[Kennedy]

#1058642

I have been diagnosed with Graves for about a month. My TSH levels are at .02, I have been reading the previous posts and it seems as though this will cause trouble conceiving? Also I am on PTU 25mg twice a day. I was told this is the one to take if I was to get pregnant or try to get pregnant. I am also on Antenolol for tremors, heat intolerance, etc. My endo said not to do RAI because we wanted to try to have a baby. How long should we wait to conceive? We have put it on hold since diagnosis. I want a child, I’m getting older, but do not want to put this baby at risk. Need advice.

[Kimberly]

#1169147

Hello – No one here can give you a specific timetable, but the important thing is to make sure your levels are *normal* and *stable* before trying to conceive. Having thyroid hormone levels out of balance not only makes it more difficult to conceive, but during pregnancy can be dangerous for both mother and baby.

Here is an article from Dr. Giuseppe Barbesino on Graves’ and Pregnancy Planning; he recommends waiting to try and conceive until thyroid hormone levels (T3 & T4) are within the "normal" range and TSH is between 0.5 and 2.5.

http://www.ngdf.org/cms/modules/files/uploads/46291.pdf

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

Hope this helps!

[Kennedy]

#1169148

Thank you, that article was helpful. As I am new to this I have another question, unrelated to pregnancy, I am having neck pain on my left side. It seems to travel up to my ear. This began after I started on PTU. Is this a side effect? It is so uncomfortable!
I also wanted to comment on how helpful this site and message board has been to me. It is nice to have other people who understand how you are feeling, and be able to seek answers.

[Kimberly]

#1169149

Hello – Thanks for the kind words! Joint pain is a possible side effect of PTU, but I’m not familiar with neck pain specifically causing an issue. You might mention this to your doctor or pharmacist, though, if it continues to bother you.

[gangstabear]

#1169150

I was wondering how long can one be on PTU? I don’t hear a lot about PTU. My endo didn’t even suggest it when I told him I would like to have a baby in the next year or two. He was fast to tell me to stop taking Methimazole and do RAI. Im on 5mg of Methimazole and my levels are stable.

[Kimberly]

#1169151

Hello and welcome! PTU is associated with a higher risk of liver complications than methimazole, so it is generally not used as a front-line treatment for Graves’.

However, methimazole can increase the risk of a couple of specific birth defects if taken during the first trimester. The latest professional guidance is for patients who are pregnant and on ATDs to switch to PTU during the first trimester of pregnancy and then switch back to methimazole during the second trimester.

If you use the “search posts” option in the top right-hand corner of the screen, you can do a search for “pregnancy”, “pregnant”, “conception”, etc.. There are many women on this board who have had healthy pregnancies while taking ATDs. One caution, though, would be to make sure your levels are stable prior to trying to conceive, as being in either a hyper or hypo state can be dangerous for both mother and baby. Take care!

[gangstabear]

#1169152

Thank you, Kimberly!

My levels are stable but sometimes I feel I am heading towards hyper (and increase my dose of Methimazole to 7.5mg). I am not sure about the antibody level. It is not common practice to do the TRab test in Canada. I requested to have it done to make sure my TED was not getting any worse (I have moderate TED), and the levels came back normal. Both my Endo and Opthalmologist said they do not look at the antibody levels when deciding the treatment choice for patients with GD.

[Kimberly]

#1169153

Hello – The latest guidelines from the American Thyroid Association note that when a patient has a past or present history of Graves’ disease, antibody (TRAb) testing should be done at 20–24 weeks gestation, with the involvement of a maternal-fetal specialist recommended if antibody levels are excessive. I assume that the docs in Canada are at least somewhat involved in the ATA, as their upcoming conference is in Quebec City this September!

Antibody testing is most commonly used for diagnostic purposes and for determining whether Anti-Thyroid Medication can be discontinued. Some eye docs also use antibody testing to determine when TED is no longer in the “active” phase, although physical symptoms need to be considered as well.

Antibody testing usually does not impact the course of treatment, although excessively high antibody levels are considered a risk factor for worsening of TED after RAI.

[susanne13]

#1169154

Kennedy,
I have no idea if this will help you…I was in a similar situation, after being diagnosed in January 2010 and put on PTU because were thinking about having a baby. I ended up having a total thyroidectomy after A LOT of research and discussion. But yes, it’s true that your endo will not advise getting pregnant until your levels are stable and within normal range! Best of luck to you!!
Susanne

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