Hypothyroidism during & after Pregnancy
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Hypothyroidism during & after Pregnancy
April 2007
I am 20 weeks pregnant with my second child and 39 years old. I
took two blood tests that came back with results of subclinical
hypothyroidism. My level on the first was about 6.4 (done at 12
weeks when hormone is highest) and the second was 4.9 (done at
18 weeks).
My doctor is recommending levoxyl treatment basically citing
that the benefits outweigh the risks.
I am of course worried about medicating myself during
pregnancy, though have been researching it-has anyone else had
this diagnosis and if so what course did you take when pregnant?
thank you!
J
I have postpartum hypothyroidism and have done a lot of reading,
both about the condition in general and during pregnancy (since I
am considering #2). From what I understand, a fetus relies on a
mother's thyroid hormones for the first trimester. After that,
the baby develops his/her own thyroid gland, and can produce the
hormone himself. In the first trimester, the baby is at risk of
developmental problems and even miscarriage if you do not treat
the condition. After the first trimester, the greatest influence
the medication will have will be on YOU--your moods, your
appetite, your weight, your general well-being. I can imagine it
being hard to know what symptoms are the pregnancy and which are
the low thyroid, but I'm guessing if you chose it treat it you'll
have a much better time being pregnant.
By my logic, keeping the thyroid levels in normal range help make
the pregnancy healthier because your body is able to stay
healthier. Having had an untreated thyroid condition, I wouldn't
dream of going through a pregnancy without treatment if I needed it.
Best of Luck
I've been hypothyroid for 10 years and had the condition throughout both of my
pregnancies. I having been taking levoxyl daily for 10 years. Absolutely take it while
you are pregnant! It is not a ''medication'' in the sense that it is altering a bodily
function or fixing a disease process. It is simply replacement of a hormone that you
need to have an adequate amount of. I see it more as a supplement than a medication,
although obviously it is a prescribed and controlled substance. I have had no ill
effects
of levoxyl and am sure that not only would being low thyroid during pregnancy feel
crappy, there may be ill effects on the fetus of your being low thyroid (don't quote me
on that one, but ask your health care provider).
anon
Hi, I also have hypothyroidism and have a healthy one month old
boy. You really need to treat it while pregnant, too low
levels can lead to cognitive impairment in the child. I took
175 mg. daily of levothyroxine while pregnant and my baby is
fine so far. The risks of not treating it greatly outweigh the
medication (neither my ob or my gp were concerned about the
meds, they were concerned about me keeping my levels high
enough). Hope this helps.
took the meds
I have had type 1 diabetes since age 18 and I am now 32. I have no complications
except borderline diabetic hypothyroid disease. I am not sure what my lab numbers
are, but they always come out on the threshold like yours. I am also not sure what
the relationship is between diabetic hypothyroid disease and the subclinical type
you describe. However, as soon as I got pregnant at 30, my (hi-risk /endo/) OB
required that I take a very low dose thyroid replacement during my pregnancy. They
explained to me that it would bring my levels up to where they should be since the
thyroid is overworked during pregnancy. I had regular blood tests throughout
where they monitored it (among other things). I stopped taking it after I gave birth
and my levels stabilized back to pre-preg levels which require no intervention,
although it continues to be something my endocrinologist closely monitors. I had
no problems while taking it, had a wonderful pregnancy as far as t1 diabetics go,
and had a very healthy baby boy. One benefit would be that you may find that you
get a little boost once you start taking it since the hypo might be draining your
energy. I found that I was kind of tired more than I should have been (although the
pregnancy would definitely cause that too). I would ask more about what kind of
stresses it would cause baby/pregnancy if you did not take it and go with your gut
feeling on it, or just see how it goes and ask if there would be any harm in taking it
later if you see your numbers change for the worse.
slightly hypo too
I had Graves Disease and subsequently had my thyroid removed. I take Synthroid and
have done so for the past 15 years. During my pregnancy, three years ago, I continued
on my medication and had my levels monitored regularly by both my obstetrician and
endocrinologist. From what I learned, it is important, if not mandatory, to treat your
thyroid disorder with the proper medication for your benefit and your baby. Your
doctor should confirm this. Baby is doing great at 2.5 years old!!!!
