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How long does it usually take for Hashimoto’s to settle into a new normal after having a baby?

in by HJL
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I’ve had Hashimoto’s for about 20 years. My levels were fairly stable until I became pregnant with my first child. My endo increased my synthroid dosage from 137 to 150 during pregnancy then reduced back to 137 after I delivered. I’m also on 5 micrograms of Cytomel. My last THS lab was high, so my endo increased my dose back to 150. Just got my follow up lab back and it’s basically the same (too high still). Today I start 175, which is the highest I’ve ever taken. How long will it take to find my new normal? I’m 17 months postpartum, and am thinking about another (and worried about possible fertility issues related to high TSH levels).


About HJL

Conditions: Hashimoto's thyroid disease

Doctors seen: MD – specialist

Treatment: Prescription medication/shots

Children: 1

Age: 35-44

HJL
0

2 Answers

2

Hi and thanks for posting a great question. Let me first say that I wish I could just give you a number (i.e. a length of time) and tell you that everything will be sorted by then but, alas, of course I can't. I do have a bunch of thoughts, though, for your consideration. What you're going through is not at all uncommon. Sometimes thyroid glands just act squirrel-y and take more than a year or two to sort out; you may have had post-partum thyroiditis on top of your Hashimotos and, so, your hypothyroidism might have gotten worse from that (no way to really tell at this point, but a possible explanation). Also, the dosage of 175mcg is still very much in the common range. Questions/considerations for you: are you breastfeeding? if so, the increased metabolic demand could cause the increased levothyroxine need. Have you lost your pregnancy weight? If not, again this equals increased demand. Are you taking your meds on an empty stomach in the morning and taking them consistently? If you're not taking meds as directed - you may be getting sub-therapeutic levels. Are you taking other medications that might reduce absorption (iron supplements are a potential culprit)?

After you've checked (and if necessary, fixed) any of the above situations, I have a few more ideas. Many doctors habitually say "let's recheck your labs in three months" but you can reliably re-check at 4-6 weeks so, if you're in a rush, ask to be rechecked sooner. If the levothyroxine still doesn't seem to be doing the trick after several months, perhaps you can up the cytomel slightly as well - you should discuss this with your endo.

Regarding another pregnancy, you're wise to have waited this long. Research clearly shows that spacing pregnancies at least 18 months apart gives the best outcomes for moms and babes. That said, you're eager to get going. I hear you. You need to discuss this with your endocrinologist and obstetrician/midwife for two reasons: 1) we recommend even tighter TSH control around pregnancy (ideally a TSH of under 2) so you just want to make sure that while you're doing these medication adjustments, you're targeting the tighter TSH level. Reason number two is your age. You've marked that you're between 35-44 which puts you into the lovely category of "advanced maternal age" (along with me and many others). Our fertility does decline more rapidly in this time frame and so you should ask, under this circumstance, is it better to begin trying to conceive despite imperfect TSH levels (knowing that you're being followed closely), or is it better to continue to work on the thyroid even though it's proving to be somewhat stubborn recently. In general, our recommendation is to wait, but occasionally doctors will treat individual situations differently and yours might be one of those cases.

Hope that's helpful and I wish you good luck,

Kathi Kuntz, RN, MSN

Kathi Kuntz, RN, MSN
20

About Me:


Answered on November 15, 2012

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Thanks for the good info Kathi! I've been back to my endo a few times and my levels have gotten much better - around 1 now. This is good news too since I'm expecting again. :) Thanks for the info and encouragement!

HJL
0

About Me:

Conditions:

Hashimoto's thyroid disease

Doctors seen:

MD – specialist

Treatment:

Prescription medication/shots

Children:

1

Age:

35-44
Answered on February 10, 2013

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