Pregnancy with Hypothyroidism or Hashimoto’s–what patients have learned
I remember when I, Janie, hypothyroid patient and creator of this site, made the phone call to my doctor to find out if I was pregnant. “Yes,” the nurse said, “you are.” And my reaction? OH MY GOSH. I AM PREGNANT! ME!! Pregnancy was shocking, exhilarating, scary, fun.
Pregnancy: a time of a growing belly, different clothes, new dreams…and a host of physical demands on your body:
… Your breasts increase to prepare for nursing.
… Your body’s blood volume increases to give nutrients to your baby.
… Your heart rate will rise to meet the demands of your increasing blood supply.
… Calorie storage will increase.
… Progesterone and estrogen levels will rise.
And not only will your thyroid gland enlarge slightly, your TSH will raise and thyroid hormones will increase by 50%.
Why does my TSH go up with pregnancy?
As your estrogen levels go up with pregnancy, so does a particular protein called T4-binding globulin (TBG). That, in turn, binds and lowers your thyroid hormones. Your pituitary responds by producing far more TSH (thyroid stimulating hormone) which will increase your FT3 and FT4 to equal things out. Additionally, the placenta secrets high amounts of a hormone called human chorionic gonadotropin (HCG) which also stimulates the thyroid similar to the TSH. That can even cause some women to have symptoms of HYPERthyroidism.
How can I detect if I develop a thyroid problem when I’m pregnant?
Though your thyroid gland will enlarge slightly with pregnancy, it shouldn’t be detectable. But if your thyroid gland is noticeably larger, or you notice far more fatigue than you think you should have, it’s time to suspect you have a thyroid problem and need to talk to your doctor. You could either have HYPOthyroidism, or HYPERthyroidism. Many women end up with Hashimotos disease during or after pregnancy–the autoimmune version of thyroid problems–and some just find themselves with plain ol’ hypothyroidism.
If I am already on thyroid medication for my Hashi’s or just plain hypothyroidism, will I need to increase it when pregnant?
Possible yes and fairly immediately, say many knowledgeable doctors. Even this study from the New England Journal of Medicine confirms it, since the growing fetus and its tiny brain will need your thyroid hormones for many weeks. It’s only when your baby is about 20 weeks old does it start to use its own thyroid hormones, but demand for your own thyroid hormones will continue until the baby is born. (And this early need is why some mothers outright “become” hypothyroid while pregnant! The demand overwhelms the thyroid!) The need to increase your thyro)id hormone medication, whether a working natural desiccated thyroid (most don’t work as well anymore. But as of this writing, Armour still does, as does compounded NDT or T4/T3-only, occurs because as estrogen increases with pregnancy, so does the binding of thyroid hormones.
Additionally, if you have the autoimmune version of hypothyroidism called Hashimotos, you’ll want to keep a check on adequately treating your hypothyroidism and antibodies, since some experts state that thyroid antibodies cross the human placenta and could attack your baby’s thyroid.
How much do you increase it? That is something you should talk to your doctor about. It may not be much.
P.S. though the above mentioned study refers to Levothyroxine, a growing body of informed thyroid patients know that having T3 in your treatment is key, whether a still-working NDT like Armour, or T4/T3, etc, has proven to be a MUCH better treatment than T4-only.
What about iodine when I’m pregnant?
Just as the need for thyroid hormones increases, so does the need for adequate levels of iodine. Many scholarly articles and health organizations recommend this, ranging from 150 to 250 µg (mg) of iodine supplementation. You can work with your doctor on this.
Why T3 in my treatment for hypothyroidism if I’m pregnant?
Because, say informed new moms, T3 is the active hormone, and a growing fetus needs it.
How do healthy levels of my thyroid hormones, or the right supplementation, affect my little growing baby?
Even by the late 1800’s, medical professionals knew about the importance of thyroid hormones on the developing brain of the fetus. Since then, numerous animal studies haves supported that knowledge. Your thyroid hormones also positively affect your baby’s nervous system.
What if I’ve given birth and am nursing?
Your own need for good thyroid function (or having T3 in your treatment) and iodine still continue when nursing, and is higher than when you are not nursing. Janie, the creator of the Stop the Thyroid Madness movement, was sick, sick, sick when nursing her second and third babies due to undiagnosed hypothyroidism!! You can read her story right here and more in the introduction of the updated revision STTM book.
What about the use of Hydrocortisone or Adrenal Cortex when pregnant, taken due to saliva testing revealing low cortisol?
There have been several patients who were on cortisol due to saliva testing having revealed low cortisol, and were pregnant, and said they were just fine as was the baby. Work with your doctor please, as we aren’t about predicting. This is just information based on patient reports.
Check out this interesting story of a woman’s hypothyroidism during pregnancy
- A scholarly article on thyroid hormones and fetal brain development
- Read about Thyroid hormones and the fetus
- Article about multi-vitamins and iodine content
- Read about low thyroid hormones and a hard birth