Tuesday, January 11, 2011

Hashimoto's Disease During Pregnancy


Gabriel is three months old now.  He's a nice, plump, pleasant, chunky-monkey of a baby.  I'm so thankful that he's healthy.  Although there was some stress associated with my pregnancy with him, there were never any direct worries about his health.  He checked out great at every stage of prenatal care.

I do have Hashimoto's  Disease, and have been diagnosed with it for at least 5 years, which means that my last three pregnancies have come to term while having thyroid problems.  I thought I'd write a little about it in this post.  I never did find too much information regarding Hashimoto's and pregnancy (other than to say that sometimes thyroid problems can cause infertility...not my problem, obviously,) when I needed it.  Maybe this will interest some other woman who finds herself in the same situation someday.


Since this wasn't my first dance around the pregnancy/Hashimoto's block, I decided to try some new things with Gabriel's pregnancy.  First, I guess that I should tell you some of the discomforts of Hashimoto's Disease. You can read the standard symptoms by clicking on the link, but for me, specifically, the issues were extreme fatigue, random joint pain and swelling, dry skin, dry hair, frequent headaches, and weight gain on a diet of lettuce.  (I'm kidding about the lettuce part, but only slightly.)

Since I'm a grand-multi-para (that means that I've had lotsa kids,) I have had plenty of time to observe myself while pregnant.  (Don't let my brilliance dazzle you.)  I figured out that my metabolism worked more normally while pregnant than it did while un-pregnant.  Maybe my body decided that being pregnant was more normal for me than to not be pregnant.  (Which stands to reason seeing that I've been pregnant for 81 months out of the last 18 years.  I've also been nursing a baby for over 9 years, total, thus far.  Wowzers!)   Whatever reason, my metabolism just works better while gestating.  :)

Early on in the pregnancy, I spoke to my doctor about the possibility of trying to not gain too much weight.  I told her that in the long run, I weighed about 20 pounds more than I wanted to.  She agreed with me, that due to the Hashimoto's I could try to keep my weight gain low.  I recognize that there is a lot of controversy over how much pregnant women should gain, and whether or not women should be given guidelines at all, and how dogmatic obstetricians should be regarding weight gain.  (I'm up on all of the pregnancy/childbirth/breastfeeding controversies.  :)  I feel that by now I should have gained my Ph.D in pregnancy, if that were possible.)  My doctor and I avoided all controversies, looked at my situation as an individual with a proven track record and thyroid problems, and treated me as such.  That's one thing I appreciate about my doctor - she treats me as an individual.  She's also the doctor for our entire family, which I really like.

I usually gain about 10 pounds in the first trimester due to grazing to keep the nausea at bay.  With Gabriel's first trimester I didn't feel too bad at all - just a little queasy.  I kept pretty strict guidelines over what went into my mouth, making sure to eat non-greasy protein and green veggies (spinach, kale, chard) and very little junk food.  I didn't gain anything, but felt great.  The baby was growing well, too.

I had been exercising for at least six months prior to pregnancy with a video program called T-Tapp.  T-Tapp is many things and has several strengths, but it is designed particularly to help with auto-immune diseases and lymphatic pumping and spinal alignment and the left brain/right brain connection and even hormonal management.  I kept up with the T-Tapp throughout the entire pregnancy, up until the last month.  My work-out routine was only 15 minutes a day, and I did it 3 times a week.

Our lives fell apart around the first part of May, when my husband was in the hospital.  I couldn't be as careful  with what I ate at that point, and exercising was rather hit and miss.  I realized that I was not nearly as stiff or sore if I exercised, and I was able to function so much better when I did.  We told people that we were expecting around the middle of May.  I hadn't gained any weight by then (16 weeks?) but the baby was becoming obvious.


These pictures are a few days post-partum, so my eyes look especially tired.

Gabe's pregnancy was very carefully monitored.  I had ultrasounds every two weeks, and I weighed in at each visit.  I met with the specialist each time to go over any concerns.  I also saw my regular doctor once a month throughout, up until the end when the visits were every two weeks.
In total, by the end of pregnancy I had gained 11 pounds.  I ate well.  I did not starve myself.  I did not eat much sweets or much junk.  It's not that I'm virtuous, I just didn't want it.  (I also had gestational diabetes, and it would not have been good to do so.)  Gabriel weighed 8 lbs. 12 oz out of that 11.

Since Gabe's birth, I have been extremely careful.  In previous pregnancies, I have tended to slide into a Hashimoto's crisis following delivery.  Hormones go crazy with sleep deprivation and milk production.  Metabolism is boosted for a time, but then tends to crash and enter a phase of extreme sluggishness.   I am afraid to crash.  I have too many responsibilities.  

