Disclaimer: I am not a medical professional. (Professional medical patient, maybe.) This is about my own personal experience (now at 23 weeks) dealing with hypothyroidism and pregnancy.
Background: Once upon a time, my body was basically broken from fibromyalgia. After hitting rock bottom in early 2007, I spent tens of thousands of dollars on finding a good doctor. I found a doctor who changed my life. The biggest issue in my battle to get healthy was my thyroid. It took a lot of trial and error, but a big issue was the way that my body processes medicines with T4. (It converts to reverse T3, which then screws with my T3 levels and makes the situation even worse.) Once I started on T3 on its own, everything changed. I felt better. I lost weight. I have maintained this with no major issues for the past couple of years. Then I got pregnant…
At the start of the pregnancy, I had a very detailed discussion with the OB’s office about my thyroid. A discussion during which they seemed to be paying attention. Because I was so violently ill, I tested as hyper. They explained that was very normal when vomiting that much and that they would monitor later in the pregnancy and tweak my meds if needed.
Off to the perinatalogist at the beginning of this month. His only concern was to track growth because my thyroid could play an issue. Okay.
[You know the word cretin? The OB told me that it has to do with hypothyroidism in mothers and babies not developing correctly. It's not just a mean name that my brother used for me as a child.]
Next OB appointment, they take blood to test thyroid. A couple of days later, the medical assistant calls. My TSH is fine, but my T4 is low, so they are going to call in a Rx for Synthroid.
I politely decline the Synthroid, briefly explain past experiences and ask where the levels tested because my T4 has been an ongoing problem. Get a callback after she talks to the dr. They’re going to call in Synthroid.
I decline the Synthroid again (less politely) and ask if anyone has read my history with T4 and the serious concerns that I have with how my body shut down last time. Get a callback after she talks to the dr. They are breaking up with me because I’m just too hard to treat with this. They are still my OB, but not for thyroid and I can go back to my primary.
Schedule an appointment with primary. Have a lovely visit and she knows my history and is currently treating my thyroid. She says, “look, there are a lot of things that we can do, but I’m not a prenatal specialist, so I don’t really want to mess with that if there is another doc that can potentially treat you.” She recommends that I go back to the perinatalogist.
Perinatalogist. Day before visit. Reminder call. Then another call.
Hey, we’re not sure why you are coming in again since you have an appointment in October to follow up and your OB’s office didn’t see why you were coming in.
[Big giant exasperated sigh.] They don’t read anything or, apparently, document stuff, so I’m not surprised. Give her a brief synopsis of what’s going on and why I am coming in. She is exasperated on my behalf at dealing with them and agrees that I can come in .
Perinatalogist today. Ultrasound looks great. He is big. Long legs and long arms. All organs are doing what they need to do.
Perinatalogist says that my T4 isn’t that low and TSH is great. He is fine not putting me on T4. He’s going to increase my T3 a little and if I feel like I’m having a heart attack, we will monitor the growth more and I can stay at the current dose.
I won. No Synthroid. No meds that may potentially make me really sick. I can feel comfortable knowing that I won’t have to deal with that potential thyroid crash, which would be way more dangerous for the baby.
For other women, synthroid may be a great choice. It’s not for me. I’m glad that I have had great doctors in the past and that I was able to advocate for myself.