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EO79 10-18-2007 05:13 PM

Pregnancy and Hypothyroid
Does anyone here have experience with pregnancy and hypothyroidism? I found out I was hypothyroid at the same time I found out I was pregnant. I had been gaining weight like crazy, I was super tired all the time, and I was feeling rather crazy (I was diagnosed with depression). Then, my doctor tested my thyroid levels and my TSH was 16 - very abnormal. Well, about two months later I had a miscarriage. I think it was probably due to my thyroid disorder. Well, my doctor currently has me on 100 mg synthroid, and I still feel like crap. Now, my throat has begun to swell and I feel constantly like I am choking. I also feel like a big fat blob and I don't want to do anything. I am seeing the Endo on Monday, and hopefully he will help me. I really want to get pregnant again soon, but I've been reading that hypothyroid in pregnant women can cause brain damage in the babies. Do any of you have advice on questions I can ask my doctor? Or, any words of advice for me? Thanks. :(

midwest1 10-18-2007 10:52 PM

Re: Pregnancy and Hypothyroid
I'm so sorry about your miscarriage.

Hypothyroidism puts women at higher risk of infertility, miscarriage, and premature birth. It also can cause low birthweight and IQ deficit in the baby. It might be best if you can postpone your next pregnancy until your TSH is lower and your free T4 much higher to have the best shot at success. I think if you ask the endo, he would agree.

One thing you should ask the endo for is testing for TPO and Tg antibodies. They cause an autoimmune disease known as Hashimoto's thyroiditis, which is the leading cause of hypothyroidism. TPO antibodies by themselves, even if thyroid levels are in the normal range, are thought to contribute to miscarriage and premature births. If you're found to have them, a daily dose of supplemental selenium can lower the count by up to 40%. As far as I know, Tg antibodies are not a concern for successful pregnancy.

It takes time for levels to change, but you ought to be seeing improvement within a few weeks of starting treatment. By the time you find your optimal dose, you should be feeling darned good. The thing is... It takes time to reach that optimal dose. Most doctors start the patient on a dose lower than he thinks she'll need and then increases it gradually until the right dose is reached.

You'll be healthy again, but it probably won't be as fast as you want. Try to be patient. And come here for support when things get rough.

mkgb 10-19-2007 07:27 AM

Re: Pregnancy and Hypothyroid

This is a link to my post after I got through with my Endo. I am 32 and have Hashi's.. a pregnancy in the future could be the final death nail in my thyroid.. I am actually looking forward to the bugger dying.. this hyper/hypo spiral sucks.

Key is monitoring you closely during the pregnancy.. this means routine TSH and FT3/FT4 testing as soon as you know you are pregnant and every 2-4 weeks after that. You need to have directed ultrasounds of the baby to note its growth and even detect thyroid groiters. Early on the fetus is dependent on you for its T4 and T3. This drives women hyper in their first trimester.. but if your thyroid is dead it can not provide the needed T4 to allow for the development of cognitive function and proper physical growth.

Then NACB (National Academy of Clinical Biochemistry) Recommends the following.. as does my SIL a specialized OB and many FACOG/MFM OB's that specialize in high risk pregnancies.

The studies showed that the groups treated with levothyroxine—including the TPOAb group with normal TSH levels— and the TPOAb-negative control group had similar miscarriage rates, 3.5% and 2.4% respectively, while the group of antibody-positive women who did not receive treatment had a miscarriage rate of 13.8% (95% CI, 1.13–2.25 and 95% CI 2.59–9.48, respectively). The untreated group also had a higher premature delivery rate of 22.4% (95% CI, 1.18–2.34), versus the levothyroxine group’s rate of 7% (95% CI, 1.18–2.34) or the control group’s 8.2% rate (95% CI, 7.93–18.7).

