[ksale]

#1058745

Hi All,

I am new here and so happy I found this site! I was just diagnosed with GD 5 days ago and am feeling a bit overwhelmed. My Endo did not provide me with alot of information and just told me I need to take anti-thyroid meds until my levels get to normal and then proceed with RAI. I have spent the last few days reading everything I can find on GD and treatment options.

Here is my situation: I am 35 and have a 9 month old daughter. My husband and I were about to start trying for #2 when the GD was diagnosed. I have read alot about fertility issues post RAI as well as the increased chance of miscarriage. I have also read about it taking a long time to get levels normal after RAI. This is making me wonder if surgery could be a better option.

So I guess what I’m looking for is information from people who have been in my situation. What treatment option did you choose and how quickly were you able to acheive a healthy pregnancy? What did you like/dislike about the option you chose?

I’ve made another appointment with my Endo for this week in hopes he will give me more time and let me ask all of the questions I have.

[Kimberly]

#1169780

Hello and welcome! Hopefully, you will get some additional responses, but I would suggest doing a search on this board for terms such as “pregnancy”, “conceive”, “babies”, etc. to read stories from other patients who have had to make a treatment decision while hoping to get pregnant in the near future.

Also, here is a link to several guidance documents from the American Thyroid Association. One of them is related to thyroid disease and pregnancy, and there is a good section on Graves’ and pregnancy planning. You will need to use your browser’s "back" button to return to the boards after viewing.

http://thyroidguidelines.net/

There is a section on how women with Graves’ should be counselled before pregnancy, which notes that "…surgery is a reasonable option in the presence of high TRAb [antibody] titers if the mother is planning pregnancy in the following 2 years. TRAb titers tend to increase following 131I [RAI] therapy and remain elevated for many months."

However, *all* three treatment options have risks and benefits, so you will definitely want to do your own research and make an informed decision.

Wishing you all the best!

[Bobbi]

#1169781

What do the high TRab antibodies have to do with the pregnancy decision, Kimberly? Do they have an affect on the pregnancy itself? I’m not sure how to use this info.

And, to ksale: You will find that women who have posted here over the years have used each and every one of the treatment options prior to pregnancy. One, significant issue that you need to keep in mind, however, as you weigh the pros and cons of each one, is that, optimally, you need to be healthy when you start the pregnancy. None of the options works instantly to give you your health back. It isn’t as simple as "getting surgery/RAI" or "taking the meds" and you are healthy again. The body suffers while hyperthyroid, and it takes time AT NORMAL LEVELS of thyroid hormone — months of time at normal levels — for the body to heal. I mention this because all too often we expect to feel normal as soon as we get to normal thyroid levels, and it can be a source of frustration. Stamina and energy will return. We do get well again. But it takes some healing time.

Wishing you good luck with your decision.

[Kimberly]

#1169782

Hi Bobbi – According to the guidance, high antibody levels (TRAb) in the mother at 22-26 weeks is a risk factor for fetal and/or neonatal hyperthyroidism. The guidance recommends TRAb testing for all pregnant women with a past history of Graves’ (regardless of treatment) at around the 20-24 week mark and recommends close monitoring of the fetus, including the involvement of a maternal-fetal specialist, if antibody levels are more than 3 times the upper limit.

The guidance does not recommend one treatment option over another for women who are seeing to become pregnant, but rather notes that the increased antibody levels following RAI is one factor to consider.

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