- obesity/unexplained weight gain/difficulty losing weight
- very dry or cracked skin
- menstrual problems/irregularity
- dry/brittle hair and nail changes
- muscle or joint aches and pains
- feeling cold a lot/intolerance to temperature variations
- depression issues
- "brain fog"
- fertility issues
However, for women of size (and especially those with PCOS), it probably is sensible to have the thyroid levels checked before pregnancy. Although not all research agrees, some research suggests that obese people tend to have higher rates of both overt and subclinical (or "mild") hypothyroidism. Other research suggests that women with PCOS also have more subclinical hypothyroidism. Therefore, it probably makes sense for women in these two groups to have their thyroid levels checked carefully, preferably well before conception.
Postpartum Thyroid Issues
Women who experienced severe bleeding during and after birth should also be aware of a potential for thyroid problems. Sometimes severe hemorrhage can damage the pituitary gland, which in turn can lead to hypothyroidism. This is called Sheehan's Syndrome. As one website notes:
Rarely, hypothyroidism after childbirth is caused by Sheehan's syndrome, also called postpartum hypopituitarism. This condition may occur in women who have severe blood loss during childbirth resulting in damage to the anterior pituitary gland.
Finally, women who experience thyroid issues during and after pregnancy should also be warned to watch for possible recurrence of thyroid issues during perimenopause and menopause. Advanced age is another period of time when women are particularly vulnerable to hypothyroidism too. Thus, periodic thyroid tests should become part of women's life-long care.
Thyroid Medicine and Supplements
Hypothyroid medications are generally considered safe during pregnancy and breastfeeding. Remember, these medications are simply putting back into your body what should already be there. Babies are at far greater danger from untreated hypothyroidism than they are from typical hypothyroid medications. Just make sure to monitor your thyroid levels periodically.
I know of no "official" correlation between hypothyroidism and vitamin D levels, but it's my observation that many folks with hypothyroidism also have chronically low vitamin D levels as well. Whether there's a causal connection is debatable, but they often do seem to go hand in hand. So while you are at the doctor's having your TSH etc. checked, consider asking them to run Vitamin D levels as well.