My pregnancy and my thyroid
in Not a Diet
I had a reader request to write about how my hypothyroidism has affected my pregnancy. The topic is a bit specialized, but actually, considering how many women are affected by hypothyroidism, perhaps it’s not quite as specialized as I would think. Plus, I aim to please! So, here we go.
I was diagnosed with hypothyroidism in January 2008. I was put on Synthroid to manage it. It took my endocrinologist quite some time to find the right dose for me, 150. Then I had lap-band surgery and lost a bunch of weight, which threw off my dosage again. My endocrinologist and I finally settled on a new correct Synthroid dose, 125. This kept my thyroid-stimulating hormone (TSH) at around a lovely even 1.
Quick background on TSH: the higher it is, the less your thyroid is functioning (and therefore the more your body tries to stimulate it, hence the higher levels of TSH). Normal levels of
TSH are considered (depending on who you ask) to be somewhere in the range of 0.5 to 4 or 5. If you have hypothyroidism and you’re pregnant, in general you want to keep your TSH on the low end of that range. My endocrinologist wants my TSH to stay below 2 during my pregnancy.
I happened to have my TSH checked right before I got pregnant, and it was a perfect 1.03. Shortly thereafter, when I was 8 weeks pregnant, it had shot up to 4.79. And thus began the Pregnant Synthroid Dance, where I had my dose adjusted, and my blood drawn for a TSH test, every four weeks.
Of course, the midwives who manage my prenatal care aren’t affiliated with my endocrinologist in any way. That would be too simple, right? But since I see my midwives every four weeks, they’re the ones who test my TSH. I can access all my lab results online (LOVE that), and usually by the time I get home from my prenatal appointment the result is already available. It’s always high, and then I call my endocrinologist, tell her the new number, and she calls in a prescription for a higher Synthroid dose. Since getting pregnant, I’ve been through Synthroid 125 to 137, 150, 175, and now 200.
And then, last week, I got lovely news. After a month on the 200 dose, my TSH came back at 1.34! That’s the normal and desired range, in case you skimmed the explanation above. For the first time in months I was actually able to REFILL my prescription instead of asking my endocrinologist to call in a new one. It was a delightful feeling.
Of course, this is all theoretical talk, really. My TSH, while higher than preferred throughout this pregnancy, has still been low enough that there are no concerns about my or the baby’s health. Keeping TSH this low during pregnancy is more of a precautionary measure to make sure that it doesn’t shoot up to more dangerous levels because of undermedication. And I haven’t had any hypothyroid symptoms during the pregnancy, so it really hasn’t bothered me. Plus, I am really used to having my blood drawn by now, so it just feels routine that they prick my elbow at every prenatal visit.
I will say, however, that there is one thing about hypothyroidism that is totally incompatible with pregnancy: you have to take Synthroid first thing in the morning, on an empty stomach, and you are not allowed to eat anything for at least half an hour afterward. Those of you who have been pregnant can probably imagine how painful this is. In fact, those of you who haven’t been pregnant but have heard about insatiable pregnancy hunger can also probably imagine how painful this is. There are many mornings when I truly consider just gnawing off my own arm to hold me over until I’m allowed to eat proper food. So far I haven’t given in, but there are still 3.5 months to go. We’ll see if I still have two arms by the end of this.
But yes, basically I will say that I’ve been lucky in that my thyroid issues have had only a minimal impact on my pregnancy. But I will also say that part of
this is because I am well-informed and take my own medical care in hand. My midwives would be doing this anyway, I’m sure, but I’ve been very proactive about asking for tests, calling my endocrinologist, and making sure that my levels are tested and my dose is adjusted quite promptly. i think undiagnosed or improperly managed hypothryoidism could definitely create more issues during pregnancy. I feel lucky to have avoided those.
Have any of you dealt with this? Does anyone else have stories to share about managing thyroid issues during pregnancy?