T4 makes me nauseous during 2nd trimester

[blaudag]

Hi,

I am 18 weeks pregnant and I have suffered severe nausea and vomiting past the 12/13 weeks mark.

I have subclinical hypothyroidism. Things got so hard that last week I missed my thyroid pill (I take Metavive) during 2 days. Unexpectedly I noticed I felt much better, almost normal. Took the pills again, got nauseous and vomited again. Then I tried to test if it really had to do with the thyroid pill and I did not take it on purpose. Again, I felt almost normal. I didn't take them the following days and remained nausea free. Then I decided to do lab work, with the doctor prescription I had, to see if maybe I could lower my dose or stop it altogether. My TSH was up to 4,2 (2nd trimester 0,2-3), FT4 1,1 (0,7-1,8) and FT3 3,0 (2,1-4,4).

This got me worried. My last TSH result was 1,2. The 1,2 surprised me so much back then (I felt it was too much) that I stopped alternating 30mg with 45mg and go back to just 30mg as I had done before since early pregnancy (it resulted in 3,7). I was 2,9 pre-pregnancy alternating 15mg and 30mg. So when I got these last results (4,2) I decided to take at least something again. I took 15mg, the lowest dose, the past 3 days and I am completely nauseated all day again (no vomiting so far) and plus extremely exhausted (low energy and sleeping a lot).

I have read that hypemeresis gravidarum is associated with too much T4 and I know my symptoms have been very close to it or even of a very mild state of it. On the other hand the latest scientific articles recommend pregnant women with subclinical hypothyroidism to avoid letting the TSH levels go above 4,0 to keep away any chance of miscarriage or fetal death.

This nausea does not allow me to be functional. Right now I am at loss on what to do. I am considering taking Levothyroxine to see if it makes any difference. Even if it's all the same as with Metavive, I am also afraid that taking 15mg Metavive won't be enough to avoid going above 4,0 in my TSH levels. I am pretty sure taking 30mg will take me back to the vomiting wagon again.

PS. I suffer from adrenal insufficiency and I managed successfully to take T4 without worsening it by taking Douglas Adrenplus-300 and Adrenavive, which I am still taking during pregnancy.

PPS. I cannot take Unisom or alike because I have high intraocular pressure; acupressure wrist bands hardly do anything; and ginger tea does help, but very mildly.

[soupybp]

Can’t speak to the thyroid side.

I used anti-nausea syrup and Zofran from week 12 to delivery. Without that, I had enough nausea/vomiting to be left barely functioning... luckily it was my second pregnancy so I knew it wasn’t “normal.” With that approach I was able at least hold my weight steady and stay out of the hospital.

[Hidden]

I'm sorry you're feeling so unwell. I was sick every day of my first pregnancy, over 40'years ago and I still remember the awful feeling.

Can you speak to all your pre-natal team about this ? They must have encountered mums with thyroid problems before.

I really hope you can find some relief from the sickness and enjoy being pregnant.

[silverfox7]

Can't offer any advice but years before I had a thyroid issue I was so sick for 3 pregnancies so it happens to some regardless. I did have a few weeks with the second and third where I couldn't lift my head off the pillow without vomiting. My boss was pretty good as if felt I could eat I went across the road and got a sandwich! Third was the worst as vomited throughout labour! But I think you must get expert advice re your TSH!

[jgelliss]

You might want to try B-6 it can help with nausea during pregnancy .

[blaudag]

Thank you so much for your supportive words.

I took Levothyroxine this morning and I have vomited my lunch. I was sipping ginger tea just before it happened. To no avail.

Soupybp, I had never heard of anti-nausea syrup. I am going to look it up.

06hollyberry, I have talked about it. The nurse did not give it much attention and the doctor just recommended I keep taking the 30mg dose. I think she is skeptical that the thyroid hormone is causing this...

Silverfox7, I have more or less survived the past months because I was on high risk pregnancy leave, but the original reason for it has resolved fortunately. I am now back to work and I have the highest responsibility role in the organisation. No problem for me to deal with my needs as suited, I just can't work well and it is affecting everything. I do need to do some work these weeks that I simply can't postpone, but when I mentioned the possibility of having a new medical leave if necessary, my doctor said there was no good reason to justify it.

Jgelliss, thanks. The Adrenplus-300 has a high dose of B6 (plus the prenatal has some too). Do you know the therapeutical dose to work as anti-nausea?

I guess l'm stuck at the crossroad. I'll probably consider not taking the thyroid medication a couple of days before a day when I know I have to be functional (out-of-office work) and suck it up for the rest of the days.

I can't believe how much more I have to endure if this lasts until delivery.

[Hidden]

I dont have much by constructive suggestions but you do have my sympathy I have not forgotten the nausea in my own pregnancys. You might want to try some meditation. If you can find some led stuff by somebody called Kabot Zinn. He specialises in using mindfulness for people in chronic pain. I listen to him for time to time and his approach can be applied to any discomfort. You might find it helpful and it would help with the birth as well. The only thing that really helped me when feeling sick all the time was driving lessons. I was so ingrossed with driving that I almost forgot how sick I was feeling. I used to feel sick in my sleep as well. I would turn over in my sleep and be aware of feeling sick as I did.

I hope you feel better soon. Maybe you need to divide doses.