Grave's Disease and Gestational Diabetes

[slimyak]

I'm currently 30wks preg with number 2. I had Gestational diabetes last time and managed it v. well so needed no intervention with pregnancy or birth. I have it again (from about 20 wks)and it's proving more difficult to manage so I may have to go on meds - hoping for metformin rather than straight into insulin.

I've previously had 2 bouts of Grave's Disease (over active thyroid) which have been sucessfully treated through block and replace medication and I've been off all meds for 18 months.

I've just been told it looks like my Grave's disease is making a come back - apparently very rare during preganacy, but I was expecting a come back post birth.

I've been concentrating on the Gestational Diabetes and seeing how I can do my upmost to manage it without full on medication and intervention but the reoccurance of the Grave's disease has really pulled the rug from under me. I have no idea of how the two conditions, never mind the drugs involved in treating them, will interact etc or the longer term implications for breast feeding etc. My consultant is closely monitoring me and there is no danger to my baby at the moment but he does feel I will need medication before the end of my pregnancy in Jan for my own health and ability to cope with birth and looking after a newbie. Obviously I will be talking more with my consultant but other people's experience may raise issues and questions I haven't thought of.

Sorry for the long post but does anyone have any experience of dealing with both these conditions at the same time. At the moment I feel like all I can do is hand myself over to the NHS and hope my baby and I come out the other side happy healthy and without regrets.

Hi,

Sorry you are having such a horrible time, sorry i have no exsperience in grave's disease, but do with GD, i am also on antidepressants so i understand the worry about the med's.

GD it self is horrible trying to manage it, are you finding it harder to keep cntroll this time, i also had it in my last pregnancy and am 28 weeks now and got told i had it at 24 weeks, last time i also managed diet alone but numbers seam to be creeping slowly too.

I think I'd cope with the diabetes as although things are creeping up I can manage things to a point that keeps the need for meds minimal. If I need to resort to meds I want to go for the metfomin at bedtime first rather than straight into insulin, even if that's where I end up. It's the interaction between the 2 conditions and the cocktail of drugs that scares me, but if you're coping with meds for 2 conditions you'll know what I mean.

Had my first growth scan today and all is well, baby just above the 50th centile, so things going OK so far.

Thats brilliant, i had a scan uesday and she weighs 2lb 10oz :)

Yeah sure it must be horrible and such a worry, could you maybe talk to your consultant about your worrys?

I had a nice conversation with mine who reassured me and told me i can breast feed on my tablets which is good.

hi slimyak i am almost 17 weeks pregnant and have graves disease. i was diagnosed after dd was born last year. i am on medication and now that my morning sickness has stopped i can take my medication and my T3 levels are about where they should be.
i will need to stay on the medication for the remaining of the pregnancy but at best i might come off the meds for the last 3 months. all i can say is dont worry about the two conditions too much let the consultant do the work and you just do what he/she tells you and i can guarantee you will be fine. all the very best.
xxx

I have no personal experience of Graves Disease but have learnt about it as a medical student. Just listen to your consultant's advice and take your medication as instructed and all should be well. Thyroid problems are known to be a concern in pregnancy but if managed well the outcomes are usually fine. Your consultant will be following well researched strict guidelines on your medication and management so trust in them. My understanding is it is far safer to be on medication than it is to not - so it is good that they have identified it now and are monitoring you closely.
this link might help

Tayto if you don't mind me asking what level of meds are you on? I'm presuming it's PTU rather than Carbimazole.

My second flare up of Graves was after DD1 was born and I took the lowest dose of PTU for 9 months while breast feeding and at 9 months I went onto full block and replace treatment and DD hit the bottle so to speak.

I was expecting the Graves to come back post birth but at 30weeks preg, even my consultant thinks it's an odd one. At the moment the 'free' thyroxine levels are within the right limits it's my TSH level that's dropped from 2.6 to 0.6 over the past 6 months. Until the 'free' levels start to change my consultant doesn't want to medicate.

Today I'm feeling a little less nervous about having two conflicting conditions and I'm momentarily conning myself that having diabetes and an over active thyroid means that although I'm not dealing with my blood sugar with effective insulin production my higher levels of Tyroxine are burning off any excesses with a short walk up and down the stairs. nice idea

hi slimyak im on ptu dont drop to the floor when i tell you but im on 350mg a day which is a huge dose by all accounts but im hoping ill get told on wednesday to drop the dose a litte when i see my consultant. i have by bloods done tomorrow and see consultant on wednesday. my levels were in the 200 after birth of dd my gp was shocked i hadnt had a heart attack. its taken over a year to get it down and then i go and get pregnant!!!!! i was on a waiting list to have thyroid out when i found out i was pregnant. i get seen every two weeks and im more than impressed with the great care i get. im not worried as i get seen so often,. i hope you get seen as often. dont be afraid to ask your consultant questions and dont settle for less than your happy with. is your midwife any good????