[revelea]

#1018121

Hi,
I was diagnosed with Graves’ Disease a couple years ago. I was on methimazole for one year and have been in remission for a little over a year.
I got married last July to a wonderful husband. I’m thirty-one years old and it’s about that time for us to think about starting a family. However, I am deathly afraid I will become hyperthyroid again after having a baby. What is the likelihood that that would happen?
I had a tough time with Graves’. I developed Graves’ ophthalmology and went through an orbital decompression and eyelid surgery. My hair was falling out and I had hand tremors.
I know there’s always a risk of falling out of remission and that there are treatment options if that should happen. I just wonder if everyone here thinks having a baby is worth the risks or if anyone has ever been in my position before.
Thanks for your support. ” title=”Very Happy” />

[ely2009]

#1062792

Hi,

I didn’t really "decide" to have a baby, but I’m 35 weeks pregnant and I’m 38 years old! I have an 11 year old and a 7 year old – we had lots of trouble conceiving both. It was quite a shock to learn that I was pregnant again (a WONDERFUL shock!!)

I was officially diagnosed with Graves in April 2009 and began using methimazole. I responded fairly well to it and my thyroid levels were hanging in the normal range by December 2009. My endo suggested that I try to wean from it to see if I would be in remission. She weaned me slowly and checked my levels every 6 weeks. I was down to 1/2 pill (maybe 2.5 mg – it’s been so long I don’t remember) every other day when I found out I was pregnant. Luckily for me, I was "only" about a week pregnant so I had only taken a pill and a half since conception. My doc is not worried about that amount. I immediately stopped meds and she’s just been monitoring me – about every 6 weeks. My thyroid levels have stayed normal throughout my pregnancy. My endo explained that with Graves (and I guess with other auto-immune diseases) the mom’s body tries to "protect" the baby during pregnancy and will often sustain a remission. What is more common, I guess, is a "flare" of symptoms 6-8 weeks after delivery. Her plan is to check me every 6 weeks for a few months and then not as often if I don’t have symptoms. So I’m just waiting and hoping for the best. It’s reassuring to know that I’m being monitored so closely and that I’m very aware of the symptoms to watch for, that I won’t get as sick as I was the first time around.

I don’t know statistically what the likelihood is that you’d fall out of remission. Hopefully, someone will respond that knows more from the medical standpoint. I just wanted to share my story and reassure you that you can have a healthy pregnancy after a Graves diagnosis and a healthy baby as well.

And, as much as I DON’T want to re-visit my hyperthyroid days, having a baby is definitely worth taking the chance to me!!

Good luck!

[LaurelM]

#1062793

Hi,

Like ely2009, I didn’t really decide to become pregnant with our 2nd when we did. We had always planned that we would probably have two but mother nature sent her ahead of our schedule. I was likely already in remission or just on the verge like ely2009 when we discoverd the pregnancy and I was switched to PTU but was only on ATDs for about 1 month (or less since I really didn’t keep much down my first trimester) before I stopped taking it.

I had a medical team of my endo, a high-risk OB, and my family (also our children’s) Dr who all communicated and followed me closely. I had a nice & boring (my Dr’s description) pregnancy and birth. The nurse got the do the ‘catch’ the second time as my OB did not make it in time – I didn’t even have to push.

In my case, we suspect that the GD was triggered post-partum with our first. I was diagnosed 8 months after her birth but in hindsight had probably had it for at least 5 months prior to diagnosis. I just chalked up all the symptoms to new-motherhood, long commute, stressful job, etc. I was on Methimazole for about a year (my memory is getting fuzzy for the exact length).

Any woman who has had GD and becomes pregnant does need to make sure that she has the right doctors and that they know about the GD history so that they can just keep a closer eye on the pregnancy. There is a super rare, rare, rare possibility the baby having a transient hyperthyroid state at or shortly after birth. One test they may do in the 3rd trimester is a TSI as an elevated TSI (even if the mother’s thyroid levels are normal) indicates the baby as a slightly elevated risk for this happening. All babies have the thyroid levels checked anyway. Again, a very, very, very small risk.

I was pretty much resigned that I would fall out of remission after our 2nd baby so I really thought about what kind of treatment I would want considering I would have two small children and wanting to be able to breastfeed. I was still nursing our first when I was put on the ATD. My endo wanted me to be able to continue nursing. My endo, my baby’s Dr, and a pedicatric endocrinologist all agreed that for us the benefits outweighted the risks for continued nursing while on the ATD. RAI would have forced switching to formula. Different Drs will have different opinions about ATD use and nursing and individual circumstances will factor in.

Prior to our second baby’s birth, I decided that if I came out of remission post-partum, I would again consider ATDs or a surgical thyroidectomy. Also, knowing that you are at risk, they would check your levels frequently so you have minimal time at hyper levels. Now that my children are older (4 & 6) if I were to fall out of remission, I’d consider all 3 options.

Anyway, my advice would be to talk to your spouse, your dr, find a high-risk OB, and find a pediatrician or family MD who you trust to be your medical team and get all their opinions and their advice.

Best wishes!

