Hello, I have recently been diagnosed with Graves disease 5 months postpartum. I have no symptoms other than the GP noticing a goiter in my neck and subsequently taking bloods that resulted in the diagnosis.
I am under an endocrinologist who is recommending I start medication but I am not very comfortable or confident with the options. I am also breastfeeding my baby boy and plan to do IVF again at the start of next year so want that to be considered in my treatment. I also have a history of miscarriages.
1. Is it possible that I have postpartum hyperthyroidism instead?
2. Would a more permanent treatment for Graves disease not be a better option than tablets as I plan to have multiple more children?
3. Can I breastfeed on Propylthiouracil?
Any advice is appreciated. I am aware that the doctors know what they are doing but I am only 26 and symptom free so feeling very unsure of which route is best for me.
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Emjh
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As far as I know from reading up on PTU it is recommended for pregnant women. I have taken it in the past and it is an old and trusted drug. This looks like it might resolve itself and your pregnancy has triggered this. Let your Endocrinologist treat you and see if your levels normalize
I am just adding a link to BNF so you can read up on the drug
I would still push for the correct antibodies to be tested to confirm Graves (as I was initially misdiagnosed as Graves- although presented as hyperthyroid- I followed advice from SlowDragon and others to check this)
Definitely ask for following to be tested in addition to thyroid antibodies: FT3, plus key thyroid vitamins (folate, ferritin, vit D, B12)
Looking at letter - suggesting 12 months of antithyroid is a rush / limited treatment plan. Most hospitals stick to 12 or 18 months but many do well on longer term anti thyroid.
PTU is used during pregnancy - you be switched back to carbimazole post partum.
If you do not have severe symptoms I would suspect your TSH, thyroid stimulating hormone (the pituitary signal) is low making drs think you are hyper. This doesn’t always cause symptoms. High FT4 & FT3 thyroid hormones do & usually graves causes very levels & severe symptoms.
There’s other reason for abnormal TSH & where your FT4 & FT3 are very important.
If your are confirmed with Graves you could request early definitive treatment. This often alters you to hypothyroid which doctors view as easier to treat with replacement. Some doctors would agree as this means you do not need to be monitored longer term by specialist and can be discharged back to GP.
Radioactive iodine means you would need to isolate which is not suitable with young baby & delay pregnancy plans so you’d be looking a surgery.
First confirm you have Graves with positive TSI or TRab results.
I think it's quite rare to develop Graves' post partum. Usually - and very frequently - it's Hashi's. Hashi's - or Autoimmune Thyroiditis - starts with a hyper phase because the immune system is launching an initial attack on the thyroid, and the dying cells leak their stocks of thyroid hormone into the blood, causing FT4 and FT3 levels to rise sharply. The shocking truth is that the majority of doctors don't know the difference between the initial hyper phase of Hashi's, and Graves', and are too pig-headed to do the correct blood tests. And they always seem to assume it's Graves'!
So, if I were you, I wouldn't do anything, take anything or decide on anything until the correct antibody testing has been done and you know which you have.
PS Where thyroid is concerned, doctors rarely know what they're doing!
Thank you, this is very helpful! I have another appointment on Friday and have this far refused any treatment. I really am clueless on anything to do with the thyroid!
ok, so it's not that high, given that the top of that range is exceptionally high; My gut feeling is that you have Hashi's rather than Graves'. Such a shame that they never test the FT3!
has your TSH ever been suppressed ? Your T4 is highish so it would be interesting to see what your T3 is because that usually lowers the TSH. Mine was 0.002 at diagnosis
I am trying to read the added chart but my phone keeps turning it upside down!
Just managed to read the TSH at 0.06. You need further testing to see if you have the blocking antibodies that you get with Graves’
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