Although I have eaten too much junk food, I have been careful to try to get the sleep I need (by sleeping in later in the mornings if he sleeps) and I started the T-Tapp gently at two weeks post-partum.   The 15 minute T-Tapp routine is gentle stretching and lymphatic pumping - it's not weight-lifting and high repetition.  At six weeks, I stepped it up a little and added in the full 25 minute program, 3 days a week.  Eventually, I have moved it to 5 days a week, with two days off on Sundays and Mondays.  Just this week, I switched out the regular T-Tapp program for what is called the "Ladybug" routine, which is designed especially for hormonal management.  I'm never going to look 20 again, but that's not my purpose.  I desperately need to be in shape for and have the energy and endurance for 9 children, a husband, and 2 elderly parents.  I have to work to feel good, and these are my tactics.  I tell people that I don't "do" anything, but when I think it thru that's not exactly true.  I do work hard to keep the Hashimoto's in line, and when the Hashimoto's is subdued I'm better able to function in all areas of life.  When I miss more than two days of exercise, I am feeling it.

There are times when I feel a thyroid crash coming.  I feel headachey, tense, jittery, panicky, and my heart starts to thump a little faster.  So far, I have been able to head off the crisis by fitting in the work-out and by trying to get good sleep.  I weigh 15 pounds less than I did when I was first pregnant with Gabriel, and I notice that I have more energy and I feel a lot stronger.  I don't mind getting on the floor to help the little ones get their snowsuits and boots on.  I don't avoid digging for a specific pan in my lower cupboards.  When my joints or hips ache, I make sure to do at least the 15 minute stretching and spinal alignment exercises.  They really help.

I have not figured out all of the components of managing Hashimoto's and pregnancy.  What I have tried might not work for everyone.  It might not even work for me every time, but it has been interesting to try and figure it out.  I am not on any thyroid medications at this time.  For me, it seems difficult to try to regulate medications while pregnant or breastfeeding.  Endocrinologists are not exactly a dime a dozen these days.  They are difficult to get into, and not all agree on the treatment of Hashimoto's, particularly during pregnancy.

The above are just the things that I have tried, and over all, I would have to say that they worked remarkably well for this particular pregnancy and early post-partum period.  

23 comments:

  1. Very interesting that you aren't on any thyroid meds. My dr. thinks that the synthetic stuff is the best, but I keep going back to the raw thyroid as I feel better overall. But I just found out today that another medication he put me on causes weight gain. Hello?????? I can't believe I've been taking that med for over a year and a half. There is no way I should have been on a med that causes weight gain considering my thyroid issues. I totally understand the eating lettuce part.....it isn't a joke in my life. I am glad you are doing so well!!! That is fabulous! I am glad you are talking about your Hashimotos.

    Tracy

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  2. The meds just aren't worth it to me, Tracy. You know how difficult it is to get the right adjustments. With hormonal shifts, it's almost impossible. I've been on synthroid in the past - but with back to back pregnancies or nursing it's just hard to regulate. (It's hard to regulate, regardless.)

    And yeah - after Mariam's birth my dr. put me on a med. which would sloooooow down metabolism and all functions, really...and cause weight gain. As you say, "hellooooo????" Now what I wanted.

    I AM doing well, and I am thankful. HOWEVER - Hashimoto's is a tricksey little thing. It can flip on a dime and turn itself up or down. It's crazy! I'm only counting on how things are "now," not trying to look too far ahead, being thankful for today. I don't know that I can keep it at bay - but I am sure trying!!!!

    I do think the T-Tapp is helping me - it helped me to at least feel better and have less joint pain before pregnancy, so it was worth it even though I didn't lose any weight.

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  3. Thanks for posting this. I don't have Hashimoto's or any kids for that matter (therefore no pregnancies), but I do have Polycystic Ovary Syndrome. It's hormonal. My dr recommended the normal meds for it (which is birth control or 1 other drug), but I turned them down and told her I was going to try treating it naturally by changing my lifestyle. Two months later I haven't changed a thing :P If you can find time to exercise and eat healthy while raising 9 children (and homeschooling!) I should be able to drag my sorry butt to the gym after work a few times a week. Thanks for the motivation!!

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  4. I think you're doing a fantastic job managing. Not just your kids and homeschool and being a wife and a mom and a daughter, but a woman too. You're taking care of your health in a way that is clearly doing you a great deal of good.

