Thyroid and pregnancy

[Beverly14]

Hi all! I'm new to this site so hopefully doing this right!

I have been on levothyroxine since I was diagnosed with hypothyroidism in April 2013 up until January 2018 when I swapped to NDT (thyro gold last month)

I became pregnant a month after my diagnosis and had a healthy pregnancy and baby with no health issues.

We're thinking of trying for baby no2 in the next 6 months or so but unsure what to do regarding the NDT / Levothyroxine. I'm feeling much better on NDT already but willing to go back to Levo during pregnancy if it's safer..

Can anyone who has been in a similar situation advise?

Thank you !

[Clutter]

Welcome to the forum, Beverly14.

UK doctors usually recommend women revert to Levothyroxine during their pregnancy. The BTA don't support NDT or T3 during pregnancy due to the lack of evidence it is safe. That doesn't mean that it is unsafe, just they don't have evidence it is.

The TSH of women planning conception should be in the low-normal range 0.4 - 2.5. When pregnancy is confirmed dose is usually increased by 25-50mcg to ensure good foetal development. NICE also recommends that hypothyroid women planning pregnancy should be referred to en-docrinology. cks.nice.org.uk/hypothyroid...

Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee

13. 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 of L-T4 preconception and most importantly in the first trimester (1/++0). L-T4/L-T3 combination therapy is not recommended in pregnancy (1/+00).

onlinelibrary.wiley.com/doi...

According the ATA First Trimester TSH levels between 2.5 and 5.0 are associated with increased pregnancy loss

[Beverly14 in reply to Clutter]

Thank you very much for all this info! Really appreciate it. I shall see if I can be referred to an endo. Thanks again! Great site! 😊😊

[Saggyuk]

Yes, I was on T3 only when became pregnant. After looking into it, my endo and I couldn't find any info on it at the time apart from they don't advise it because they don't know and have nothing to go by. We decided to keep me on the same dose of T3 as it was better for me to remain well during pregnancy and I had historically been unable to convert T4 at all which would likely cause more problems plus it was possibly a good sign it had been ridiculously easy to get pregnant which we decided might mean my body was happy?? We decided as you are supposed to increase dose anyway to add 50 mcg Levo in week 5 in case the baby has a need for it to ensure it was there and he took a guesstimate as to how much a baby might need - no real science behind it just an experienced guess and the logic that this is the normal increase required during pregnancy so this might be the amount required????? My thyroid did have minor function left in it at the time so would have added to what was available?

NDT is mostly T4 anyway isn't it?

Luckily I remained stable throughout the pregnancy but endo did do monthly blood checks and extra scans to make sure as was his first T3 baby lol! She was good weight and a very healthy and contented baby and continues to seem so at age 7- as to whether there's any long term affect, I cannot say but my instinct doubts it? Only thing I can think of is she eats twice as much as most kids her age and did so since birth lol! I do get a little paranoid about it from time to time though!!!!

I suppose it depends on your doc and how comfortable you feel making that decision. You've got to go with your own gut at the end of the day?

Maybe have a look on forums or advice in other countries where NDT is prescribed more often?

[Saggyuk in reply to Saggyuk]

Oh and Good luck

[Beverly14]

Thank you so much ! I really appreciate your reply. I have a good few months to research and decide which is good! Thanks again 😊😊