.hyperthyroid.

Firstly, I apologize if this blog post seems overly technical. We’ve gotten a lot of numbers thrown at us in the last 48 hours, so I thought it might be useful to track everything that’s happened in one place for easy reference. Baby G is doing fine, and we’ve been assured that this isn’t cause for alarm, but R is apparently having some problems with her thyroid levels. Back at week seven, when we first started with the midwives, R had a battery of blood work done. We got those test results back at our eight-week appointment and everything looked really normal except for one of her three thyroid numbers, which was very slightly elevated (the normal range for t3 is 80-200 and R’s number was 202). Because the elevated level was negligible, and since the other numbers (t4 and the Thyroid Stimulating Hormone [TSH]) were in the normal range, our midwife simply made a note in the chart to monitor these levels.

On Tuesday, at our twelve-week appointment, our midwife had R go to the lab in order to redraw the thyroid labs. Again, she didn’t seem particularly concerned, and even told us that she expected to see that the t3 had decreased. Everything else from R and Baby G’s exam went swimmingly, and we were told to expect the lab results the following day. Late-afternoon on Wednesday we still hadn’t heard anything about our lab results, so R called in to speak with the nurse. The nurse was able to read-off the results, but she couldn’t give us any real context or action plan, which was frustrating. The t3 number had gone from 202 to 243 (a 41 point increase in 5 weeks). The TSH was also very low (.01 where the normal range is .27 – 4.20). We asked to speak with someone who could interpret what these numbers meant, but the nurse told us that the midwives were gone for the day. So we, being the scared information junkies that we are, got onto the internet to do some “research” of our own. Once again, the internet is a terrible place for any expectant parent to turn for information. It’s like a landmine of nightmare scenarios. We read that these levels were dangerously high, could involve R having to go on medication indefinitely, and/or could mean she had to have surgery on her neck. We read that these numbers signified an increased miscarriage rate, along with an increased risk of preeclampsia and/or early labor. Needless to say, we were panicked.

As it wasn’t even five o’clock yet, I called the clinic’s answering service and asked them to patch me through to the on-call midwife. I suspected that we weren’t actually in an emergent situation, but I was frustrated that no-one with medical authority could tell us that. The same nurse that R had spoken with earlier called back about 20 minutes later. Our midwife, B, had gone across the hall (our clinic is inside of the hospital) to Maternal Fetal Medicine (the clinic that oversees high risk pregnancies) in order to consult about the lab results. Dr. H (at MFM) recommended that R’s bloodwork be rescreened for Free T3 (a more specific test, which would help us understand how much thyroid hormone was just floating around in R’s body) and to run a beta-HcG (to determine the pregnancy hormone content of R’s blood). B said that they would authorize and run those tests overnight and that the results would be available the next morning. In the meantime, though, the nurse told us not to panic, and to try to relax and enjoy our evening. She also told us that very very few women miscarry once they’ve heard strong fetal heart tones in the twelfth week, so the pregnancy was not in danger. This was reassuring for us, and we were able to have a normal evening.

Cut to this morning, when the second batch of lab work came back in. We called the clinic nurse around 11am. R’s Free T3 test came back still elevated, but not as dramatically elevated as the Total T3 test was, which is a good thing, though it doesn’t put us out of the woods yet. R’s beta-HcG is extremely elevated (at 136,000), which is still in the normal range for twelve weeks. The elevated HcG could be causing the elevated thyroid numbers, in which case the thyroid levels should drop as the HcG levels begin to drop throughout the second trimester. It’s also possible that the progesterone cream that R was on for ten weeks may have increased the thyroid levels, as well. Many women who have hypothyroidism (abnormally low thyroid levels) use natural progesterone cream in order to boost their thyroid production. So in my humble (not at all a medical professional) opinion, it seems that maybe the progesterone cream in conjunction with the high HcG production may have overly stimulated R’s thyroid in the first trimester.

Regardless of the cause, our midwives have referred us to Maternal Fetal Medicine for an initial consult. They should be calling us today or tomorrow in order to schedule an appointment for sometime next week. This consult is a little scary because there’s a chance that Dr. H could decide to classify us as high-risk (in which case we wouldn’t be able to continue with our midwives; we’d have to be under an OB Dr.’s care). The odds of this happening are small, though, and more than likely they will simply monitor the thyroid issue and make follow-up recommendations for our midwives to carry out. This is, obviously, what we’re hoping for. In the meantime, we’re trying not to stress out (and definitely not looking anything up on the internet). We’ll keep you posted as we find out more information.

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