    Hats off to you! You are living proof that success is possible. :)

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  5. Very interesting that you're not on meds! I'm essentially non-functional without my meds LOL. I have Hashi's too (and, like you, NOT the fertility problems! ;-) ). Oddly enough, I haven't had too much trouble monitoring my meds throughout pregnancy - I simply go get my blood drawn every 6 weeks, and my endo has increased/decreased my meds based on the lab results and how I'm feeling. I'm kind of weird in that my labs stay roughly the same during pregnancy. AFTER I have the baby it can get a bit wonky though.

    I had a TERRIBLE time nursing this last go around. I think part of it was him (sorry latch), but I think part of it was me.

    I'm currently on both Synthroid and Cytomel (synthetic T-3, since I don't convert T-4 to T-3 very well), and it seems to be a good mix.

    I'm about to start T-Tapp for core strengthening so I don't have to have herniated disc surgery AGAIN, so it's good to know I need to watch out for changes in my thyroid function as well.

    My 10yo dd has Hashi's too, but all her labs are OK at this point. She does have symptoms, so I plan to find her a pediatric endocrinologist. Although, she is about to start T-Tapping with me, so maybe that will be enough to keep hers under control???

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  6. Kat, I am a very lazy person when it comes to exercise. I really do have to MAKE my sorry self do it.

    Ness...I have my struggles, that's for sure. It's likely fear that motivates me! :)

    K - I am pretty sure that if we'd had a smoother year I would have sought out meds. Actually, if I hadn't done the T-Tapp I am sure I would need the meds and regular chiro treatments. With our crazy year (I counted 70 doctor visits between Jeff/me/my parents between May and September) I just couldn't even stand to bring up the mention of another thing to deal with.) I also had the Anti-E thing, which I will also blog about soon. I suppose they could have monitored the bloodwork along with that - since I had labs drawn every two weeks - but maybe my labs weren't so bad since I was T-Tapping. Who knows? I just know that I didn't choose to enter it all into the equation. I hated being on the meds I used to be on (synthroid treated me nicely for a time, until my 7th pregnancy) and then my dr. tried something else to "shock" the Hashimoto's back into latency, and that was awful. I was so tired I couldn't function and I was gaining weight. It didn't seem worth it.

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  7. Kat, I was just thinking, too...I've got several other friends who read here with PCOS. That's such a hard thing to regulate and deal with. (())! Does it classify as auto-immune? I don't remember...

    One thing I want to be sure and say to everyone is that I'm NOT saying "work harder." "Work harder" or "exercise harder" doesn't work with a lot of autoimmune illnesses. It doesn't work with Hashimoto's, or Adrenal Insufficiency (quite the opposite with that one...), or Fibromyalgia and I suspect, with PCOS. Working harder just makes you more tired and more sore. That's why I wanted to emphasize the T-Tapp portion of what I did. I think it was the key, really. Also - I wanted to be sure and say that sleep is important. So often we feel lazy or "ungodly" even if we sleep more than other people. You know, that's just not true. There's no virtue in making yourself more ill by not getting the sleep and rest you need.

    Keer - I was also thinking that I'm amazed that you have a doctor that would even think to look for Hashimoto's in your ten year old! I've thought that a couple of my children have it, and I can't get a doctor to even run tests on them for it. Basically, the consensus is (wrongly) that kids don't have thyroid troubles (unless they present with an obvious mass or unless they are horribly, horribly sick.)

    Around here, endos are scarce. My Dad has a good one - but she is only in one day a week, for half a day! Her wait time is 6 months out (that's what my regular doctor tells me, anyway) and with pregnancy, if you have to wait six months, why bother??? :)

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  8. You know the sleep issue does make me feel lazy. But, if I don't get a nap each afternoon I just don't function. I need the sleep. I can't explain it. Which is so weird as I functioned on 6 hours of sleep most of my life.

    Tracy

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  9. You are likely one of the least lazy people I know, Tracy. :) You're awesome, girl. Take that nap if it helps you function!!!!

    I was a high-driven individual in h.s./college and sometimes I think that I pushed myself into auto-immunity. I don't know if that is possible, but I wonder. ???

    Also, funny, since I just said that doctors don't test kids for thyroid much around here....but I had a child in to the dr. today and the doctor suggested running a thyroid test. I don't even know what to say about that, other than that I was wrong. :)

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  10. Oh LOL Holly about the child/thyroid thing!

    It came about because she had some pretty severe weight gain in between well child checks, and the PA doing the exam was diagnosed with Hashi's at age 14, so she's aware of it. Interestingly, my dd's antibodies came back elevated, so she does for sure have it, but her free T4 and TSH were peachy keen. I AM wondering about her free T3 though - perhaps she isn't converting T4 to T3 very well???? But as of right now her actual labwork is OK. Her dr. tried treating just her symptoms with some Synthroid, but that made her free T4 go above normal, her TSH bottom out (it was less than .01 LOL!), and she was getting daily headaches. So now she's on nothing. (I do have to say that he started her out on a high dose of Synthroid - she was taking 125 mcg, and my dose is only 50, with 10 mcg of Cytomel. So I'd love to find a good pediatric endo for her.)

