[kbolling]

#1018662

I was also just diagnosised with Graves’ last week. They had suspected it for sometime and just had my uptake done last week. I have been taking PTU for the last year with several ups and downs and even balanced out for a while. I just switched to a new endo who finally figured it all out for me (I had not had an uptake before because I was breastfeeding when the it all began). I go to her this week to discuss treatment. I am hoping to avoid RAI and I feel like everything I have been reading about online and in books doesn’t show Anti-thyroid drugs as a strong option. I’m 36 (almost 37) and was hoping to become pregnant in the next year. I have no idea what RAI could do to affect getting pregnant…the affect on my body, future baby, etc… I also wonder about what it could do if I am breastfeeding. If I can’t seem to level out and this is my only option, how long to I have to wait before getting pregnant..does anyone know?

Also…I am not finding much to tell me about how Graves’ will affect a pregnancy if I am still on PTU. They continue to tell me that the symptoms will get better, but I do worry about the baby…any insight from anyone who has gone through this?
Thanks so much….I appreciate the support.

[Bobbi]

#1066290

When someone has Graves disease, the normal mechanism for controlling our thyroid hormone levels is broken. Antibodies have disrupted the process. During a pregnancy, the immune system adjusts, so that antibodies do not attack the "alien" tissue of the baby in the mother’s body, and so many of us who are hyperthyroid and on antithyroid meds (ATDs) like PTU, find that we become less hyperthyroid over the course of the pregnancy. (Antibody levels are lowered, symptoms go away.)

Normal thyroid hormone levels are important for a lot of reasons when it comes to pregnancy issues. If they are out of whack, they can make it harder to get pregnant in the first place. Both hyper and hypo conditions have been cited in the literature as causing infertility. So, the first thing you need to do is get those levels under control. If the ATDs are not controlling your levels, it can make it harder for you to get pregnant. If you have had surgery, or RAI, you need to be at controlled normal levels for the same reason.

In addition, the developing baby needs to have access to adequate amounts of thyroid hormone in order to have his/her brain develop normally. HypOthyroidism is a leading cause of mental retardation in the world.

So what this all amounts to is that during a pregnancy, the mother who has Graves is monitored frequently for her thyroid levels to keep them in the normal zone.

The ATDs are known to cross the placental barrier into the developing baby. They are also known to cross to the baby in breast milk. PTU has been the ATD of choice if a hyperthyroid woman is pregnant, because it does so in more limited percentages than does methimazole apparently. We have seen successful pregnancies reported through the years of this board, from women who went through their pregnancy while on PTU.

Women who have had their thyroid removed, and are on replacement hormone still have to be monitored during pregnancy to be sure that her thyroid hormone levels remain in the normal zone. There may be a need to adjust the amount of replacement hormone during the course of the pregnancy. (Typically "some" thyroid tissue is left after either surgery or RAI, and if there is enough of it left, our replacement needs will fluctuate over the course of the pregnancy.)

We are typically advised to wait a minimum of six months to try for pregnancy after RAI. The rationale for this is twofold. First, to err on the side of caution, it allows for the most mature eggs from the ovaries to be discarded during menstrual cycles. The theory is that if radiation is going to affect an egg, it would be the ones that are most active, most ready to be released from the ovary. Second, it allows for time for us to get to normal controlled levels of hormone, and, more importantly, to HEAL after the ordeal of hyperthyroidism. The timing can vary, because some of us take longer to hit normal, controlled levels of hormone than others. Surgery is typically a bit faster that way. But alllowing our bodies to return to a healthy state improves the likelihood that a pregnancy will go smoothly.

I hope this information helps,

[kbolling]

#1066291

This really does help. Interesting…I never knew about the mental retardation fact..wow. Interesting facts about the eggs too, I had no idea that was the reason. I really just want to get my levels in control and need to find the best method to do it. I am assumming that it is very different for everyone. It’s really good to hear real perspectives.

[Author]

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