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Are there any ways to treat thyroid disorder during pregnancy naturally?

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Posted on Tue, 12 May 2015
Question: This is a question for an endocronogist. I am 29 weeks pregnat and on 25 micrograms of synthroid. Wirh my first son (perfecly healthy child) my thyroid was never tested (i had him 2 years ago). This pregnancy my tyroid was tested and at 10 weeks my TSH was 4.5. I did one more blood test 2 weeks later before starting syntroid and TSH was 3.5 (unmedicated at 12 weeks) I then began .25 micrograms of syntroid and my next TSH test 4 weeks later was 2.54. I have remained at that number for the past few months. My last TSH (2 days ago) was 2.94 (at 29 weeks). My obgyn wants to up my dose to .50 micrograms of synthroid. I know this is simple enough however, i am reluctant to become dependant on syntroid as i usually take a wholistic approch to health care and i trust that once im no longer pregnant i will deal with my thyroid naturally. The less im on the less i will have to ween off of. At these numbers am i endangering my fetus? I should note, i do not have Hashimotos and my condition is sub-clinical. Looking forward to your reply thank you again for your time.
doctor
Answered by Dr. Binu Parameswaran Pillai (5 hours later)
Brief Answer:
Subclinical hypothyroidism in pregnancy

Detailed Answer:
Good day,
Noted your concern.
You did mention that you do not have Hashimotos. How did you arrive at that conclusion ? Were the antibodies ( anti TPO and Anti TG) checked?

TSH has a lower threshold to start treatment in pregnancy. Sucbclinical hypothyroidism can cause adverse outcomes to mother and the fetus. During the fisrt 12 weeks, fetal thyroid is not fnctional and get thyroid hormones from mother.

It was right to start Thyroxine in your case. Studies have shown that, the optimum TSH cut off is less than 2.5 during first 3 months of pregnancy and less than 3 during rest of pregnancy. As there is weight gain in pregnancy, the requirement increases as pregnancy progress. So there is no harm in increasing the dose now. However, you may not require 50mcg every day with TSH of 2.9. My advise would be to take 25 mcg for 5 days a week and 50 mcg for 2 days ( saturday and sunday). That would suffice in your case. Recheck TSH after 4 weeks of increasing the dose.

There are no or negligible adverse effects on fetus with your level of subclinical hypothyroidism. If the fetal growth profile is normal, not to worry. Remember to take sufficient iodine during pregnany and later durin lactation.


If the antibody levels are negative, in most cases of subclinical hypothyroidism, we will be able to stop Synthroid after delivery. So not to worry. Please remember to check TSH of baby 48 hours after birth.

Regards XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (9 hours later)
Thank you for your prompt reply. I will in fact up my dose from .25 to .50 micrograms of synthroid 2 days a week, wonderful comprimise!!
As for Hashimotos, i asked my obgyn to test for the anitbodies when the results came back i was told i do not have them, thus i do not have Hashimotos. I will confirm with a second opinion in the next few weeks but its seemed clear i was free of the antibodis. My current obgyn has scared me into beliveing that once i start synthroid that i will need to be on it for the rest if my life as i will most likely always have an underlying thyroid condition.
Is this true? Are there holistic methods of dealing with this condition that dont requier prescription medication?
Also, since my condition went undiagnosed during my first trimester and my TSH was 4.5 is it possible that my child could have impaired brain function (even mild) Im worried sbout autism/learning delays due to my TSH level in the critical first trimester.
On another note, the baby is growing super well...in fact he is almost 2 weeks ahead of his groth expectancy. Our first son is very big aswell, he has been in the 100th percentile in hight and 95th percentile in weight since he was born.
So having another big boy is no XXXXXXX
All other tests on the featus came back very well (genetic ect.)
I just did my gloucose test 3 days ago and I did very well with no XXXXXXX of diabetes.
On another note i am 5foot 7inches and began my pregnancy at 134lbs to date at 29 weeks i have gained 26lbs, so i do not feel my weight is out of control...i do feel more sluggish than with my first child and my nails are not as strong but otherwise i think the hypothiroid conditin is A-symptomatic.
Please let me know how my TSH in the first trimester could affect my child and also how i can restore my thyroid function post baby without synthroid. Thank you very much!
doctor
Answered by Dr. Binu Parameswaran Pillai (8 minutes later)
Brief Answer:
Not to worry

Detailed Answer:
Good to know that your antibody levels are normal. In that case, we should be able to stop Synthroid after delivery and recheck TSH after 6 weeks of stopping.

In most recent studies, there is no evidence of obvious cognitive damage or IQ issues in fetus born to mothers with subclinical hypothyoidism. We treat this in pregnancy more for favourab;e maternal outcome rather than fetal outcome. Ofcourse in severe overt hypothyroidism, there can be fetal damage. Yours is a mild subclinical hypothyroidism.

Your requirement of synthroid is not huge. I strongly beleive that you should be able to stop it post delivery
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (1 hour later)
Thank you!
doctor
Answered by Dr. Binu Parameswaran Pillai (25 minutes later)
Brief Answer:
Best wishes

Detailed Answer:
My pleasure. You are Welcome to ask more questions. If you have no more questions, may I request you to please close the query. Best wishes and have a safe delivery.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (2 hours later)
Thank you. Lastly does getting off of synthroid post partum contribute to any kind of depression? Also does it affect the breast milk? Thank you
doctor
Answered by Dr. Binu Parameswaran Pillai (19 minutes later)
Brief Answer:
If Free T4 and TSH normal, not to worry

Detailed Answer:
Postpartum blues and depression are quite common. People with thyroid dysfunction can have an added effect on depression. But , as long as your TSH and Free T4 remains normal, stopping synthroid will not contribute to depression
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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Are there any ways to treat thyroid disorder during pregnancy naturally?

Brief Answer: Subclinical hypothyroidism in pregnancy Detailed Answer: Good day, Noted your concern. You did mention that you do not have Hashimotos. How did you arrive at that conclusion ? Were the antibodies ( anti TPO and Anti TG) checked? TSH has a lower threshold to start treatment in pregnancy. Sucbclinical hypothyroidism can cause adverse outcomes to mother and the fetus. During the fisrt 12 weeks, fetal thyroid is not fnctional and get thyroid hormones from mother. It was right to start Thyroxine in your case. Studies have shown that, the optimum TSH cut off is less than 2.5 during first 3 months of pregnancy and less than 3 during rest of pregnancy. As there is weight gain in pregnancy, the requirement increases as pregnancy progress. So there is no harm in increasing the dose now. However, you may not require 50mcg every day with TSH of 2.9. My advise would be to take 25 mcg for 5 days a week and 50 mcg for 2 days ( saturday and sunday). That would suffice in your case. Recheck TSH after 4 weeks of increasing the dose. There are no or negligible adverse effects on fetus with your level of subclinical hypothyroidism. If the fetal growth profile is normal, not to worry. Remember to take sufficient iodine during pregnany and later durin lactation. If the antibody levels are negative, in most cases of subclinical hypothyroidism, we will be able to stop Synthroid after delivery. So not to worry. Please remember to check TSH of baby 48 hours after birth. Regards XXXXXXX