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  11. Holly,
    thanks for sharing all of this.....it is really motivatin to read. If you can do all that, by listening to your body and caring for it as you are, then that is an encouragment for us to do the same. It may not all look the same, but caring for our bodies is a universal need....esp. as we are getting older. I am noticing huge changes in my body all of the sudden (will be 39 this year). I see more clearly how much I NEED better eating and exercise. Thanks for the kick in the pants:o)
    Andrea

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  12. WOW - i'm surprised you are not on meds and have Hashimoto's. I have Hashimoto's and my doctor told me the minute i stop taking meds i will become lazy, depressed, lose EVEN more hair, etc. Pretty much how i'm feeling now, even though i take the meds. I'm glad to know that your pregnancy went well and that you were even more energetic, and feeling great during pregnancy. I hope and wish the same for myself, that is, if i ever get pregnant. I'm glad you decided to post your story and pictures. They are adorable!!! thank you for sharing!

    ANAPositive

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  13. Thanks so much for the post. My thyroid levels keep going lower and lower over the last few years - I am due to have our 5th baby in 6 years - so no fertility problems here either! This pregnancy though my "levels" were out of range low - finally folks did not think i was crazy for saying something was wrong with my thyroid! I have gained 60 pounds over the last few years - eating a raw vegan diet for a large part of it - juice fasting - nothing worked! Now they want my on thyroid medication, but I am determined not to be on anything for life like that. I am using essential oils over my throid area, changed my diet to include meat and cooked veggies, and am looking into adding t-tapp also. I have worked out with 3 personal trainers over the last few years and ALL of them told me to go have my thyroid checked - they just could not see how I could work out so hard and eat so well and not lose weight or inches. I have worked out with a trainer this entire pregancy - since I am not seeing her in this last month, I am thinking I will do t-tapp at home. We added on to our house recently and my hubby added a workout room for me - it is finished and I really enjoy being in there.
    Thanks again for your post - I think it made my decision for me (purchasing t-tapp)

    Beverly

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  14. Just found your blog! Really enjoyed reading it.
    I also have a blog you might be interested in about my journey with Hashimoto's disease.

    http://hopeforhashimotosdisease.blogspot.com/

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  15. I believe I have Hashimoto's too but I am not sure who to see go get a correct treatment. I don't think thyroid meds are the way to go.I would love to hear more about your journey, especially if you are from Indiana.

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  16. Desiccated porcine thyroid capsules have no side effects and basing on my blood test, it seems to be working well.

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  17. Just found your blog when I was searching "pregnant with Hashimoto's." I was diagnosed with Hashimoto's in February, and my antibody levels are off the charts. I do take 75 mcg of Synthroid, and I am trying to treat the antibody levels with a daily selenium supplement. My husband and I did have fertility problems because of the Hashi's. We just found out that we are pregnant after 14 months of trying and one round of Clomid. I noticed that your doctor saw you every 2 weeks during your pregnancy - how awesome! My OB doesn't want me to come in until I'm 11 weeks!! She didn't even want blood work done. I will say that my regular doctor (who has been treating my Hashi's) has instructed me to come every 6 weeks to check my TSH. Do you think I should be concerned about not being seen by my OB? I'm worried about miscarriage since my antibodies are so high. (My OB told me to take a baby aspirin each day as well.) Any thoughts would be appreciated!

    -Erica

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  18. This was exactly what I needed.I am 35 years old. I was diagnosed with Hashi's 14 months ago and have done a phenomenal job caring for myself. I have lost 12 pounds but cutting out sugar, flour, and processed foods. I know it sounds harsh but how does a rib-eye steak with veggies for dinner sound? Delicious! I take about 11 natural supplements a day and usually work 50-60 hours a week. I do not take any meds. I was running(slow jogging)about three times a week, until recently.

    I am hoping to concieve soon and of course am worried/ concerned about the pregnancy and the baby's wellbeing.

    I recently experienced what I believe is a thyroid storm. It was frightening. I did not go to a hospital or see a doctor. It passed within ten minutes but left me extremely exhausted.

    I have a Dr appt coming up. My doctor is great. She practices intergrated medicine so I get the best of both worlds.

