[Ski]

#1065573

Not really, since you’ve had trouble with PTU, methimazole is not recommended for pregnant women, and the RAI precautions for pregnancy are at least six months out from the procedure. TT is what’s left! Make sure you are talking with a surgeon who does MANY of these procedures with very low complication rates. If your surgeon will not give you that type of information, find another. That area can be tricky, but a surgeon who "knows their way around" will give you the best possible outcome.

[susanne13]

#1018539

I was diagnosed hyper in February and given PTU because I wanted to get pregnant in the next few months. The PTU wasn’t working for me (liver issues) so now I am on methimazole, which isn’t good if you want to get pregnant. SO, I am moving toward a thyroidectomy and met with an AWESOME surgeon (my endo is awesome as well, I am very grateful).

My question is: If I want to become pregnant in the next few months, are there any other options for me besides the TT that are safe?

Thank you all in advance, this board has been very helpful!!!

[mamabear]

#1065574

susanne, I must stress this….. I have been where you are! It is not worth it to try something immediate just because you want to get pregnant! Heal first then get pregnant.
My dh and I wanted to have a baby, I didn’t understand why it was taking so long (i wasn’t a patient person lol as it has only been a few months!).
During that time i had the flu then a few months later I finally had a diagnosis of Graves’. I was told RAI, i said no due to the fact that I wanted to get pregnant.
I went to another dr. and was on PTU. Was on it for a few months and was stable then was told to try to get pregnant. My eggs were poor, I had to go to a Reproductive Endocrinologist(RE) to get help.

From the we wanted to have a baby till the time I actually did get pregnant was about a year and half. From the time I was on the PTU and was stable was about 9 months.

Please get better first. DON"T try to kill yourself with this surgery or that one or what you think will get you better faster. Remember you have to heal from the surgery if you have it. AND then you have to be stable with your levels and might have to go on Thyroid replacement and be stable on that before you try to get pregnant.

Fighting either hyperT or hypoT while pregnant isn’t an option i’d suggest to anyone. 2 of my 4 kids were with help from an RE.

If your body isn’t healed properly and your levels are off and you get pregnant you wont feel good and when baby comes you wont have fun. You’ll be tired and cranky and it wont be a good motherly experience. Everyone is different but I woudlb’t be a good person if I didn’t mention this to you.

I was also of the mind that RAI wouldn’t be good because I wanted to get pregnant, and although I didn’t do the RAI it still took me 1 after I was told to take it to get pregnant. I don’t regret not doing it, i have mild graves and it is in remission for 3 years now with no meds. But again if you aren’t healthy before pregnancy you wont have a fun time with the pregnancy and being a mom. You’ll think every ache and pull and stretch of your tummy is from the Graves’ disease.

THink of your options with this in mind please. I am sorry that PTU didn’t work for you. It did work me, we had some side effects but nothing major.

Good luck on this journey!

[LaurelM]

#1065575

A benefit of doing either RAI or the surgery is that you won’t have to worry about needing to take an ATD while nursing. I had to start taking Methimazole after our first child. (Graves often resurges post-partum.) Not only did I have to be monitored but my baby had to have regular blood work as well. No fun. My endo and baby’s Dr and a pediatric endo all agreed that continued nuring was the best for our baby but it was a worry that you won’t have to deal with after RAI or surgery.

Make sure that when you are healed and ready to conceive that your OB & whomever you choose to be your baby’s Dr (family medicine or pediatrician) both know about your Grave’s history. Even after RAI or surgery, in very, very, very, very, very rare instances auto-antibodies can linger and cross the placenta requiring treatment for your baby. They will want to keep a closer eye on your pregnancy. Again, very, very rare that this occurs. I have had two beautiful and healthy children during dealing with GD as have many many others on this board.

