Help! I'm pregnant! (this is a good thing)

[XMRSPX]

Hello ladies (and gents),

Well last year I had a miscarriage at 9 weeks, and after post natal depression and an emotional breakdown, I am pregnant again! I have hashimotos, am taking 3 grains of NDT a day, and started selenium, vitamin d and B12 last month. Is there anything else you could suggest that will help me keep this stupid thyroid of mine in check so I can have a healthy and successful pregnancy? Any help would be massively appreciated!

XXX

[eeng]

If you were taking Levothyroxine you should have regular thyroid blood tests, and your TSH should be kept well below 2.5.People who are pregnant and take Levothyroxine usually have their dose raised by 25-50mcg a day during pregnancy, particularly the first 3 months. This is equivalent to (very approximately) half a grain of NDT I believe.

Having said that, you are taking NDT, so your TSH will always show up as low. Also your midwife will probably throw a wobbly that you are even taking NDT at all. Don't let them make you change it, and it might be best to just avoid the subject of NDT and thyroid altogether. If they ask it might be best to say you are just taking a natural thyroid support supplement. There are lots of those available on amazon that don't contain any hormone, and it might be best if they believe you are taking one of those. However keep an eye on your symptoms and if you feel even slightly hypo then take another half a grain of NDT to be one the safe side. A problem may arise if you have to spend any time in hospital - they won't give you NDT there, so be prepared.

There is a website called hypothyroidmom where you might get more help.

[XMRSPX in reply to eeng]

Oh crikey, I hadn't thought about that. My GP was already against me taking NDT, but I feel so much better on it. Thank you so much for your help xxx

[EleanorM-G]

Congratulations on your pregnancy!

I am currently on my 3rd pregnancy (16 weeks) with an underactive thyroid. I take NDT and extra T3. Apols for the "cut and paste" answer, but there is so much info, it's the only way to do it!

Check out the website, hyperthyroidmom.com. It has lots of great articles, (I have included some thyroid/pregnancy articles at the bottom) and advice you can take to your GP. (You GP will know very little about the thyroid in pregnancy, so it is very important for you to get as knowledgeable as you can. If you are lucky, you will have one like mine, who is very open minded and willing to read the articles and go with my suggestions.) Buy the book she wrote on pregnancy-it’s amazing! “Your Healthy Pregnancy with Thyroid Disease”, by Dana Trentini & Mary Shoman.

If you have just found out that you are pregnant, then increase your Levo/thyroxinne by 30% . The demand increases as soon as 4-6 wks into pregnancy and we are trying to avoid miss carriage. Then go to your GP and let them know you need blood tests every 4weeks until 20weeks. The results of these tests, will likely show that you need further increases. (Don’t increase without the blood tests to tell you how much you need.) Your blood tests need to include T3 results. If your GP won’t do this, get private testing done through “Blue Horizon.” As always, get copies of all your blood tests, and post on here for advice. Do not accept your GP telling you that you are “normal” or “within range” as very few of them know what is healthy for pregnancy. At 20 wks, the demands usually plateau and you will need tests/increases less often. (The book tells you how often.)

If like me, you take NDT (T4 and T3) rather than Levo/thyroxine (T4) then the instructions for increasing are not as straight forward, but can and must be done. To get advice, I emailed Lyn Mynott who began Thyroiduk: [e-mail]. I put “Pregnancy Guidelines” in the subject line and she asked a doctor for me. He advised that I follow the instructions for increasing levo, but that I shouldn’t increase T3 at the same rate as increasing T4. (This was easy for me, because I take NDT plus extra T3.) You will read some articles saying that you shouldn’t take T3 in pregnancy as it crosses the placenta and some saying its fine-you will need to do your own research.)

The book I mentioned above, gives this advice about the TSH levels you need to have to have a healthy pregnancy. This is really helpful to take to your doctor.

First trimester: less than 2.5 with a range of 0.1-2.5

Second trimester: 0.2-3.0

Third trimester: 0.3-3.0.

TSH should be monitored every 4 weeks during the first 20 weeks of gestation, then once again between 26 and 32 weeks

If you are on NDT (Ie. Taking T3, your TSH should will be almost 0 with a low T4 in pregnancy (and non pregnancy)

Keep an eye on your B12 levels, as pregnancy places a high demand on these and people with an underactive thyroid are usually deficient to begin with. (You can’t overdose on B12, anything you don’t need you will pee out. A bit of a waste of money, but not dangerous!)

Some articles, you may like to read:

thyroid.org/professionals/e...

cks.nice.org.uk/hypothyroid...

cks.nice.org.uk/hypothyroid...

hypothyroidmom.com/what-eve...

dl.dropboxusercontent.com/u...

thyroiduk.org.uk/tuk/about_...

thyroid-info.com/articles/p...

healthunlocked.com/thyroidu...

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum

online.liebertpub.com/doi/p...

[XMRSPX in reply to EleanorM-G]

Thank you so much for this xxx

[EleanorM-G in reply to XMRSPX]

You are very welcome. Good luck with your journey.