    I guess what I'm looking to learn about is: Are natural delivieries at home possible and is it possible to have a minimally invasive pregnancy with a midwife, even with my Hashi's?

    I'm a little freaked out. I don't know what my next step should be. Any POSITIVE advice is welcome.

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  19. Hi Maria - (and everyone else, I am sorry that I missed your posts way down here...)

    Are naturally pregnancies at home possible with Hashimotos? Oh, yes! No reason why not, really. I needed extra management not due to the Hashis but due to an isoimmunization (anti E, anti c) that i have.

    I think you will be fine! I'm not just saying that, either. :) Sounds like you have a good doctor, so that is a big bonus right there. Feel free to ask any other questions.

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  20. I appreciate the blog. I have Hashi's and didn't find out until I went through 2 miscarriages and my doc decided to test my thyroid. Once I was put on Synthroid, I had a successful pregnancy and I now have a healthy 15 month old boy.
    I really hate taking meds, though. But, I haven't "perfected" my routine as far as natural alternatives yet to feel safe going off them- especially b/c we'll be trying to conceive again soon.
    Did you breast feed consistently even throughout pregnancies? My son still breast feeds and I am considering keeping it that way if I become pregnant. I've wondered, though, if it whacks out hormones more, or if you're cheating the unborn baby of any nutrients as those w/ Hashi's tend to not readily absorb certain nutrients as well (iron, b-vitamins).
    Do you eat a gluten-free diet? I've heard several times that gluten wreaks havoc on the thyroid of those w/ Hashimoto's specifically, so I've been GF now for about a month and I do have more energy now. Helps me not eat too many carbs (like croissants) as well ;)

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  21. I just found your blog today and am excited to start reading. I am a HS mom of 3 and was diagnosed w/Hashi's a few months ago. I look back now and see the roller coaster ride I've been on (esp postpartum) is a result of my thyroid. I blamed myself for years about it being a spiritual problem. So sad, but I have learned SO much. I have used homeopathy to get my TSH level back in the range. My T3 and T4 are good so no meds for me. I do not have the typical hypo struggles of weight gain, hair loss, puffiness, etc. I have always been at a normal weight or underweight, I'm guessing from the hyper states. I'm reading that dessicated hormone tends to make the Hashi's worse. Same for iodine. I was hoping for an easy fix, but it doesn't look that way. This is all so confusing b/c of differing opinions as well as how each person is unique. My progesterone is low and I think I must have adrenal issues as well. My antibodies were 134 which I suppose could be worse. Are you gluten-free? I am reading that's very wise to do. Seems very overwhelming to me. We hope to have more children, but I am a little nervous about it. We had three homebirths and would like to do that again and of course breastfeed. Thanks for sharing your journey and giving hope that babies are possible w/Hashi's.

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  22. Hi Cassidy - I have nine kids, so, depending upon spacing between children I have done different things. I did not conceive baby number 9 until I was finished nursing child number 8. She nursed until she was 2 years of age. I reluctantly weaned her - and then within a couple of months was expecting baby number 9. So, no tandem nursing there.

    Honestly, I don't know what "normal" is. I know that sounds crazy, but I've either been breastfeeding or pregnant for 20 years now. I'm pretty sure my body operates more normally when pregnant or breastfeeding. I don't think my systems know how to "act" when I'm not doing one or the other. But I'm not necessarily the best one to ask about this - because I have more pregnancies than normal and I also nurse longer than most mothers do. I'm sorry to not be able to help better with this.

    Also, I don't do gluten-free. I would if I felt badly enough, but since my son's pregnancy and birth (He is now 15 months old, so for two years I've been able to stave off the flare-ups. I can feel when they begin to come on, and I adjust my exercise and sleep, and I can head it off. I must be very sensitive, because I can tell immediately when I'm going into imbalance. My heart flutters a little bit, and I know I'd better change something. I am wondering if things will change when I wean him, however - and at 43 I am not sure if there are any more babies in my future. I'm accepting either way.

    (Hopefully that will answer one of anonymous' questions above, too? :) )

    Also, anonymous? I think there is much hope for future children with Hashis. I think that it sounds like you are doing a good job with managing.

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  23. Hi Holly,

    I stumbled upon your blog because I was searching for Hashimotto's and pregnancy info. I am very happy to have read your post. I really needed to know everything you said. I hope you have not stopped blogging. You have inspired me to try the t-tap program. Hopefully I can update you on how it went. I also do not take medication anymore. However, I still suffer. The endocrinologists in my area are dismissive. I also suffer from a goiter and nodules. I have been trying to figure this out for a long time. I also felt better when I was pregnant than when I was not. Anyway, I just wanted to thank you for posting this.
    Nicole

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