Thyroid UK
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preparing for pregnancy with hashimotos

Hi everyone- just looking for some advice of things I can do to prepare for pregnancy. Ive had Hashimotos for 5+ years, up and down with health, but overall pretty good. Last year I think my thyroid finally 'blew' so to speak. (My thyroid went into hyper for 4 months last year then dropped further hypo- now I need double the medication than i used to).

I have read that often happens, and is a sign that your thyroid has finally stopped producing thyroid hormone, and your body is completely reliant on medication from then onwards.

So bearing this is mind, is there anything I can further do to prepare for pregnancy to give my baby the best health it can have?

My last blood test was good (TSH= .50 and T4= 22.3). I dont know my antibody reading as my doctor won't do it. I've been gluten free since diagnosis, and i currently take quite an array of supplements including iron, b vit complex, vit D, cod liver oil, selenium and probiotics.

I also have reduced my dairy intake and changed to a non-dairy milk, just the occasional cheese now. My husband has a family history of thyroid problems for the women in his family, and all the women in my entire family, including aunts cousins, grandparents etc all have hashimotos, so its pretty strong.

Im guessing thats enough to ensure our child will most likely suffer from the same disease. Is there anything I can do to reduce the likelihood? and am I a terrible person for wanting a child, knowing that they will most likely live a life with thyroid problems?

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Hi Roosta

I know exactly how you feel as used to contemplate that all the time and kept dismissing the idea but accidentally got pregnant anyway lol - I think biologically instinctively, I always was attracted to those with a genetic disposition of having fast or ultra strong metabolisms (skinny ones who can eat huge amounts) in the unconscious hope it would counteract my crap one lol!!! My other friend with the same problems had two children and was just glad that they were both boys as far less likely to suffer with the same issues and you have 50 per cent chance of having one of those. I think we all ponder it but I don't think there's any reason not too, I would still rather be here than not at all if my mum had known she had problems at the time and you have the added benefit that the family can be understanding and supportive if the worst case scenario does happen which would have made a huge difference to my life when I was a child/teenager and got struck down.

In regards to my little one, I ensure she eats extremely healthily and very little rubbish and gets everything she needs to ensure she has the best chance of good health. I'll be honest - she was indicating quite early on that she was having the same problems as me - constant sore legs, stunted leg growth, supposed toddler diarrhea and eczema with coughing asthma at night but this completely reversed and disappeared when she went gluten free also when I figured out it was my problem so am now hopeful we've nipped it in the bud. But that s because we did figure out it was the cause for our family and maybe not the case for you as you mention on your other post

in regards to preparation, all you can do is make sure everything is as it should be. Your T4 and Tsh look like good levels but you might want to double check your T3 and make sure all okay there too. Also get your iron, folate, vit b12 and vit d blood tests done to ensure all seemingly okay nutritionally wise and not too high or too low. Maybe review your diet and ensure getting all the little micro-nutrients too and not missing something and even calcium if you have given up dairy - you can use a food tracker like cronometer. Let us know if you want to get your own tests done if GPs wont as they are cheap enough to do and people here can advise where to get them done.

You should talk to GP now and see what he intends to do should you get pregnant and if he doesn't give you the right answers and doesn't have a clue, find another one who does.

You will need an increase in your meds by about 25-50mcg Levothyroxine by the time you are six weeks pregnancy or near when pregnancy is confirmed as the baby will need it from you. I increased mine by 50mcg by 4 weeks and remained stable throughout. You must ensure you're tsh doesn't go above 2 as per guidelines but mine was kept nearer 1 or just under which would be best.

You should be referred to an endocrine specialist and have further monitoring- I had monthly blood tests to ensure thyroid levels okay and extra scans to ensure the baby was growing okay.

See these NICE guidelines:

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

And have a read through this also so you know exactly what to do:

btf-thyroid.org/projects/pr...

