Pregnant NDT

[Kirsty_S]

Hi I need some advice I've been self medicating on NDT since Jan 2016 and I've been doing really well.

I'm now 13 weeks pregnant and I've not told my consultant I'm on NDT because I'm terrified they will tell me off or refuse to treat me. My latest blood tests came back as TSH 0.21 T3 5.7 T4 10.0. They think I'm on 50mg of Levo.

I've been to clinic this morning and they have told me to take 75mg of Levo. I'm scared and don't know what to do. If I stop the NDT and do what they say will I harm the baby if I continue with my NDT will it harm the baby?

I'm very scared!!!

[Clutter]

Kirsty_S,

If you were on 50mcg Levothyroxine I suspect FT4 10 would be below range and that's why the clinic wants you to increase dose to 75mcg.

When taking NDT FT4 is usually lower than when taking Levothyroxine and sometimes below range. Your TSH is low and FT3 good so you aren't under medicated on NDT.

Because UK doctors aren't trained to prescribe NDT pregnant women are usually advised to switch to Levothyroxine until after delivery. If you want advice on using NDT throughout pregnancy check out some American sites and Facebook pages ie Hypothyroidmom, Mary Shoman and Gena Nolin.

[Kirsty_S in reply to Clutter]

Hi Clutter

To ease my anxiety and to basically go a long with them whilst I'm pregnant would I risk any harm if I stopped my NDT and started the 75mg Levo?

Or could I reduce my NDT and add some Levo?

[Clutter in reply to Kirsty_S]

Kirsty_S,

There shouldn't be any harm if you switch back to Levothyroxine. Adding some Levothyroxine to NDT might raise FT4 a little.

[Ruthi]

There shouldn't be any harm, but it depends on why you are taking the NDT. If you weren't well on the levo before, you probably won't be now. And your health and the baby's are intricately bound up.

[humanbean]

Bear in mind that for many decades NDT was the only treatment available for women with hypothyroidism, and there were many, many thousands of babies born during those decades with no problems at all.

There are posts on this forum from women having successful pregnancies on NDT who had either never managed to get pregnant on Levo or who had miscarried while on Levo. (Sadly, the search function on HU is so dreadful that finding those posts would be extraordinarily difficult.)

If you feel well then I think you shouldn't rock the boat by changing meds now. As Clutter said though, if you wanted to increase your Free T4 you might want to add a small amount of Levo to your existing NDT dosage. You may only need 25mcg every day or every other day to raise it a little. And after all, as far as I can see, you are only doing this to keep your doctors happy, so keep any changes you make to a minimum.

Like Ruthi above, I'm concerned that you might have a past history of not tolerating Levo. If you feel good on NDT then deliberately making yourself feel worse is not a good idea.

[HIFL]

How much NDT do you take? Your latest bloodwork indicates that you might want to raise your T4 levels. T4 is extremely important when you're pregnant because T4 is essential for brain development of your child. There's a process called actin polymerization as the brain is formed. This process uses T4 or rT3. T3 has no effect on this process. In fact, too much T3 can negatively affect the eyes and ears as they develop. This topic is discussed in the Tired Thyroid book in the chapter on reproduction. There's also some info here: tiredthyroid.com/blog/2013/... You should read the first link in that post. It's a bit lengthy, but it clearly explains why you need T4 when you're pregnant.

At this point, since you say you've been doing really well on NDT, the best thing to do would be what you already asked about, that is, just add a little T4 to a reduced NDT dose. Best wishes for a healthy pregnancy!

[Kirsty_S]

Thanks for your advice! I came off Levo because of really bad anxiety and panic also it made me feel even more sluggish and my joints particularly my hips hurt.

GP didn't listen said I had mental health issues and prescribed an anxiety drug so I researched stuff and I changed and increased very slowly to naturthroid. I've basically been using my symptoms as a guide and been on the same dose 4 grains since April. I feel fab to be honest still tired but obviously I put that to pregnancy.

I might add 25 mg every other day see how I get on I just really don't want to do any harm. I got pregnant by IVF and keep thinking surely if my NDT was a problem then the IVF would have failed!