HELLO I KNOW YOU HAVE A CONCERN ABOUT TAKING MEDS WHILE BEING
PREGNANT I CAN RELATE. WHEN I WAS 18YRS I WAS DIAGNOISE WITH
HYPERTHROID THATS OVERLY ACTIVE. I'M NOW 28YRS. I WAS ON PTU
FOR AWHILE WHEN I GOT PREGNANT WITH MY 2ND AND 3RD CHILD I
STILL TOOK MY MED. IT WAS IMPORTANT TO TAKE THEM BECAUSE BEING
PREGNANT YOUR BODY CHANGES WITH DIFFERENT PREGNANCIES. I
SUGGEST IF THE BETTER OF TAKING IT OUT RATES THE RISKS I
SUGGEST YOU TAKE THEM BECAUSE IF YOU DON'T IT COULD COMPLICATE
YOUR PREGNANCY AND YOU COULD LOSE GOD FORBID IT. BUT MAKE SURE
THAT IT'S NOT GOING TO HURT YOUR BABY. AFTER MY FOURTH CHILD MY
THYROID WENT BACK TO NORMAL AFTER 5YR ALMOST 6YRS. TAKE CARE OF
YOURSELF BECAUSE YOUR BABY IS COUNTING ON YOU. BE SAFE AND TAKE
CARE GOD BLESS YOU AND HAVE A SAFE PREGNANCY.
MOMMY
Hi there. I am hypothyroid and now have a 3 month old son.
Thyroid levels, I am told, are extrememly important to brain
developement of the fetus. I had to double my regular
medication during pregnancy. The baby is perfectly fine and
happy now. I would take the medication, you don't want to risk
brain develepment....
hypothroid mom
Hi there - hypothyroidism is not a big deal. I got diagnosed
with it right before my husband and I were about to start
trying to get pregnant. My doc recommended I wait and get the
condition regulated before we start trying, which was
frustrating because it does take a while - several months
anyway, of figuring out what level of meds is correct for you.
The idea of getting it regulated before you become pregnant
(when possible) was because apparently pregnancy can change
your levels around a bit, so it's harder to know how much med
you need. But I didn't get the impression it would have been
the end of the world if I had accidentally gotten pregnant at
that point. But we were careful, and didn't. Then when I was
in the safe range, we got pregnant, and yes, you continue to
medicate through the pregnancy, and everything I read (and all
the people I talked to) said it's a complete non-issue. The
medication is giving you something that your body should be
producing anyway. I had/have no side effects. I had a healthy
baby.
I do recommend though remembering to get your TSH checked not
too long after you give birth because the pregnancy can change
your levels once again. I think I'd been told to do it about a
month later - time got away from me (imagine that!) and I
waited 6 months or so, and by that time my TSH was a completely
way off the mark number. A couple of increased levels of the
med later (I take synthroid/levothroid - one is the generic
name for the other) and I'm back in the good range.
I should note - I, even when I was wackily off the charts, am
lucky enough not to ever suffer much in the way of symptoms for
the hypothyroidism, which is why it was easy for me to forget
to get it checked for so long. So just keep it in the back of
your mind that you'll want to remember to get it checked again
post-pregnancy. Write it down somewhere because your brain
will be fairly busy with other things! :)
Good luck!
me too! 2nd pregnancy was diagnosed. did my own research and
agreed to take meds. AND was pleased I did. I felt so much
better once TSH readings were corrected. Now PP I still take
meds, though my dosage has changed. I was tested every 6 weeks
during PG and now its every 2 months while BFing.
spritelier!
I am not a doctor but what I'm writing I have culled from my experience having
hypothyroidism. I have seen 2 different endocrinologists (one UCSF, one CPMC),
both of whom I respect very much. I don't mean to scare you but the most recent
research points to a TSH level of 2.0 as being the optimum level. I have
hypothyroidism which was diagnosed in the midst of fertility treatments after
miscarrying twice. If you're above 2.0, you have hypothyroidism, according to my
endo's. My endo would not ''ok'' me to resume fertility treatments until my TSH was
below 2.0 (from 8-13). The traditional thought has been that TSH of 5.0 or so is
fine. There is a statistically significant diference in baby's IQ borne to mothers with
a TSH greater than 2.0 compared to higher numbers. Extreme deficiencies in thyroid
hormone (which means higher TSH) could result in poor brain development and
other problems. (Your levels are not considered extreme.) But the bottom line is
that the thyroid replacement hormone is simply replacing the hormone in your body
that your body doesn't have anymore (driving the TSH up). You would not be
medicating your body by taking the levoxythyrone in that it's not a foreign
substance being introduced to your body. It's a synthetic version of what your body
needs. Incidentally my sister in law started taking thyroid hormone replacement
long before me, back when it was derived from pigs- this is the old version. She
said when she started taking the human synthetic version she felt much better. I
have only taken the human synthetic version so cannot speak to that issue., but the
pig derivative is still out there. I don't know if the medication passes into mother's
milk so if you start nusring I would consult an endocrinologist asap. I would do this
anyway if I were you to prepare for the fluctuations that may occur after you give
birth. I found the fertility endocrinologists unprepared to answer any of my
questions about my thyroid hormone issues.
anon
I took a low dose of levoxyl/Synthroid throughout my twin
pregnancy. I had been diagnosed as low thyroid while trying to
get pregnant and this was actually one of the treatments to help
me get pregnant. It is a chronic condition and I still take the
levoxyl today, 5 years after giving birth. I don't know what
the research is but at the time none of my doctors advised me to
stop taking it during pregnancy. My twins are healthy and
happy, very bright, growing normally.
