Graves Disease and Pregnancy

Hi All

I have just found out i'm pregnant yay! But I have had Graves Disease for the past 6yrs, it's pretty much under control and I have been feeling really well for the past 6months. I'm on PTU which I know is OK to take during pregnancy. I just wanted to know if anyone has been in the same boat as me, i am a little concerned about any implications and want to ensure I am as healthy as possible.

It's really early stages and i'm seeing the midwife next week - just wanted to reassurances and the truth really.

Thanks

7 Replies

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  • Hi congratulations on your very good news. I am hypo so cannot answer your question but I will give you a couple of items I have read or links.

    web.archive.org/web/2010103...

    Excerpt from Pulse Online article by Dr Toft:-

    8 Should all pregnant woman with hyperthyroidism receive specialist endocrinology management?

    In Graves’ disease the TSH-receptor antibody responsible for the hyperthyroidism crosses the placenta and, if the mother is hyperthyroid, the foetus is too. Good control of maternal thyroid function is therefore important as it will be mirrored in the foetus throughout pregnancy.

    All pregnant patients with hyperthyroidism due to Graves’ disease should be managed in a specialist clinic and reviewed every four to six weeks.

    Autoimmune disease tends to improve during pregnancy, so the dose of antithyroid drug needed to maintain a normal serum TSH concentration is usually in the order of 5-10mg of carbimazole daily or 50-100mg of propylthiouracil daily.

    It’s customary to stop the antithyroid drug some four weeks before the expected date of delivery – when brain growth is at a maximum – to avoid any possibility of foetal hypothyroidism. It’s unusual for hyperthyroidism to recur before three months post-partum.

    It’s important to distinguish between recurrent Graves’ disease for which treatment is necessary and post-partum thyroiditis in which the hyperthyroidism is short-lived followed by an equally transient episode of hypothyroidism, then recovery.

    In Graves’ disease the TSH-receptor antibody is detected in serum and isotope uptake by the thyroid is normal or increased. But in post-partum thyroiditis the TSH-receptor antibody is usually absent and the isotope uptake by the thyroid gland negligible.

    9 How does a hyperthyroid woman’s decision to breast-feed affect treatment?

    If antithyroid therapy is required in a patient who is breast-feeding, propylthiouracil is the drug of choice as its excretion in breast milk is one-tenth that of carbimazole. If the dose of carbimazole can be restricted to 15mg daily there will be no significant effect on thyroid function in the infant.

  • Hi and congratulations!

    I had Graves when I was pregnant and my pregnancy was fine. From 20 weeks onwards I was having scans and blood tests every four weeks to make sure that the baby was growing properly and not effected by the Graves. I saw this as one of the few positives as I got to see her more times than most people do!

    I was seeing the midwife as normal and then attending a special clinic run by the endo where I'd have my scans, get the results of my blood tests and then adjust my medication.

    I was on PTU and thyroxine but from about 28 weeks I was weened off all the meds as the pregnancy hormones had reset my thyroid. So when my daughter was born I wasn't taking any medication!

    I tried breast feeding but it ended up being too painful for me - although there was no obvious reason for the pain. I did express for several weeks though so that she did have some breastmilk.

    When my daughter was born I was told they'd be testing the umbilibal cord and then doing another blood test on her 48hrs later to make sure she hadn't got a thyroid problem. They managed to loose the sample from the umbilical cord so had to do a heel prick test and that came back fine. We had to stay in hospital for two nights to wait for the second heel prick test and that was fine as well.

    I had been told that the pregnancy hormones were likely to reset my thyroid - but also warned that I could relapse, which unfortunatly I did. I went back onto the medication just before my daughter's first birthday. She is now three and hasn't shown any signs of thyroid problems and I hope that continues!

    Good luck.

    Liz.

  • Hi i have Graves and suffered pre eclampsia with all 3 babies. Which is more likely for people with Graves. Just a heads up. All the best and good luck.

  • Just on that topic, because I have a lot of random info on vitamins floating around in my head, research suggests a link between high levels of homocysteine and pre-eclampsia. Homocysteine can be elevated in deficiency of folate, vitamin B12, vitamin B6 and vitamin B2.

    In pregnancy, we are drilled to within an inch of our lives to take folic acid, which we all dutifully do. But the other key nutrients are never mentioned. In Graves Disease we are already more likely to have nutritional deficiencies because of low stomach acid, and increased demand. Demand is increased even further in pregnancy.

    So at the very least it's a good idea to get your folic acid from a really good B-Complex, and also get your B12 and folate levels checked in the beginning to make sure you don't have an underlying deficiency (with low normal levels usually NOT being OK).

    H x

  • Thank you all so much for your responses, it's good to hear the truth and have a heads up on what could happen. It's such an exciting time but then you just have that worry. I am seeing the midwife tomorrow and hope to speak to the doctor as well - i ams ure they will want to take copious amount of blood from me!

    I will keep you updated on my progress!

    Jem

  • Hi. Hope you don't mind me asking but did you have problems getting pregnant. My husband and I have been trying for 6 months and nothing. I have Graves' disease but I'm in remission now.

    Thanks

  • Hi I'm 28 weeks pregnant and I have just been put on carbimazole. I am very scared taking the tablets as i know it will have a affect on my daughter. I was on ptu wen I lost another baby mid last year so I guessed that's where I'm a bit scared to take it now with this one. My doctors and all have told me it's totally safe to ttake but I'm still not up to it. I'm scared of the fact that she might be blind (yes I know) she might have lung,kidney problems or even brain functions when growing up. So does anyone out there know if its safe to take or am I over reacting or. Is carbimzole safe for pregnancy. & will my daughter have trouble with learning etc.

    Hope to hear reply soon

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