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Thyroid Diseases

Want to Get Pregnant but Have Hyperthyroid

05/18/2009

Question:

Hi. I have hyperthyroidism for almost a year now and I am 20 years old. My husband and I really want to have a kid, which I know is kind of dangerous while I have hyperthyroidism. I have talked to my doctor about having kids. So right now I am taking PTU, because my doctor told me that it is safer. If I were to get pregnant, can I still take PTU? Is it safer, and will there be any effects on my baby and I?

Another question is I have been trying to have kid for couple of months now but nothing is working. So by having hyper is that the cause of not having any kid right now. Can hyper cause me to have less chance of getting pregnant, and have there been women with hyper that have got pregnant before.

I also have a question about my thyroid level. Just recently my doctor told me that my TSH is normal but my T3 or T4 is not. So what does that mean? Is the meds actually helping me or not. And by having only one level normal but not the other is that going to be dangers or what should I been taking to help level the other one. Right now I am taking PTU is that going to help me. Thank You.

Answer:

You have several related questions that are difficult to answer without your complete medical record.

It appears that your hyperthyroidism might be on the basis of Graves’ disease. In this case, the patient has an autoimmune response (like you usually have against an infection) against their own thyroid gland. This response stimulates the thyroid to release T3 or T4 even though TSH (the hormone that usually stimulates the thyroid) is not elevated. The result is hyperthyroidisms and several other symptoms.

Hyperthyroidism does not usually prevent pregnancy. However, if it is poorly controlled, it can cause significant problems during pregnancy. For this reason, it is not recommended that you try to get pregnant until it is under control. Hyperthyroid can be treated during pregnancy, but this can be more difficult. Hyperthyroid medication can cause the baby to be hypothyroid and even develop a goiter. For this reason, it is much better to have your hyperthyroid treated prior to becoming pregnant.

A common treatment for Graves Disease is to destroy the thyroid with radioactive iodine, and then place the patient is on thyroid hormone replacement. This treatment cannot be done during pregnancy. Prior to attempting to become pregnant, it is important for you to discuss your options with your thyroid doctor and a high risk obstetrician.

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Response by:

William W Hurd, MD William W Hurd, MD
Professor of Reproductive Biology
School of Medicine
Case Western Reserve University