For What It's Worth
I have been treating my hypothyroidism with synthroid for 5
years and just had a healthy little girl 5 weeks ago. Her
newborn screen results show that her thyroid is totally
normal. My understanding from my endocrinologist and
obstetrician is that it is a much bigger problem to let
hypothyroidism go untreated than to treat it. The synthroid is
a synthetic substitute for the real thing, which I apprarently
don't make enough of. I've been told that your body doesn't
necessarily recognize the difference, it just needs to have
enough. As long as you are at normal levels between your own
thyroid hormone and the treatment being suggested by your
physician, you would be eliminating any risks to your baby
based on your condition. Not treating your thyroid has much
worse consequences for you and your baby, and typically,
doctors recommend treating subclinical thyroid disorders
because a lot of times treatment can prevent them from getting
worse.
I took synthroid through both my pregnancies. I consulted with
my OB and pediatrician at the time I was expecting my first.
There was no evidence of any risk to fetus. In fact, I think I
was more concerned about having my dosage right and sometimes
MDs will increase the dose, bc thyroid can dip lower during
pregnancy (as with you?) and that can be more of a concern.
Both my kids are perfectly healthy and developing beautifully.
Deb
I don't have a thyroid anymore so took levoxyl throughout both
of my two healthy pregnancies. I think you are being
overcautious here. If you have been researching this you should
know that thyroid hormone is not optional, nor a 'drug', nor are
you 'medicating' yourself (whatever that means). Thyroid
hormone is like insulin, your body needs it to function and to
maintain a healthy pregnancy. If I were you I would be
concerned about normal fetal development if you do not have
adequate levels of thyroid hormone in your body. Maybe you
should discuss further with your doctor what the
specific 'risks' and 'benefits' are of this treatment. There
are NO risks associated with maintaining a normal level of
thyroid hormone in your body--most people's bodies will do this
for them automatically. The risk associated with taking the
hormone is that it could be hard to regulate and you could end
up taking too high a dose and becoming hyperthyroid which is not
good for the pregnancy either. Please ask your doctor to
monitor your TSH levels closely (I had my blood tested every two
weeks at the beginning of my pregnancy which was overkill but
reassuring to me) and please ask your doctor to educate you a
bit more before sending you to the internet to seek medical
opinions. You should also find out the symptoms of being hypo
and hyper thyroid.
good luck
Recent research is suggesting that TSH should be at 1 for
pregnancy - higher values (much higher) have been implicated in
loss of IQ points. There is also a link to higher rates of
miscarraige. Its great that your doc caught this - many would
not - it also puts you at risk for thyroid issues post partum
which are really tough - you are already tired & trying to lose
weight - throw in thyroid stuff and it gets pretty complicated.
I'd reccomend taking the medication.
good luck
Elevated thyroid is not uncommon during pregnancy. You should
read online about hypothyroid and pregnancy if you want to get a
sense of what the medication does, why it's important, etc. Any
number of sites have some good information, so you'll easily be
able to pick up some more info.
''My doctor is recommending levoxyl treatment basically citing
that the benefits outweigh the risks. I am of course worried
about medicating myself during pregnancy.''
You have good instincts, you shouldn't medicate yourself and you
should listen to your doc.
anon
March 2007
I'm looking for an endocrinologist, preferably in the Berkeley/Oakland area, possiblt SF,
for a second opinion on treating my post-partum hypothyroidism. My internist doesn't have
much experience with this condition. I'd prefer someone who specializes in/sees lots of
patients with thyroid issues before, during, and after pregnancy. Good bedside manner is a
plus. anonymous
I've been seeing my primary care provider
at east bay internal medicine - my reccomendation will be
luke-warm - nothing wrong with her exactly but I am still trying to get my meds right and its
frustrating. she does not move fast which may be more to do with the thyroid than her style.
just out of school & very knowledgeable on what pregnancy does to thyroid. good at getting
back to you on email - phone is a bit harder. I am considering going to a Reproductive
Endocrinologist at this point as am having lots of period difficulties but have no names yet.
good luck
Editor note:
also see reviews of endocrinologists
Jan 2006
Hi, I just turned 39 and had a miscarriage at 8 weeks about two months ago. My
OB/GYN told me not to wait to try again, so we have tried twice since then, but so
far nothing. I guess my request for advice is twofold: one, how long does it
generally take to conceive after a miscarriage, and how long should I wait before I
seek intervention (like with Clomid)? Two, I have many of the symptoms of an
underactive thyroid. I have had thyroid levels tested, but doc says they are normal. I
know that a thyroid issue can impair fertility, so what should I do? Is it possible to
have hypothyroid but have tests come out normal? Thanks so much for your help, I
really appreciate it!