Laurel

[revelea]

#1062794

Thank you so much for your feedback! It’s nice to know that during the pregnancy, you are monitored very closely. It’s also nice to know that thyroid levels can stay pretty normal throughout the pregnancy. I guess it’s easier to control when you know what you’re looking for. I just hope I have a team of doctors who are as competent and caring.
I feel much more comfortable with the idea of having a baby. I think it would be horrible for my husband and I to decide not to have a baby just because of what "might" happen. I will just have to trust that everything will be okay.
I am always afraid that I will become hyperthyroid again but I think I would be able to handle it better the next time around should it ever happen. Does anyone know the chances of falling out of remission after being hyperthyroid?
I know Graves’ is a life-long disease and I’m so glad grateful for your support. It is so hard to find people who know what I’m going through. I live in a major metropolitan area and there are no support groups anywhere near here. It’s nice to know I’m not alone.

[ap123]

#1062795

My dr. said that a reason why people fall out of remission is due to the body going through some shock as is the case with a pregnancy when so many changes are taking place.
Im glad i found this forum Im thinking of having another baby. My son is now 3 and i have been in remission for about a year now. But im afraid that my thyroid will go wacky again, especially if it happened during a pregnancy. Has anyone experienced problems with their thyroid becoming hyperactive during pregnancy?

[cdstrate]

#1062796

That is what I’m curious to know about as well. I recently decreased my med from 10 mg to 5 mg and hopefully goes in remission. Once I’m in remission, I’m hoping to try and have a baby again. I went to see two specalists; the one in Boston said I will conceive no problem without complications.. another said I can relaspe and the graves can come back. THere are also risks of miscarriages, so I been getting my hopes up and down…Im really confused.

[Kimberly]

#1062797

Hello – I’m aware of a couple of studies that have suggested that women are at higher risk for relapse after pregnancy. One study suggested that women with a past history of Graves’ should have routine thyroid function testing done at 3 months and 6 months postpartum, just to make sure everything is OK.

*During* pregnancy, the key is making sure that you don’t end up either hypO or hypER. In addition to making sure your FT3 and FT4 stay in the “normal” range, be aware that there are newly released guidelines for TSH during the first trimester of pregnancy. The American Thyroid Association has recommended that labs develop their own specific ranges for each trimester of pregnancy, but if that info is not available, they suggest a range of 0.1 – 2.5 mIU/L during the first trimester. Here is an article on Graves’ and pregnancy from Dr. Giuseppe Barbesino at Mass General Hospital: http://www.ngdf.org/cms/modules/files/u … 541955.pdf

(You will need to click your browser’s "back" button to return to the boards after viewing).

[Georgeste]

#1062798

You have hypothyroid issues, which is an underactive thyroid. I’ve read this is actually quite common postpartum, and at one point suspected I may have had the condition, but since I had no insurance, I couldn’t verify my suspicions. If that was what going on with me, it did resolve – perhaps after 6 months?

Hypothyroidism is actually preferable to a certain extent. Not great. But I have a friend who has had it for years. When she’s able to see a doctor and have her meds properly adjusted, she actually gets back to normal and can lead a fairly normal life. She’s even lost a great deal of weight in recent times by counting calories – and she’s still nursing her toddler. In fact, she even had her hypothyroid condition while pregnant with her most recent child.

If you have hyperthyroidism – like Grave’s Disease – something which is more common among family (ie. my mom has Grave’s and thus I have a far greater risk of developing it), the only treatment will ultimately be to zap the thyroid. My mom has struggled a great deal since her thyroid was essentially killed. Without any thyroid function whatsoever, they have had a hard time adjusting her synthetic thyroid medications, and she has never gotten back to feeling ‘normal’ again.

I know that one thing the doctors have done both for my mom and my friend despite their different thyroid issues is to give them mega-doses of Vitamin D. Apparently Vitamin D is crucial to thyroid function, and so if your doctors have not already done tests to determine whether or not you are deficient, perhaps you could suggest this. If they have done tests, I recommend – under their supervision – upping Vitamin D intake significanty. Perhaps this would be what your body needs to kick your thyroid function back to normal.

[Kimberly]

#1062799

Georgeste wrote:If you have hyperthyroidism – like Grave’s Disease – something which is more common among family (ie. my mom has Grave’s and thus I have a far greater risk of developing it), the only treatment will ultimately be to zap the thyroid.

Hello – Anti-Thyroid Drugs are another option for treating hyperthyroidism. A certain percentage of patients will go into remission after a course of ATDs, and other patients are able to maintain "normal" thyroid hormone levels using a low dose of the meds for the longer term. All three options (ATDs, surgery, RAI) have risks and benefits, so it’s important for each patient to do his/her own research before making a decision.

[snelsen]

#1062800

Ad responding to the message above addressing Georgest’s post, Theo other treatment is surgery, which is the treatment I chose.
a suggestion for your mom, Georgeste, is for her to ask her doc to change to another brand of thyroid hormone. It is not supposed to make any difference, but in my body, it does make a difference. I am on Synthroid, which is still more expensive, but when I changed to generic, O got all out of whack with how I felt, and my labs.

[Author]

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