[Anonymous June 20, 1998 at 1:54 pm Post count: 93172]

#1149530

Hi, JMT!

I’ve posted this info on the BB before (sorry for the repeat), but
these quotes have some answers to your questions:

***From the National Graves’ Disease Foundation’s bulletin #14,
“Graves’ Disease and Pregnancy”:
“The first precaution is to normalize the mother’s condition before
conception. Women using anti-thyroid drugs should establish a stable
maintenance dose of PTU. For women treated with surgery or RAI,
replacement thyroid hormone dose should be stabilized. Waiting six
months after RAI to conceive minimizes the effects of the radiation on
developing eggs. . .Any treatment or testing with iodine during
pregnancy should be strictly avoided. (I was told to wait one year
before trying to conceive, and your year of waiting is up.)

The child can be affected even when the mother’s Graves’ is well under
control. No matter how long ago they were diagnosed and treated, most
women with a history of Graves’ have measureable levels of thyroid-
stimulating antibodies (TSAb, TBII, and LATS) present in their blood.

These antibodies can cross over the placental barrier and cause Graves’
symptoms in the fetus. The symptoms – hyperthyroid, goiter, bulging
eyes – usually disappear within a few months after birth, when the
baby is no longer exposed to the antibodies. But in some, the symptoms
linger for years or reoccur later in childhood. In these cases, the
mother’s antibodies may have triggered Graves’ Disease in the child.

Because pregnancy “stirs up” the thyroid, even women who presumably
have little of their thyroid left after RAI or surgery can’t rule out
a hyperthyroid episode. The normal elevation of thyroid hormone in
pregnancy can mask a recurrence for women with a history of Graves’.
For this reason, close monitoring of fetal signs and maternal blood
levels (every 2 to 4 weeks) is important.”

***From “The Thyroid Sourcebook” by M. Sara Rosenthal:
page 113 “If you are hypothyroid or are taking thyroid hormone
replacement from a thyroid condition prior to pregnancy, the thyroid
hormone thyroxine – the usual treatment – is fine. Very little
thyroxine crosses from the mother to the fetus. Sometimes a change in
dosage is needed because requirements for thyroxine can increase during
pregnancy; it’s normal to require as high as a 40 to 50% increase in
your dosage. In this case doctors generally monitor the TSH level
anyway and will increase your dose as necessary.”

page 139 “…if the mother’s hyperthyroidism occurred in the past and
was already treated with RAI or surgery, she can still have thyroid
stimulating antibodies (TSAs) in her blood even though she’s not hyper-
thyroid anymore…When the fetus is hyperthyroid, the fetal heart rate
is consistently above the normal range of 160 to 180 beats per minute,
and high levels of TSAs will be present in the mother’s blood.

All women with Graves’ disease or a history of Graves’ disease should
be tested for TSAs late in pregnancy. The consequences of untreated
fetal hyperthyroidism can lead to low birth weight and small head
size, fetal distress in labor, neonatal heart failure, and respiratory
distress. Putting the mother on antithyroid drugs during pregnancy
will treat the baby in this situation, but after delivery it will be
necessary to continue treatment for the baby as well as performing
follow-up tests.”

***”Your Thyroid, A Home Reference” by Wood, Cooper, Ridgway also has
some similar info on page 152. From page 153: “Even though this
condition is extrememly rare, a pregnant woman who has hyperthyroidism
or who has been hyperthyroid in the past should alert the obstetrician
about her thyroid problem *during the pregnancy* so that her doctor
will be prepared to look for a thyroid abnormality in the baby.”

I haven’t been able to locate any info specifically about Graves’ eye
disease and pregnancy. However, the natural course of eye changes in
the soft tissue, eyelids, and orbits usually occur within a six month
to two year period. You may be already heading into the inactive phase,
being your symptoms are mild and calming down.

Consult with your endo and ophthalmologist about your decision and
concerns. There are risks with any pregnancy, so don’t let Graves’
disease take away your wishes to be a mother. Know and understand the
risks, and stay in close contact with your doctors.

Wishing you health and happiness, Debby

[Anonymous June 20, 1998 at 5:18 pm Post count: 93172]

#1050541

Hi,

I don’t have any first hand knowledge about Graves’ Disease
and Pregnancy so I just stuck in the Yahoo Search and right
away a neat site came up on the topic, Pregnancy and
Hyperthyroidism. So if you can’t find it just send me an
e-mail and I will send you a hyperlink to it!

Good Luck,
Michele B.
BeBeBoss@aol.com

[Author]

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