Introduction

Under normal circumstances, thyroid function can be managed before pregnancy through thyroid function screening, iodine nutrition management, medication dose adjustment, stress hormone regulation, and avoidance of environmental toxins. Iodine intake can be assessed via urinary iodine testing. Women planning to become pregnant should maintain an iodine intake of 150-250 μg/day. In coastal areas, consumption frequency of kelp and nori should be controlled.

Generally, thyroid function can be managed before conception through thyroid function screening, iodine nutrition management, medication dose adjustment, stress hormone regulation, and avoidance of environmental toxins. If necessary, it is recommended to seek medical advice 3-6 months in advance. Detailed analysis is as follows:

1. Thyroid Function Screening: Test three indicators—TSH, FT4, and TPOAb. TSH should be controlled below 2.5 mU/L. Individuals with positive TPOAb should undergo evaluation and intervention in collaboration with an endocrinologist. Patients with hypothyroidism should adjust TSH to pregnancy-specific reference ranges using levothyroxine.

2. Iodine Nutrition Management: Assess iodine intake through urinary iodine testing. Women planning pregnancy should maintain an iodine intake of 150-250 μg/day. Coastal residents should limit the frequency of consuming kelp and nori, while inland residents are advised to use iodized salt and include seafood once weekly.

3. Medication Dose Adjustment: Individuals undergoing thyroid hormone replacement therapy should immediately increase their medication dosage by 20%-30% after confirming pregnancy, as HCG secretion enhances thyroid hormone metabolism. Dose adjustments should be based on TSH test results every two weeks and implemented gradually.

4. Stress Hormone Regulation: Elevated cortisol levels inhibit TSH secretion. Cortisol circadian rhythm should be maintained through regular exercise, meditation training, and sleep management.

5. Avoidance of Environmental Toxins: Avoid products containing perfluorinated compounds, bisphenol A, and flame retardants, as these substances can interfere with thyroid hormone synthesis and receptor function.

The first thyroid function assessment should be completed three months before planned pregnancy. Individuals with diagnosed thyroid disease should develop a prenatal management plan together with an obstetrician and avoid adjusting medication doses on their own.

References:

[1] Tian Qingqing. The Impact of Assisted Reproduction on Thyroid Function in Infertile Women [D]. Yan'an University, 2023.

[2] Beijing Expert Consensus on Integrated Quality Control Indicators for Hashimoto's Thyroiditis (2021 Edition) [J]. Journal of China-Japan Friendship Hospital, 2021, 35(06): 323-327.

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