It is based on these findings, that many clinical biologists and the MFM Ob specialist recommend screening women early in pregnancy for TPOAb (Hashimoto's identifier) and thyroid function. Also it is stressed that administering levothyroxine at least to women who have a TSH value greater than 2.0 mIU/L and/or a high titer of the thyroid antibodies is essential for a healthy lower risk pregnancy.

So to summarize the garbledy goop... the guide line is to take a T4 or T4/T3 supplement and maintain a TSH less than 2.5 your whole pregnancy. Especially if you have an AI like Hashi's. If you do not chances of damage to the fetus, miscarriage, and hypo issues with you come to the forefront.

Testing and medication adjustment should be done every 2 to 4 weeks. Supplement demands can increase by as much as 60% during pregnancy. Many women have healthy babies who are hypo thyroid. The key is treatment and rigid control of the T3/T4 levels in your body. My family is riddled with thyroid dysfunctional women.. my mother Hashitoxicosis had to children.. all my aunts had children with my youngest Aunt (Graves sufferer) having 4. All the children were and are healthy. I am the first of the newest generation to have thyroid issues. Hashi's! Wheee! But I am not going to let it win.. I know it is there and thus will treat it. I have a healthy, too smart for his own good five year old. Man he is either going to be a lawyer, mad scientist, or engineer. He says he will do it all. One never knows.

You can to. Get your self balanced and get the TSH, T4, and T3 concentrations in your blood to optimal levels. Go through your Ob and hook up and consult a maternal fetal medicine OB specialist for care and treatment of your thyroid. The Endo will get you in normal range but not optimal.. you need to be optimal to have success in getting pregnant and having a good pregnancy. Use the FT3/FT4 test to monitor your T3 and T4 levels. Keep the T4 and T3 levels in the 50-85% range of normal.. this is optimal. It is better to ride a little hyper during your pregnancy, than hypo. Do not allow your self to go to hyper.. this has issues of its own. Once you are in the 20 week mark the child should be producing its on T4 and T3, but it is dependent on you for the iodine.. salt cravings are a good indicator that you r iodine is off. If you are not allergic to iodine.. make sure your prenatal vitamins contain iodine. Iodine allergies make life a bit more difficult getting the necessary iodine in your system.

I hope this helps.


Reece 10-19-2007 07:57 AM

Re: Pregnancy and Hypothyroid
Reproductive endocronologists are specialists in getting your hormones right for and thru. pregnancy. If you have that option, perhaps you can see one, and ease your mind and worries at your next try.

I agree with midwest, you should wait until your levels are more stable to start either way.

EO79 10-19-2007 12:29 PM

Re: Pregnancy and Hypothyroid
Thank you so much ladies - I truly appreciate all the info. When I was pregnant, I did advise my OB of my hypothyroid, and he never asked me any questions. He said my PCP could regulate the tyroid, and he never indicated any connection (I have since come to realize he is a total quack). Are there Endo/Ob docs that specialize in hypothroid pregnancies?

I know I need to wait until I'm regulated to get prego... I also want to lose a little weight first too - my self esteem is seriously suffering, and I don't think I can handle another 20 pounds right now.

mkgb 10-19-2007 01:33 PM

Re: Pregnancy and Hypothyroid
Yes there are specialized Ob's. You need to look for one with the specialization abbreviations of MFM and FACOG. They are high risk OB's.. they do not do the delivering or c-section if need be.. instead they monitor all high pregnancy patients.. be it diabetes or miscarriage or thyroid or age.


EO79 10-19-2007 04:59 PM

Re: Pregnancy and Hypothyroid
OK, Thanks! My OB was FACOG, but he was also a plastic surgeon... I totally felt like he didn't care about me. When the time comes, I will definitely be more picky next time. I'm totally afraid to get pregnant before I have the hypo under control. Thanks again.

mkgb 10-19-2007 07:29 PM

Re: Pregnancy and Hypothyroid
My SIL OB.. recommends MFMs over FACOGs, but MFMs are rarer. MFMs are often asssociated with a hospital.


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