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Thyroid, weight gain. Taking thyroxine. Increased TSH. Is it safe to have second pregnancy?

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Practicing since : 2002
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I have got thyroid since 2009 December due to this I have gained 23 kgs in last 2.5 years and now my husband is insisting that we should go for a second child. My son is currently 5 years old, he was born in march 2007, post preganany I had put on weight and it was stable as well, it wasn't fluctuating at all but since December 2009 it is increasing continously.
Iam not sure what should I do, Iam scared that I will put on more weight after my second pregnancy and therefore Iam avoiding it right now. Iam currently 103 kgs. Iam a pure vegetarian and generally take a good diet, Iam not skipping my meals, so not sure what exactly is causing continous weight gain.
For my thyroid Iam taking Thyroxine 100 mg daily in the morning. I am also attching my last report for your reference, this test was done last week on 28th april 2012. Also wanted to share, when I continue to take my medicene my thyroid is under control but if I leave it even for a month, in that case my TSH shoots up to 22.
I want to confirm how I can control my thyroid without being dependent on medicene and what should I do to reduce my weight. Since I want to plan for a second child soon. Please suggest.. Can homopathy be of any help in case of thyroid.
Posted Wed, 23 May 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Anantharaman 2 hours later

First of all let me reassure you that the problem you are facing is a fairly common one and it is definitely manageable. You definitely have primary hypothyroidism requiring Thyroxine supplementation (since you are saying that the TSH goes up on stopping the Thyroxine for a month).

I will address your last two questions first.

You need to be on lifelong thyroxine replacement there is no doubt about it. Thyroxine is not a drug but is a replacement therapy as your thyroid gland is not producing enough of thyroxine. Usually by the time the TSH rises and we discover hypothyroidism the thyroid gland is destroyed permanently by an auto immune process. Currently there is no therapy in any form of medicine which can make your thyroid gland produce a normal amount of thyroid hormone by itself hence you need to be on lifelong replacement. We check the TSH periodically to see if we are giving enough of Thyroxine.

The amount of weight you have gained cannot be due to hypothyroidism alone. It is usually due to combination of factors. Usually women gain weight post delivery because of a) increased caloric intake, b) less physical activity and lastly c) Hormonal disturbances such as hypothyroidism.

Even a small degree of change in physical activity per day - for example if you were working before pregnancy but have stopped after delivery- coupled with slight increase in energy intake can add up to a lot of weight gain. But having said all this you need to be examined by an Endocrinologist who will look for some rare causes of rapid weight gain clinically and order some test if he/she feels necessary.

Also since you are planning a pregnancy your Endocrinologist will (and should) order a Glucose tolerance test and a lipid profile and a TSH as pre pregnancy evaluation. So firstly, you need to XXXXXXX an Endocrinologist. Secondly, you need to improve your lifestyle. Start walking for 20-30 min every day and increase it to 1 hr over a period of 2 weeks. Simultaneously reduce your calorie intake by 500 Calories. Simple ideas include using sugar substitutes instead of sugar in your beverages, reducing the size of each meal by 25% (take 3 chapatti instead of 4). Consume instead fresh boiled XXXXXXX vegetables, cucumber etc which have low caloric value. You will get a better idea if you XXXXXXX a Dietitian. You can very well have a second child. Please remember that your life style changes (that surround pregnancy) are what causes weight gain not pregnancy itself. If you are physically active and have a healthy diet you should do well.

Dr Anantharaman R DM (PGIMER)
Consultant Endocrinologist
Above answer was peer-reviewed by
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