Graves' disease/ hyperthyroidism in pregnancy

[nopun]

Does anyone have experience of this? My Graves' disease has been in remission for ages, and I did have my thyroid levels checked at the booking appointment (and they were normal) - but not since then. Should I have? Coming up to 36 weeks now and suddenly feeling as though my thyroid is out of whack, and freaking out that I haven't been told earlier to keep an eye on it.

Hi,

Yes you most certainly should have! They need to be monitored every 4 weeks. Pregnancy can kick start Graves' again. What meds are you on? I had Graves' but had a total thyroidectomy last year before falling pregnant so I'm solely on Levothyroxine now. This has had to be increased as the baby takes quite a bit of it from you. Have you not been seeing your endocrinologist? I can't believe you've made it this far without nobody bringing it up! I'd speak to your doctor or midwife asap xx

I had monthly blood tests and extra scans from 26 weeks to make sure my thyroid levels were ok and baby was growing ok. I'd only had 1 episode of low levels 4 years ago that didn't need medicating. Pregnancy can trigger thyroid issues apparently.

Any thyroid problem needs to be monitored during pregnancy, it’s a major hormone issue. Yes see your gp asap

I believe you should be under consultant care and a blood test in each trimester to monitor things.

No need to panic now, but a call to the GP and midwife and hospital as soon as they open today (to cover all bases) is your next step.

Thanks everyone - I'm completing freaking out now!!

I haven't been on carbimazole for ages and was discharged from the endocrinologist about 10 years ago. For this pregnancy I was under consultant-led care until a few weeks ago, but only because I had a previous early premature birth - and they were mostly interested in cervix length and infections, and never ordered any thyroid checks or even talked about it (it was in my history obviously, so I kind of figured they'd have said something if it mattered). I've had quite a few scans since 26 weeks and they weren't particularly worried about fetal growth.

To be honest there have been so many issues in this pregnancy I kind of forgot to keep asking about the thyroid, even though I really should have known better!! I'm kicking myself for not having insisted on regular monitoring. I demanded a blood test this morning, but it's so late in the day - what happens if my thyroid levels have been off for ages? It can affect the baby, right? Arrrgggh.

I've had a blood test every trimester (although I did extra ones in the first trimester as my T4 went abnormal, which consultant then said is normal for early pregnancy!) and am consultant-led. You do have to point it out to them at midwife appts etc as they won't think to look through your history. Midwives aren't v clued up on it in my experience either - they usually confuse it with being underactive.

If it has gone a bit wonky again don't panic - they can treat it, although in my experience they won't until after birth unless the maternal risk is greater. I wasnt given carbimazole when I had graves after my first DC as I was breastfeeding, I had propylthiouracil (PTU). I think it would have to be seriously off the scale for it to affect the baby, and you would have noticed by now if it had as you'd feel terrible. You say you've been feeling a bit under the weather? Mention this to your midwife asap as it could be a whole host of other causes - with my first I ended up with high bp in 3rd trimester, I felt like my heart was racing and I was breathless and a bit confused. Similar sort of symptoms to Graves!

There no use stressing now but you do need to contact someone.
Were you able to ring today?

Really appreciate your reassurance, thank you. I've had a blood test today and should find out the results by Monday. I also remembered that my GP had ordered a thyroid function test at 20 weeks, which was apparently normal, which has made me feel less panicked - at least the first half of the pregnancy was ok.

I did tell the hospital today that I've been feeling off (lightheaded, nauseous, racing heart - all reminded me of Graves), but they pointed out that my blood pressure was ok at my last midwife appointment a few days ago.

Well that's all very reassuring and positive.

do keep reminding them of your thyroid as they should be keeping you and the baby in after birth so its levels can be tested too to ensure it doesn't have its own thyroid issues - my thyroid is underactive and my consultant said they wouldn't need to do this for me, but that they definitely would if it was overactive