[smj78]

#1017823

I was diagnosed with Graves, hypeTr in Dec 2010. In the beginning of Feb, 2011 I had RAI. I turned hypoT about 2-3 months later and have been on Levoxyl. The dose has been changed a few times and now I am on 125 mci. I feel pretty ok, beside the weight gain. I started weight watchers and have fluctuated with motivation, but am not gaining as rapidly.

Anyway, the 6month mark is next month and as long as my blood work is ok, I would like to try to conceive again. I see the endo this Tuesday. I started reading and am freaked out. I am so nervous about everything. Especially if I will get pregnant at all and if I will maintain the pregnancy and have a healthy baby. I had no idea the negative effects there can be on a baby.

What effect do the antibdies have on pregnancy? I don’t think this was every checked for me. What is the treatment for the antibodies?

Also, I read that optimal TSH is < 2 for pregnancy. Is that correct?

I have started a prenatal and calcium. Should I be taking an iodine suppliment? What else can I do to prep for the healthiest pregnancy?

I am so scared of miscarriage or the baby having problems. I know women have healthy pregnancies being HypoT, but I wonder if I’m being slefish wanting another baby. It would kill me to not have another though.

[Kimberly]

#1061121

Hello – The key to a successful pregnancy is to make sure your thyroid hormone levels remain in the “normal” range – not hypER *or* hypO. It’s best to check with your doctor on TSH levels, as the range can vary from lab to lab, but a recent article recommended having a TSH level of 0.5 to 2.5 (along with normal T3/T4) prior to trying to conceive.

The Graves’ antibodies (which can remain elevated after RAI) can potentially cross the placenta and cause neonatal hyperthyroidism. This is rare, but still something that you and your doctor will want to keep an eye on. This issue is more common when the mother’s TSI levels are high, so it might be worth getting this test done prior to conception.

I would not suggest taking any iodine supplements without checking with your doctor. If you have no thyroid function, it really won’t make a difference; however, if you still have some thyroid function, this could throw your levels off balance.

There are many women on this board who have had healthy babies after treatment for Graves’. Some choose to see a high risk OB/GYN to help guide them through the process.

[Bobbi]

#1061122

The reason, smj78, that you might be considered a "high risk" pregnancy is typically ONLY because your thyroid levels have to be managed "manually." This manual management of thyroid levels during pregnancy would occur no matter what treatment option you had chosen. The female body, during a pregnancy, tends to suppress antibody action,which makes it less likely that the mother’s body will mount an antibody offense against the baby while in utero. So, when someone has an autoimmune disease, the antibody levels will lower, and if that person has Graves it would mean that she would need less of an antithyroid medication, and perhaps a different amount of replacement hormone (if the thyroid has been removed).

Lots of women have had normal pregnancies after having treatment for Graves. Kimberly explained how things need to be managed. But I do send you best wishes for any future pregnancy.

[smj78]

#1061123

So lets say I get my antiodies and TSI checked before conception. Is there anything that can be done to regulate elevated antibodies? I am so confused on this. The literature makes it sound like it should be checked, but that there is only treatment for the thyroid.

My endocronologist told me I would not have to see a high risk OBGYN, as long as I regularly see her too for blood levels and medication management. Should I look into it anyway? I have my regular gyno appointment next month. Maybe I should ask them. I just want to do what is right.

[Bobbi]

#1061124

There are no treatments for the antibodies that do not suppress the entire immune system. That is why, since we can live healthy lives without a thyroid, our Graves treatments do not include such drastic measures. Some folks with autoimmune diseases DO have to suppress their antibody levels, but it puts them at risk for getting life-threatening infections. I also have no idea what problems this type of intervention might have on the baby in utero, either. I would suspect not good.

Also, according to my endocrinologist antibody levels fluctuate for no well-understood reason. It is why she checked my antibodies once but not at any other time. It was helpful to test for them when I was first being diagnosed, and had rampaging symptoms, apparently, but would do little good otherwise since I chose to quit the antithyroid med and have RAI done.

Worst case scenario with the pregnancy (with respect to the antibodies) is for them to cause the baby’s thyroid levels to go hyperthyroid. This is a temporary condition. The baby is not creating their own antithyroid antibodies. The mother’s anti-thyroid antibodies have simply passed through the umbilical cord, and affected the baby’s thyroid function termporarily. The antibodies die off, and the baby’s thyroid function returns to normal. This would be something to discuss with your pediatrician. I have not heard of it happening much, but I have heard that it happens occasionally.

The important thing for you is to have your blood levels of thyroid hormone checked periodically, to make sure that they remain normal. This is for your health, and for the best outcome of the pregnancy.

[pinky35]

#1061125

I had RAI in October 2010, and after the 6 month wait started trying again. I may be a little different story because I did use infertility treatments for this pregnancy–but wanted to let you know my endocrinologist fully supported us starting to try again. He was not concerned about the antibody levels at all. I am only 6 weeks right now, and had a scare this week, however we did see the heart beat today, so I feel good for now.

The biggest advice I have is to get your thyroid level checked immediately when pregnant. I was told I didn’t need the first check until about 8 weeks, however at 5 1/2 I had them checked for my routine 3 month follow up. Imagine my surprise when the labs came back at tsh of 17.2! My meds were immediately increased and I’m told it is just going to be constant monitoring to make sure my levels stay at an appropriate place (he would like it between 1-2). I am a bit frightened by such high tsh, but can only hope we can get it fixed quickly before any damage is done! I have unfortunately done too much reading on the effects of being so hypo on a pregnancy and fetus.

Good luck to you! It’s an added challenge, but my endocrinologist is willing to follow me through out pregnancy and provide the support needed to keep my thyroid levels in an acceptable range.

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