Monday, 27 March 2017

Being Butterfly-Free and a Mama-to-Be

As you may have gleaned from previous posts, I have a small human growing in my (as yet only slightly expanding) belly. The little human is currently at 22 weeks of gestation, weighing in at a healthy 390grams and with all measurements as expected. And, judging from the most recent 4D scan images, he is shaping up to be quite the mini-me of his father (yaay!)

If I'm being very honest, I didn't expect to get pregnant quite as quickly as I did, given my previous (misdiagnosis) of polycystic ovaries, coupled with my thyroid condition. I wasn't necessarily worried that I might struggle with fertility - in fact, that precise thought had never crossed my mind - however, I just assumed it wouldn't happen immediately. But it did! And for that we are extremely thankful and blessed.

When the OB-GYN confirmed my pregnancy at 6 weeks and 5 days, she immediately ordered a full panel of thyroid blood tests; something which is NOT standard procedure for all expectant mothers, but further to my research on the topic, I truly believe should be.

My partial right thyroid lobe, which had been magnificently maintaining my TSH at a steady 1.8 prior to pregnancy, had instantly shot up to 4.6 since getting pregnant. This (along with the standard first trimester tiredness) explained why I had been struggling to get out of bed most mornings in recent weeks; something my husband had kindly encouraged me to indulge in since I had just become free of the pressures of a full time job.

It is entirely normal for TSH levels to increase in pregnant women, particularly in those who have a pre-existing thyroid condition, but also in those who don't (or are unaware that they do). Pregnancy typically requires an additional 25-30% of thyroid hormone, and for those who are struggling to produce or regulate a normal amount by themselves, it will become even harder during pregnancy. As I have found out, it is absolutely crucial for the healthy development of the foetus for the mother to keep her TSH level below 2.5 during the first trimester of pregnancy, followed by keeping it under 3 for the remaining trimesters and breastfeeding postpartum. This is why I find it astonishing that a TSH check is not mandatory for all newly-expectant mothers.

Acting swiftly to counter my rapidly rising TSH, my doctor immediately prescribed me a 25mg daily dosage of Euthyrox. It's a very low dosage, but considering my partial thyroid's remarkable strength to return to regulating itself after my surgery, she was confident that it would be enough. And she was right. My TSH soon dropped to 2.4 - within healthy range for pregnancy. She is also hopeful that, with close monitoring, I will be able to be weaned off the thyroid medication after giving birth and go back to living a tablet-free life again. So, going onto Euthyrox/thyroxine/levothyroxine is not always an irreversible lifelong decision.

The correct supplements can make a world of difference

During the first trimester the foetus relies entirely on the mother's thyroid function, hence why the recommended TSH level is lower during those formative first three months as the T4 crosses the placenta. By the second and third trimester the developing foetus has its own thyroid, which begins to function and regulate by itself, but it is still important for the mother to keep her TSH below 3 and thyroid antibodies as low as possible.

Hypothyroidism can be a root cause of infertility, but is often overlooked as a possible diagnosis in women who are struggling to conceive, whilst during pregnancy (or at the exact time of conception), maternal hypothyroidism can greatly increase the risk of miscarriage, stunted growth, reduced brain development and has even been linked to a heightened chance of autism and Down's Syndrome.

As soon as I found out I was pregnant, I took it upon myself to research the best foods to eat and supplements to take to support the healthy development of my baby, in addition to following my (highly capable) doctor's orders. Once again, Google has been my best friend, and I came across a fantastic online docuseries called The Thyroid Secret by Dr. Isabella Wentz. The 9-part docuseries shed light on many myths and misconceptions related to thyroid function and illnesses, and Episode 7 - 'Motherhood Interrupted' - was particularly fascinating for me.

For some, the role of motherhood begins before even conceiving, as they plan ahead and prepare their bodies for the best chance of fertility. For others, like me, motherhood started as soon as I got that positive test, and with it came the immediate responsibility to take care of my health to my best abilities in order to provide the optimum conditions for my foetus to develop. Sometimes it's daunting, particularly when you know you have a condition that may compromise the health of your baby, but keeping informed of the latest research and following the recommended guidelines is an important first step towards giving your baby the best possible start in life.

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