I can't speak to the miscarriage/thyroid issues specifically,
but based on my own experiences with infertility I'd say don't
wait to try the Clomid (and to move on to something stronger if
that doesn't do the trick) if you suspect you need a boost,
especially given your age. We wasted 3 years doing nothing and
then trying Clomid, when what we really needed was a different
drug - after all that time, I got pregnant my first cycle with
injectables. Good luck to you and sorry to hear about your
loss. I think both my friends who miscarried were pregnant
again with healthy babies within 4-6 months.
Straight to the drugs next time
My sister-in-law, who lives in S. California, was in a situation that sounds
much like yours. She too was in her late thirties and had trouble
conceiving, and I think she had a miscarriage. She too thought that she
had low thyroid, but her blood tests came up on the low side of normal.
She ended up going to a physician in LA who also does sort of
alternative medicine and he gave her thyroid medication. She was
pregnant within two months and gave birth to a son. 16 month later,
she gave birth to twins. If you backchannel me, I can contact her and
see if she would be open to corresponding with you. Good luck!
elza
The TSH levels that most labs use as normal are a bit higher than many experts feel
they should be, so if your doctor is using the lab range to determine if your level is
right nor not, you still could be hypothyroid (higher TSH = hypo, or under functioning,
thyroid), particularly if you are symptomatic. In addition there are other tests that may
more accurately determine the activity of your thyroid There is a great article about
this on the about.com thyroid page. Low thyroid can indeed affect your fertility, so if
you are suspicious, you may want to look into it more closely.
Tara Levy
I'm not sure what the average period is for getting pregnant
after miscarriage, I think it depends a lot on why you are
miscarrying. I had 5 miscarriages between my first child
(born right before I turned 36) and my second (born right
before turning 40). For me, I had no trouble conceiving: I
could miscarry in April, conceive again in May, only to
miscarry again in June/July. But having talked to lots of other
women who have miscarried, I think this is unusual.
I have a ''low but normal'' thyroid (my mother has been on
Synthroid since I was born) and I do think it makes a
difference. I've been tested several times as I show many of
the symptoms of low thryoid and have often fantasized that my
energy levels, etc. would be better if I could take the pill.
But each time it comes back ''low but within normal range'' and
my doctor tells me to live with it.
So while I suspect my thyroid levels might have had something
to do with the miscarriages, since I did manage to get and stay
pregnant the second time (and you probably will too, don't lose
hope, though it didn't happen to us until I'd basically given
up...and therefore maybe relaxed a bit?), I haven't pursued it
further.
Good luck!
anon
June 2003
My child is 21 mos now and I weaned him at 11 mos. I thought my sex drive
would slowly come back after weaning, but to the contrary, it continued
dwindling until it finally disappeared (completely, absolutely disappeared). I
was so alarmed that I insisted to have my hormones checked (my ob-gyn kept
telling me that it was psychological). It turned out that I was very hypothyroid.
Now I am being treated, but I find it difficult to believe that things can go back
to normal after hitting so low. Also, in all of my readings, the loss of sex drive
in hypothyroid individuals is just mentioned in passing and not listed as a main
symptom, when for me it has been the most disturbing one (pretty much the
only one). I could not find any specific reference to this in the website. It
would help to hear from other people whose sex drive has returned after
thyroid levels went back to normal. Thanks!
Anon
The Thyroid Sourcebook is excellent as are the many internet sites for
research. Dosage for any thyroid condition is tricky. Once my dose was
on the mark all systems were go and have been for six plus years :)
living in balance
I was diagnosed with hypothyroidism when my 1st son was 6 months
old...it was hard to tell if lack of sex drive was the
hypothyroidism or exhaustion from having a new baby.
As soon as I went on thyroid hormone I felt better within
days...all my symptoms (I had every one in the book) went away.
My sex drive returned.
Lack of sex drive could be related to other hormones too. Have
you had a complete blood panel done to check everything?
Good luck
anon
I have borderline hypothyroidism that is now being treated.
