Should I be tested for thyroid issues?

Q: I've heard thyroid problems can cause trouble in pregnancy. Should I be tested?  

A: Experts agree that both hypothyroidism (too little thyroid hormone) and hyperthyroidism (too much hormone) are a threat to pregnancy. However, they differ in whether all pregnant women should be screened for these disorders. The American College of Obstetricians and Gynecologists says you don't need to be tested unless you have symptoms or a history of thyroid disease. Others argue that because screening is relatively inexpensive and simple—and has such a potentially profound effect—all pregnant women should be screened. "A number of poor outcomes are associated with thyroid disease," says Jared Robins, M.D., a reproductive endocrinologist at Women & Infants Hospital in Providence, R.I. "These include preeclampsia, preterm birth, low birth weight and impaired neurodevelopment of the fetus." Robins adds that thyroid disease can also cause fertility problems and possibly recurrent miscarriage. Hypothyroidism typically causes fatigue, insomnia, unusual weight gain, feeling "foggy," dry skin, constipation, hair loss and cold intolerance; hyperthyroidism symptoms include rapid heartbeat, diarrhea, weight loss and nervousness. If you have symptoms, get tested; both can be safely treated during pregnancy.