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5 Things You Need to Know About Hypothyroidism and Pregnancy

I had my thyroid removed when I was 23 because of a pre-cancerous tumor. Since then, I’ve been on thyroid medication to regulate my thyroid levels and make sure all my hormone levels are balanced. I never thought I would be dependent on medication to … stay alive, but what are you gonna do?

At the time, I didn’t even think about how not having a thyroid would affect future pregnancies. I was single at the time, and babies were not on my radar. But when I got married, I remember my endocrinologist asking me when and if I planned on having children. I told her we weren’t trying to have babies right then, but we wanted to eventually. Then she said, “Ok, whatever you decide to do, you need to call me the minute you find out you’re pregnant. Tell your husband and then you call me.” Even though she said it jokingly, I knew she was totally serious.

Hypothyroidism and Pregnancy: What to Expect

That one comment made me nervous for the first time about being pregnant while on thyroid medication. It was then that I realized my thyroid condition no longer only affected me; my thyroid levels would play a huge role in my baby’s development.

The good news is that people have healthy babies all the time with thyroid issues, and you can have a perfectly healthy pregnancy while treating hypothyroidism—I’ve had two. But there are definitely some differences. Here are some of the things I noticed about dealing with hypothyroidism during my two pregnancies.

1. The first trimester is critical

During the first trimester, your baby depends on your supply of thyroid hormone for the normal development of their brain and nervous system.1 Without the right amount of thyroid hormone, the baby may experience developmental problems. At about 12 weeks, the baby’s thyroid begins to function on its own, making the mother’s thyroid less critical to their development.

Don’t get me wrong, it’s important to have normal thyroid levels throughout your entire pregnancy for your health and your baby’s. Even when you’re not growing a baby, thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels.1 So I guess it’s pretty important. But the most critical days are within the first 12 weeks, so be sure to test your thyroid levels as soon as you find out you’re pregnant.

2. You’re going to have to do a lot of blood work

If you’re not a fan of needles, get ready to face your fears. Even if you don’t have a thyroid condition, you’ll have to do a lot of blood tests while you’re pregnant either way. It’s safe to assume that you’ll do blood work just to check your thyroid levels at least once a trimester. That’s about how it worked out for my first pregnancy. My second pregnancy was a little bit more complicated:

Pregnancy #1 (Boy):

  • Month 1 – Blood work
  • Month 3 – Blood work
  • Month 7 – Blood work

Pregnancy #2 (Girl):

  • Month 1 – Blood work
  • Month2 – Blood work
  • Month3 – Blood work
  • Month 4 – Blood work
  • Month 5 – Blood work
  • Month 6 – Blood work
  • Month7 – Blood work
  • Month 8 – Blood work

Yep, I had a lot of trips to the lab. Since the gender was the main difference between the two pregnancies, I assume baby girl made my levels go crazy. With my second pregnancy, my TSH levels were always so high (TSH is released by the pituitary gland to regulate thyroid hormone production. When thyroid hormone levels are low, the pituitary releases more TSH).1 It felt like we just couldn’t keep up with my body’s demand for thyroid hormone. We had to increase my thyroid dosage dramatically in the first trimester, and then we kept increasing it throughout the entire pregnancy.

My baby girl sucked my thyroid dry. But every person is different and every pregnancy is different, so your experience may be totally different than mine. Just be prepared. You’ll also have to continue regular blood work after you give birth as your body goes back to normal. The time it takes for your body to get stable again after pregnancy is different for everyone. For me, it took a few months with baby boy and about a year with baby girl.

3. Your doctor appointments are going to double

The number of doctor appointments actually depends on if you decide to see you’re your endocrinologist and OB/GYN during your pregnancy or just your OB/GYN (your OB/GYN can monitor your thyroid levels along with everything else). If you feel totally comfortable with your OB/GYN, I suggest keeping it simple and just see your OB/GYN during your pregnancy.

I did not keep it simple. I continued to see both my endocrinologist and OB/GYN throughout my entire pregnancy. My OB/GYN even offered to perform the tests, but I didn’t take him up on it. This was my thought process: I had been seeing my endocrinologist for 5 years and I would continue to see her after my pregnancy, so might as well keep her in the loop during my pregnancy.

This meant that my doctor appointments doubled, which was a pain. But it also meant that I got to see a doctor that knew my entire thyroid journey and knew how my body reacted to increases and decreases in dosage.

4. Your thyroid levels are going to be different with each baby

I kind of already mentioned this in my second point about blood work. I’ve had two pregnancies and my experiences were entirely different. My first – a boy – was very predictable. My TSH levels gradually increased throughout my pregnancy, and we had to increase my dosage a little each trimester. With my second pregnancy – a girl – my thyroid levels were never stable.

Every month, I did blood work, and my TSH levels were always off the charts high. My endocrinologist and I were always so confused, especially considering my previous pregnancy. But it just meant we had to be more diligent about monitoring my levels. But my OB/GYN never seemed to be concerned. Which leads me to my next point.

5. Your endocrinologist and OB/GYN will look at lab results differently

To preface, the normal range for TSH levels is 0.4 to 4.0. For one of my regular visits, I walked into my OB/GYN’s office and told him—with a very worried tone—that the results from my most recent blood test showed a TSH level of 8. I and my endocrinologist had never seen my levels that high and were kind of freaking out. My OB/GYN calmly turned around and typed the number in my medical history. I then told him that my endocrinologist had been very worried about that number and subsequently increased my dosage. He agreed with the change in dosage and then said, “I’m not too worried about it. If your TSH level was like 700, I’d been worried, but you’re doing fine.”

While the contradiction between my two doctors was a little confusing, I was relieved. I hadn’t had any of the adverse symptoms of low thyroid levels (except fatigue, but I was pregnant, of course I was suffering from fatigue), which was good news. And my OB/GYN was familiar enough of baby’s development to know a TSH level that high during that point in the pregnancy was not going to affect my baby. 

In that way, I was glad my endocrinologist was there to fine-tune my thyroid levels, while my OB/GYN was there to keep tabs on baby. And guess what? Everything worked out and I had a perfectly healthy baby.

 

Navigating pregnancy can be tricky even if you don’t have other medical conditions. And keeping your thyroid levels in check during pregnancy is so important and totally doable. Sure, you have to do more blood work and possibly have more doctor appointments, but you can do it. The most important thing is that you test your thyroid levels early in your pregnancy and continue to monitor them until baby comes. And be sure to get your levels checked about a month after birth as your body begins to stabilize.

Disclaimer: The information contained in this blog post is of a general nature and does not constitute medical advice. Always seek expert medical advice tailored to your individual circumstances.

Sources:

  1. https://www.niddk.nih.gov/health-information/endocrine-diseases/pregnancy-thyroid-disease
  2. http://www.healthline.com/health/tsh#results5
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