[nursetak]

#1060357

Hi all,
I haven’t been on here for quite a while, almost two years. I would like to see what you think about my current thoughts.

I was dx with graves about a year and a half after my daughter was born. I went on PTU for about a year and then was taken off because I had gone into remission. Excited and feeling great, my husband and I decided to try for a baby #2 (and last) during my two years of remission. Well, I lost one due to miscarriage and then other one was an extremely complicated identical twin pregnancy that was so rare and required me to have very risky fetal surgery which we did not want to have, so we had to end the pregnancy. This was this past August.

In January, only a few weeks ago, BAM. My graves symptoms returned. I am very sensitive to my symptoms. My TSH was 0.34 (0.34-5.0), T3 131 (87-178) and FT4 0.9 (0.6-1.6). My endo did not want to start me on meds and asked if it would be okay if we waited a little longer to see where the TSH went because it can “fluctuate”. I understand this, but I sent him back an email begging him to let me please start the PTU because I was looking at the trend and my symptoms are back. He agreed to start me back on PTU 100mg twice/day which I have been on now for 2 1/2 weeks. I am really nauseaus, but I am feeling better.

After our loss in August, I was so depressed and took myself to the Reproductive Endocrinologist because I was absolutely convinced that my pregnancy problem was because of my graves. But she said no, and that I was just unlucky and that we could try again. She ran a ton of tests on me and this time, she ran Thyroid antibodies which I had never been drawn before. My TPO antibodies were very low and normal, but my Thyroglobulin antibodies are 206 and the normal is <116. This came to me as a red flag because I was never aware of any antibodies but I was never told I had any or tested for them in the past.

My question is what does this mean for another pregnancy? Iknow I am at high risk for miscarriage because of antibodies as my endo told me. But does it increase my c hances to give a baby graves disease? I am a nurse and I always understood that if a baby gets antibodies from it’s mother, that is okay and never means that it will get the actual disease. But those are viral type antibodies and not sure form an immunological standpoint is the same thing.

I need info! I am scared and anxious. We want to give our daughter a sibling but I don’t want to give a baby graves disease. I know that because graves may be hereditary, a child might get it no matter what, but am I literally transmitting a baby my disease because of my antibodies. I have full faith that my OB would monitor my levels and keep me on the PTU as needed, etc. He told me that with my last problem, graves is easy and that he currently has 5-6 patients with active as well as non active graves right now. My endo is great, but he doesn’t have much to say because a lot of this is unknown. I have an appointment with my RE again because my husband and I have tried consecutively for 4 months with no success and I know it is probably from my graves…. not sure what our next step might be.

Please if anyone can offer hope, insight, knowledge, etc. etc. PLEASE! Thank you.

Any

[Kimberly]

#1182154

Hello and welcome back! {{{Hugs}}} to you and your family for all that you have gone through in recent months. We are fellow patients here, not doctors, but here are a few thoughts.

First, definitely check out the latest guidance from the American Thyroid Association that covers thyroid issues and pregnancy:

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

(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).

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

As far as I know, Graves’ disease itself does not lead to miscarriage, but being hyper or hypo can increase the risk of miscarriage. Being hyper or hypo can also affect fertility. So it would be important to get your levels to a place where they are normal *and* stable before trying to conceive.

Yes, the Graves’ antibodies can be passed on to the fetus. This is why the ATA recommends checking antibody levels during pregnancy (as noted in the link above) and bringing in a maternal-fetal specialist if antibody levels are extremely elevated. The effect is usually temporary (since the baby’s own immune system isn’t directly producing the antibodies), but the situation does require extremely close monitoring to protect the baby. The stats from uptodate.com are that approximately 1-5% of infants born to Graves’ patients have this issue.

We have had many posters here over the years who have had successful pregnancies, so hopefully, some of them will chime in.

I hope that this helps. Wishing you and your family all the best!

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