From my psychiatrist who I see for depression, I learned that
thyroid problems can cause any and all symptoms, even mimicing
psychiatric disorders (doesn't mean it's all in your head just
cuz the symptoms are psychiatric!). I am being treated at a
higher dose than usual, pushing me to the upper range of normal,
to treat the depression (an accepted treatment used even in
people who do not test low, although it is not
known by most GP's or unsophisticated psychiatrists). This
treatment is supported by my progressive Kaiser internist, even
though she would not have known to do it herself. It has been
very helpful, affecting both my energy level and state of mind.
Don't give up, and seek out a good, up-to-date psychiatrist if
you suspect that you may be being under-treated.
anon
Nov 2002
Since giving birth to my daughter 9 months ago, I've lost a lot
of wieght, and am now almost 20 lbs below my
prepregnancy weight. I was chalking it up to the
breastfeeding, until a friend suggested I have my thyroid
checked. Sure enough, I was diagnosed with mild
hyperthyroid, which I now understand is not uncommon
postpartum. My docter has prescribed methimazole, but I
am still breastfeeding, so the medicine is contraindicated
due to the meds being passed through breastmilk. Since I
have a mild case of hyperthyroid, I am interested in
alternatives to medication so that I can continue to
breastfeed. Anyone have this problem postpartum? Any
advise, or input on treatment options? How about herbs or
dietary changes? Thanks in advance for any feedback.
Amy
Amy,
I am a trained lactation counselor with the Santa Clara County
Nursing Mother's Counsel.
According to the LLL Answer Book, methimazole is compatible with
breastfeeding. Here's a reference to bring to your doctor: Cooper
DS, Bode HH, Nath B, et al. ''Methimazole pharmacology in man:
studies using or newly developed radioimmunoassay for
methimazole.'' Journal of Clinical Endocrinological Metabolism.
1984;58:473
FWIW, most medications are OK for breastfeeding, except illegal
drugs (cocaine, heroin, etc), radioactive drugs, and most
psychotropic drugs. It is not uncommon for MDs to be
unknowledgeable about medications and mother's milk. Please
contact La Leche League or a lactation consultant for more
information.
Hope this helps,
Laurel
I have HYPOthyroidism so all the things I need to AVOID might be
helpful for you. The literature certainly suggests this! Rebecca Wood
(WHOLE FOODS ENCYCLOPEDIA) suggested that using sea vegetables, even
though they contain iodine, can modulate thyroid activity. Raw
cruciferous vegetables, soy and carrot juice are goitrogenic and
therefore can inhibit thyroid function. I had a client with asthma
and hyperthyroidism. Interestingly, when we addressed her food
sensitivities/allergies through an elimination diet, she was able to
reduce her meds for both the asthma and thyroid issue (same med as you
have been prescribed).
Good luck!
Nori
I am currently being treated for a more severe hyperthyroid with a
beta-blocker that is safe to use while breastfeeding. I was diagnosed
about 3 months post-partum. I do not feel 100% better but my symptoms
are more tolerable (extremely high heart rate, muscle treamors,
anxiety, being hot & sweaty, etc.) I do think it is something you need
to take care of. Evidently, I was close to what is called ''Thyroid
Storm'' which is more serious and can require hospitalization.
Luckily, I have a very competent doc. that figured this all out when I
went to see him for joint pain. Ask your doctor about a
beta-blocker. According to him, even though it does not attact the
thyroid it does decrease the symptoms. I have had no
side-effects. Both my doctor, and the research I have seen, say this
should go away (yea) or switch into hypothyroid (yuck). Feel better.
Another Amy
I experienced a postpartum hyperthyroid condition shortly after
the birth of my second child. My most prominent symptom was a
very rapid heartbeat, as much as if I had done strenuous
excercise, from just waking up and getting out of bed. My heart
was just racing! I was treated with propylthyuricil (PPU) in a
low dose since I was also breatfeeding. After 18 months of the
medication and monitoring from my endocrinologist, the condition
fortunately has gone into remission. Still I am being monitored
every few months via a blood test to make sure that it does not
recurred. In my case, should the condition recur, I would need
to do radioactive iodine treatment to dissolve the hyperactive
thyroid and then take supplements for the rest of my life. So I
really want this conditon to stay in remission. I did not
research any alternative methods.
anon
I am surprised that your doctor didn't perscribe PTU. This is
the drug you should check if you are nursing. I take 100 mg of
PTU a day and am still nursing. I checked on the dose with the
pediatrician and he said that was fine.
There is a good thyroid discussion group that you might want to
look at: http://maelstrom.stjohns.edu/archives/thyroid.html
Helena
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