Best wishes,

Laurel

[snelsen]

#1065576

I can understand completely why you would like to move along with things so you can get pregnant. Makes perfect sense to me. My view is that you are doing a very careful consideration of your options. I have had a thryoidecomy, it is not a terrible horrible thing. My recovery was rapid, and I had a three month old baby, was working full time and breast feeding.
Sometimes you do not want wait, ya wanna work on getting a baby!
So, I am pretty much reflecting Ski’s thoughts. You can check with your docs, but it is very logical that you will not become hyperthyroid if you have had a TT. You may be euthyroid, you may need a little bit. But either way, having your docs, and it sounds like you have AN EXCELLENT team, working with you, you and your husband can make a good decision that fits with your personal goals.
Shirley

[susanne13]

#1065577

Hi All,
Thank you very much for the replies! Yes, I definitely want health first, baby second! I don’t think I mentioned that I do have a 16 month old and know the craziness that pregnancy (even though mine was super easy) and a newborn bring!!

I am weighing my options carefully and have a lot of questions for my endo when I see her tomorrow. I do want to make sure I am not going for the "quick fix" and instead doing what is right for me in the long run and not just right now. I think part of it is feeling crappy for so long and knowing that even though I could become hyPO after TT, I would NOT be hyPER! And I am guessing a lot of people have felt this way ” title=”Smile” />

A couple other questions that came out of the posts: what does it mean to have a mild case of GD? Also, in regards to breastfeeding, is methimazole absoluteley not safe while breastfeeding? I have read old studies that said so but recent information I read does allow for breastfeeding, including KellyMom.com?

Thank you again for your responses and I have a lot to think about!!
Susanne

[snelsen]

#1065578

Hi Susanne,
I don’t think I mentioned that we decided to have our second a few month after my TT. Remember i had a newborn, then TT when he was 3 months old! (grin)
It was wonderful to KNOW that I would not be the crazy hyper that I was post baby and pre surgery. That was a very important piece of knowledge that I held on a high pedestal! I never felt hyper again. I detested being hyper.

I know that one belief is that you cannot be a little bit hyper. I don’t think I completely agree with that. First, we have to decide if we mean hyper by symptoms or hyper by labs. I have NEVER been hyper again in the way I feel after my surgery, and it has been over 40 years. But, for a reason nobody can understand, I was maintained a "little bit hyper" by labs, (tSH@.002-.006) but it was because my Synthroid dose was too high. No good explanation for that, and I have always felt perfectly fine. But having too much thyroid is not a good idea for bones and hearts, so I am still puzzled by why she kept me at a higher dose. I have been reducing the dose for the past year.
I wish you the best with your appt. today. it is such a gooooood feeling to have a good team, so glad you have one.

[Ski]

#1065579

There are people who have mild symptoms of Graves’, but there’s really no way to quantify a "mild case," because anyone who has GD has the potential for a severe spike in symptoms at just about any time. Typically at just the worst time, since stress stimulates the immune system, which would also stimulate the antibodies that make us hyperthyroid.

Methimazole is definitely not recommended while nursing, it would trigger a need for frequent testing of the baby’s thyroid hormone levels to ensure that it is not affecting them, and it could also be dangerous for their liver function. Testing often may minimize the risk, but the risk is definitely there. Smaller daily doses would minimize the risk as well, but babies are very tiny, so even small amounts have the potential to cause harm, and we know the drug crosses into breast milk.

[LaurelM]

#1065580

The American Academy of Pediatrics has Methimazole on their list of medications that is USUALLY compatable with nursing. http://aappolicy.aappublications.org/cg … ;108/3/776

As Ski points out it depends on how soon (how old/big) is the baby and what your dose is. You can’t predict if, when, or how much post-partum you would need to start taking.

I grilled all of the doctors, our regional children’s hospital endo were consulted and they all agreed that for us, the benefits of continued nursing outweighed the risks. It worked out fine for our family but it was worrisome and I would have preferred to not need to take it while nursing.

It is something you should talk about with your doctors.

Laurel

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