Good luck :-)

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given my experience of Hashimotos hitting my husband our daughter and 4 of 6 grandaughters yet i do not have any illness or autoimmune background i would strongly caution you against even thinking of getting pregnant add on the links to other problems that exist in thyroid families with the genes coming from both sides things could be very dicey

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Yes, I think that's why I had it so young compared to others in my family as autoimmunity on both sides unfortunately. However, I suppose I just feel huge relief that I haven't had to worry about the other rare massive genetic flaw that exists on one side of my family which would truly be unbearable to live with which is a very nasty genetic problem and faulty thyroid is nothing compared to this so just feel glad tbh. men can't carry it recessively, they either have the full on problem or don't have a trace of it and my dad doesn't (although two of his siblings do and in no fit state to have kids) but women can carry it recessively so it's a worry for my other aunt and her daughters so I feel for my cousins more. There's far worse than thyroid and I think most people with thyroid issues would still rather be alive - not heard of many people seeking assisted suicide because of it maybe? I think the the mismanagement of it is the bigger problem with people not being treated adequately because of crap docs - you can be alot more normal once you get many of the issues resolved.

The more I read up on thyroid, the more I feel that in most cases (probably not all), it is triggered by environment/other issues etc rather than true faulty genes and maybe the genes are there for good reason so I just think more needs to be done in regards to figuring out what is triggering it and dealing with those before it happens and is irreversible. And anyway, maybe in thirty years, they can give you a replacement robotic fully functioning thyroid lol??

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I do not 4 one minute belueve environment has anything to do with hashimotos and instead of moving forward over the last 70 yrs my husband has clearly had it things are moving backwards

Hypothyroid seems to run on same gene link as dyslexia, hayfever, endometriosis, aspergers autism and all the other auto immune diseases

All i know is had i known 50 yrs ago my husband had Graves /Hashis i would have chosen not to have children it would have been a very hard decision but it would have been correct

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Just out of curiosity, what kind of non-dairy milk do you use? And did reducing your dairy make you feel better?

I think I would prefer to eat/drink normal dairy products if I could, if I wanted to get pregnant with a thyroid problem. But if it will make you sicker then stay as you are. I'm just thinking about the calcium levels of non-dairy milk as well as the vitamins and other minerals you might get from milk.

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A link you might find helpful in dealing with doctors :

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

On that link, notice the sentence buried at the bottom of the page :

Women with known thyroid dysfunction who are taking levothyroxine may need the dose increased by 30–50% from as early as 4–6 weeks gestation [De Groot et al, 2012].

Please also note that doctors are not obliged to follow the NICE Clinical Knowledge Summaries, but it is always nice to have something to back you up.

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Please also note that reference ranges for TSH and other hormone levels are different (and narrower) in pregnancy. You do not want your results to be compared to the normal adult reference ranges or you might end up under-medicated.

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The British Thyroid Association has never produced any guidelines for the treatment of hypothyroidism in the UK. All they have produced is a "statement". And it deliberately mentions that they have not given much thought to conception or pregnancy when writing it.

british-thyroid-association...

Quote from the above link

We have focused on patients with primary hypothyroidism and have not addressed in detail the care of subgroups such as pregnant women, patients treated for thyroid cancer or secondary hypothyroidism.

End quote

The "statement" does mention the narrower TSH range for use in pregnancy though :

The serum TSH reference range in pregnancy is 0.4–2.5 mU/l in the first trimester and 0.4–3.0 mU/l in the second and third trimesters or should be based on the trimester-specific reference

range for the population if available. These reference ranges should be achieved where possible with appropriate doses ofL-T4 preconception and most importantly in the first trimester

(1/++0). L-T4/L-T3 combination therapy is not recommended in pregnancy.

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Another suggestion I would make is that you do some research on the effects of low vitamin B12, low folate, low iron, and low vitamin D in pregnancy. None of the possible effects are desirable, so make sure your levels are optimal before getting pregnant.

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If you aren't already eating 100% gluten-free I think you should seriously consider it. It reduces thyroid antibody numbers in many people with Hashi's, and helps stabilise thyroid function test results and may reduce the risk of your offspring having a thyroid problem in the first place.

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