[jclark31]

in reply to: Breastfeeding while hyperthyroid #1184079

Hi All,

Apologies for the delay in updating. December was incredibly busy at work. The short version is that everything is fine. The long version is below.

Our pediatric endocrinologist appointment was moved to December. My daughter was evaluated by a resident pediatric endocrinologist (RPE) at Children’s Hospital Boston (CHB). After arrival, my daughter was weighed and measured. They tried to get a blood pressure reading but couldn’t because of her wiggling about.

I was asked about my daughter’s sleep and eating habits (I hadn’t noticed any major changes in these). The RPE paid a lot of attention to the weight and height information sent over by our pediatrician. The RPE examined my daughter and tested her for neonatal reflexes.

After the examination the RPE went and spoke to the attending pediatric endocrinologist (APE) who then came into the room to discuss.

In answer to my original question, they were unconcerned about me transmitting high levels of thyroid hormone to my daughter via nursing. They said that the amount transmitted in breast milk is so small that it would not have an effect.

So really they were evaluating her for some sort of primary thyroid defect. Massachusetts has a program where all newborns are screened for a number of diseases. They told me that my daughter’s thyroid test results were all normal at birth. She had blood drawn in November and for those results she had normal T3 and T4 and slightly low TSH levels. They said that as she is so young her hormone levels are still adjusting and the ‘normal range’ is somewhat arbitrary, so the TSH result was likely nothing to worry about. Finally, because my daughter is growing well and gaining weight they all but ruled out any thyroid problems at this stage.

They offered us another blood test to look at her thyroid hormones but at this stage we were so reassured that we said that we didn’t feel the need to put her through that. Both the RPE and APE were OK with that. They gave us their business cards and said to contact them if she starts refusing food or stops putting on weight. We are very relieved that everything is OK.

Incidentally, I found out why my TSH has been weird: post-partum thyroidosis. My TSH was 0.086 in November and 25 (!) in December. This crash had put my T4 at 0.96 the lower end of the normal range (normal range: 0.93-1.7) at the time of the December blood test. So in a month I’ve swung from slightly hyper to almost hypo. I felt like I was walking through treacle last week and felt pretty depressed the prior weekend. Good to know that it was *just* my thyroid again. It’s a roller coaster!

Thanks again for all of your support.

Jo

Graves disease dx: Jan 2010 (managed with methimazole)
RAI: Jan 2013 (levothyroxine since)

[jclark31]

in reply to: Breastfeeding while hyperthyroid #1184077

Hi All,

goldenwillow and snelsen, thanks again for the positive comments. It helps to know that others have been though this. Yes, breastfeeding is going well for the most part. No issues right now.

I just received a call from CHB saying that “based on information from my pediatrician” they are moving my daughter’s endocrinology appointment to Monday. Haven’t been able to receive clarification on this as yet as my pediatrician is still busy with office hours. I have a feeling it’s going to be a long weekend.

[jclark31]

in reply to: Breastfeeding while hyperthyroid #1184073

Thanks Kimberly and Shirley for the replies. Shirley I’m glad that all turned out well with your son.

I just want to post an update in case this may be of help to others.

After I contacted her, my pediatrician called the on duty endocrinologist at Children’s Hospital Boston (CHB) and it was decided that my daughter should have a blood test. My pediatrician called me yesterday as some (but not all) of the results were back from the test. My daughter’s free T3 levels were normal but her TSH was slightly below normal range. My pediatrician said that since this was outside of her specialty she felt it best that we make an appointment with an endocrinologist at CHB which has been scheduled for January 6th.

I also called my endocrinologist and received a telephone message via a receptionist that “it was less likely due to the thyroid” and that I should stop my levothyroxine for one day. I’m not sure what this means but don’t plan on following up by phone as I feel like my pediatrician and CHB have a handle on this now.

I have a follow up appointment with my endocrinologist on the 28th Dec and hope that my TSH and T4 will be back within normal range… although, my TSH levels have been sinking for a while so that may not happen.

I’ve decided that I will continue breastfeeding my daughter. Three MDs have been involved in this now and no-one has raised a concern that this is something that needs to be addressed immediately. The blood test results so far seem to indicate that the effects on my daughter are very minor. At this point I think that the benefits of breastfeeding outweigh any negatives.

Thanks again for your input. I’ll update again if I get any useful info.

Jo

Graves disease dx: Jan 2010 (managed with methimazole)
RAI: Jan 2013 (levothyroxine since)

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