Enlarged Thyroid Gland / Goitre and Conception

[eapriest]

Hello,

I was hoping someone could help me. I am 27 and my dh and I have been ttc our 1st child for a few months now.

I am concerned however that I may have problems ttc to conceive as I have a large goitre (cyst) on my left-hand thyroid gland. This goitre measures 3.9 cm. and is very visible. I first noticed it back in July as it moves up and down my neck when I swallow.

I went to the doctors as soon as I could and had my TSH levels tested. These came back as 2.82 and normal. I also had my Vitamin B12 levels tested. Again these were normal at 384.

I have subsequently had my goitre / cyst scanned and aspirated and it has come back benign, and been advised to keep my goitre in whilst dh and I are ttc, as to remove the goitre would mean removing half my thyroid (not good during conception and pregnancy). I also had my TSH levels checked again in October - they were 2.7 and again I was told this was normal.

I have done a little more research and wondered if these TSH levels are normal? My dh and I have yet to conceive, and just wanted some reassurance. I managed to persuade the doctor to run further blood tests today for T3, T4, Thyroid Peroxidase (TPO) Antibodies and Thyroglobulin Antibodies. I am seeing him next week for the results.

Just wondered if anyone had ever been in a similar position and what sort of ranges I should be looking for?

Many Thanks,

Liz x

Hi Liz, those levels sound fine to me. I started meds when it got to 11 and that was a bit of a struggle! Not sure it's helpful or not but I have conceived twice with a tsh around 3. Antibody results would be helpful though, I was told if your antibodies were high if you are not under active you will head that way so your levels would need monitoring every few months. Good luck ttc!

I'm in the same shoe as you.. except that my TSH came back at 4.95.. the doctor i saw said it was ok but from doing a lot of research it is not. we are ttc already for 2 Years..

do you have any symptons? such as gained weight, tired but having a hard time falling asleep, etc...

They are fine but ideally you want TSH between 1 and 2 for best conceiving chances though gp may disagree and plenty of women have conceived with higher levels.

I got my level down to 2 from 8 with just 5 weeks on tiny 25mcg dose of levothyroxin.

Chrustekke2207 that gives me hope, because mine is close to 5 so that means it will take less to bring it down to under 2...

Thank you to everyone for all your replies & good to hear others have successfully conceived with thyroid problems. Yes Hartmel - saw your question, and it prompted me to do a bit more research, and push for those additional blood tests.

I think I have a few of the underactive thyroid systems, although maybe reading a bit much into things. I def do struggle to sleep, but am always so tired, suffer from mood-swings and constipation. I haven't really gained any weight, but I am always so, so cold. The heating is on a lot in our house! I also have a really strong family history of underactive thyroids - both my dad and grandma suffered. I have had an overactive thyroid in the past, and was told it would probably become underactive at some point in the future.

Hopefully will get the answers I need when I see my GP next week.

Will keep you posted...

xxx

I just wanted to let you know eapriest that I had exactly the same issue as you I had an overactive Thyroid that was diagnosed when I was 21 I had to have radio active iodine to shrink it which in turn made me underactive... cut to 4 years later after lots of infections and being really quite poorly I had my Thyroid removed completely in Feb 2008.. Aug 2008 I fell pg with my dd and had the perfect pregnancy and labour.. I have been on 250mg of Thyroxine for years and as long as I am monitored regularly I am fine, my dose doesnt ever really drop from 250 as when it does I start to become ill again but as long as you are managed correctly and are put on the correct dose this should not effect you falling pg or carrying a baby...my dd was also checked for the illness as 2, 7 and 14 days old and will be re-checked once puberty starts.. not sure if any of that helps but thought I would share anyway!

Hi Chookford,
Thanks so much for the reply. It gives me a lot of hope! I was the same as you when I first got my Overactive Thyroid, but was treated with Carbimozole at the time. I have been offered to have my thyroid removed, but was really concerned about fertility, so I am pleased you are proof that having no thyroid is a barrier to having children.
Will hopefully get some more answers / solutions when I speak to the doctor next week, xxx

No problem, glad I could be of some help! I was very closely monitored throughout my pg by both an anti-natal consultant and my Thyroid consultant just to make sure the baby was ok and I had scans every 6 weeks (which was a massive bonus!!) so as long as you are watched over you will be fine whatever the outcome.. xx

Just to update. The doctor called me today with my TSH results which have dropped to 1.45 (it was 2.7 3 weeks ago). As this is in the normal range the Lab has refused to run any T3, T4, Thyroid Peroxidase (TPO) Antibodies and Thyroglobulin Antibodies tests. With my goitre and a strong family history of Hashimotos disease should I be concerned, or just wait and see?

Also wondered whether taking pre-conception vitamins containing Iodine would help?

Thanks,

Liz

1-2 is perfect so thats vg news- i doubt iodine would improve matters.

Hello,

Just thought I would post an update. My GP called today as the Lab finally ran the anti-bodies test and turns out I have Hashimotos disease. My TPO reading came back at 1446 (anything over 100 is high and out of range). He is referring me to an Endocrinologist. Just wondered if there is anything I need to know (especially r.e. TTC) and if thyroxine would help at this stage?

Thanks,

Liz

Thanks Tangerine Feathers for the reply. My GP called this morning. Said he spoke to the Endocrinologist who didn't seem too concerned about my Hashimoto's at this stage as my TSH levels are good. He said he didn't think Thyroxine would help (but I am not too sure). Anyhow he is going to see me in a couple of weeks to answer any questions I may have. I am also checking to see if my medical insurance will cover me to see another Endocrinologist privately to get a second opinion.

xxx

www.endo-society.org/guidelines/final/upload/Clinical-Guideline-Management-of-Thyroid-Dysfunction-during-Pregnancy-Postpartum.pdf

We tend to use these guidelines. In antibody-positive women TTC or pregnant, we aim for TSH less than 2.5, so it is really very satisfactory. I wouldn't imagine that the endocrinologist would advise thyroxine in your case.

You are very, very likely to develop hypothyroidism in the future with those antibodies, so you'd probably be advised to have TSH & T4 levels checked every trimester while pregnant and every year when not so you are started on thyroxine as promptly as possible.

Hope that helps.