Preventing Miscarriage: The One Test You Should Ask For (That rarely is done)

February 01, 2020

Pregnancy is one of the most significant events in a woman’s life, and as an expert in women’s health it is one that I spend a lot of time talking about. 

And one major issue I see, is how few women are tested for this common – and preventable- cause of miscarriage. 

Lack of Lab Testing

In Ontario, where I run my women’s health practice, the standard of care is for women to receive only basic testing when they discover they are pregnant.  Women are screened for sexually transmitted illnesses (chlamydia, gonorrhea, syphilis), public health testing (rubella), blood type and Rh factor. 

Comprehensive Testing

The one test I insist all women in my practice have at the first sign of pregnancy is a comprehensive thyroid panel.  The thyroid, a butterfly shaped gland sitting in your throat near your voice box, is one of the most important hormone producing glands in your body.  Thyroid hormones are essential for metabolism – creating energy in our cells to meet the demands of our body.  In pregnancy we need to be able to make a lot of energy – making a whole new human is hard work! 

In pregnancy our requirements for thyroid hormones increase – and if our body isn’t able to meet that demand, the result can be early pregnancy loss (miscarriage).  We can identify women who may be at risk for this by running a simple TSH (thyroid stimulating hormone) test and treating women who fall outside the normal range with thyroid replacement hormones during pregnancy. 

TSH Isn’t Enough

But TSH isn’t the only important thyroid test for a pregnant woman.  Testing thyroid antibodies, especially anti TPO antibody is also essential for preventing miscarriage.  Thyroid autoimmune disease is the most common autoimmune disease in women who are in their childbearing years – impacting up to 15% of women.  Many of these women have no symptoms of thyroid disease and their TSH levels are totally normal.

Having TPO antibodies however, is a major risk factor for miscarriage.  There is a strong association with TPO antibodies and miscarriage, preterm delivery, and other negative outcomes in pregnancy (such as low birth weight and smaller head circumference). 

The Lack of Testing

Despite all the evidence, known to doctors since the 1990s, comprehensive thyroid testing still isn’t available as a screening test for most women in early pregnancy.  But that shouldn’t stop you from seeking it out.  Available from your Naturopathic Doctor at the Integrative Health Institute, this test could make all the difference in your pregnancy.

And since this cause of miscarriage is completely treatable, I encourage you to have the test done as soon as possible after you discover you are pregnant.  Miscarriage is all too common already, no woman should suffer from one that could have been prevented with early diagnosis and treatment. 

Dr. Lisa Watson believes that you don’t have to be perfect to be healthy.  Lisa encourages her patients to take a proactive approach to their health – taking meaningful steps towards achieving their goals for balanced and vibrant health.  An expert in women’s health and hormones, Lisa is a passionate advocate for women’s health and strives to educate all the women in her practice on how to achieve lifelong abundant health.  Dr. Watson practices at the Integrative Health Institute in downtown Toronto and writes regularly about women’s health on her website at www.drlisawatson.com

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