[Steph82]

#1060075

Lately my husband and I have discussed the possibility of having another child in the very near future. We are in our 30’s and have 3 kids and like the idea of having just one more. However Graves’ Disease puts a huge damper on the situation. In the past we decided we wanted a baby, got pregnant, everything went perfectly and I never had a single complication! Does anyone even know if its possible for me now with this disease?

Here is the low down – I was diagnosed in March, found out I was allergic to Methimazole in April and have been on PTU ever since. I still don’t feel right but I have good days and bad days. My doctor still hasn’t checked my liver but plans to in August. I am not ready for something permanent at this point so if I were to get pregnant I would have to stay on PTU through the pregnancy, is this even safe? I hear they generally switch to MMI after the 1st trimester but that is not a possibility for me.

I’m the type that breastfeeds past a year and I even had an unmedicated home birth (with a midwife present) with my last child. I’m thinking all of this will be out the window due to medications and that GD will likely put me at high risk. I’m not sure I want to risk my life or the life of a baby…

Of course I plan on speaking with my Endo as well as my Gyno but I want the opinion of those who have BTDT. Anyone here have experience with pregnancy and Graves? What are your thoughts on my situation? Should I suck it up and close down the baby factory for good?

[snelsen]

#1180138

HI! And a big welcome to this marvelous forum. And, as you know, we are fellow Grave’s folks. But if you use the search option, putting in different words, “pregnancy, or pregnancy and Graves,” you will see a lot of posts.

Our facilitator, Kimberly, will have very good references on this subject.

I also fed my babies way past a year. I loved it! My experience is that I proceeded to have two more babies after Graves’. No issues, no problems at all. The baby needs to have thyroid labs shortly after birth. And a pediatric endocrinologist should manage his/her care.To synthesize and reflect what you said, I think you have the right idea to move forward with getting the qualified docs involved in your care, so you know you have them, that you are happy with them, and that worry is off your mind.

You want to have another baby. Graves’ is no reason to close the baby factory, but it is a reason to give you pause, to get healthy before you decide to try for #4.

As you know, you definitely need an endo who has experience with Graves’ ad pregnancy, but there is much to be done before that time. You have been diagnosed only 3 months.

There are some good references, and many good posts about this, but your decisions are three options. The quickest one is surgery (TT) a total thyroidectomy. RAI takes a lot longer to be ready to get pregnant.
And you are interested in ATD’s. That is fine, as long as you are being followed by a high risk OB, preferably one who is familiar with Graves’, and your end.
1. Did you have a true allergy to MMI (methimazole.?) I am asking, because this is definitely a cause for attention, but there are allergies….and allergies.
A small rash, and hives. Good to discuss with your endo. Do you feel you cannot take MMI? Or was this a quick decision made because of a minor rash. Just asking…..

2. Speaking of ATDs and liver function tests, liver involvement is VERY rare, but the incidence is most prevalent at the very beginning of treatment. I would ask you endo about this in this form of a concern. I’m thinking you should be having labs more frequently, and absolutely have a set of labs before August. It concerns me a bit that this was not done.

This is a response of the top of my head, and I am sure you will hear from others. Your family sounds wonderful!
Shirley

[Kimberly]

#1180139

Hello – Shirley’s suggestion to use the keyword search function is a good one. We do have many posters here who have gone on to have more children while on ATDs. The reason that most patients are switched to Methimazole during the second trimester is that it has a better safety track record with regards to liver issues than does PTU. This is true for all patients, not just those who are pregnant – but PTU is the preferred drug during the first trimester of pregnancy, due to the risk of a couple of specific birth defects with methimazole.

The following link is a really nice resource from the American Thyroid Association on pregnancy and thyroid issues.

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

http://thyroidguidelines.net/sites/thyroidguidelines.net/files/file/thy.2011.0087.pdf

The section on Graves’ starts on page 1094 of the original journal article (page 14 if you download as a PDF).

Wishing you and your family all the best.

[Steph82]

#1180140

snelson – I do believe I had a true allergy to MMI, I had huge hives all over my legs for 3 days that kept getting worse until I stopped the meds and my hands, feet and joints swelled up to really painful levels. It hurt to walk because my feet were so swelled up. The day I didn’t take it I was totally fine!

I called my doctors office yesterday and told them I was feeling off (which is totally true!) and would like my lab work done sooner rather than later, they agreed to let me do it and I already have the order which includes liver enzymes this time so I’m going today! I have been worried about the liver part of this so it will give me peace of mind in the very least! I think I should be monitored frequently at this point still being so new to it, no clue why doctor was giving me 3 months before getting checked out!

Kimberely – Thanks for the links!

[snelsen]

#1180141

HI!
I agree 100% with you on all that you said! Glad you having liver labs,a nd that you have been proactive about getting labs now. Yay.
You bet, that IS a true allergy! For sure.

When you see endo, I would have a non confrontational conversation, simply for your education, and to evaluate your endo, expressing your concern about having labs so infrequently. This really is not the way to go when first diagnosed, with changing symptoms, and possible dose changes, either up or down.
Shirley

[LaurelM]

#1180142

Hi,
My laptop harddrive died so I hadn’t checked the forum for a few days. I am typung onmy tablet and much prefer a real keyboard so ignore any typos.

I was on methimazole for several months during my first round of Graves and then developed hives and at the same time we discovered were pregnant with our second so for both reasons I was switched to PTU.

Our baby is now a happy and healthy 6 year old. I have written some lengthy posts about my experience. You can search on my user name if you would like to read more, and I would be happy to answer any questions I can about my experience.

It is a lot to think about.

Best wishes,
Laurel

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