Hyper, Pregnant, and Bad Liver HELP!!

iVillage Member
Registered: 06-06-2003
Hyper, Pregnant, and Bad Liver HELP!!
12
Sun, 11-28-2004 - 3:48pm


I am new to this board and was hoping to get some BTDT words of wisdom.

I was diagnosed Hyperthyroid (Graves) in Sept. DR started me on PTU, 5x/day. In Oct we discovered I was PG (hooray!) and my thyroid was looking good, he lowered my PTU to 3x/day. Last week the DR had labs done and found Thyroid was looking normal along with red & white blood cell counts however liver function is 3x normal. He dropped me to 1 PTU/day and wants to do an Ultrasound on my Gallbladder and Liver. I'm concerned about the limited treatments due to my pregnancy, anyone ever deal with this?

It seems my only options are Iodine Radiation (bad during pregnancy) or Surgery to remove the Thyroid. I'm worried about my Liver and want to get it healthy so I can enjoy my family. Any advice/experiences would be greatly appreciated.

Nadine

Lauren 02/03/04
Baby #2 EDD 06/27/05

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iVillage Member
Registered: 05-27-2003
Mon, 11-29-2004 - 4:37pm

Holy Smokes!

 

iVillage Member
Registered: 11-09-2001
Mon, 11-29-2004 - 10:47pm

Hi and welcome - here are two articles I found for you on the treatment of hyperthyroid while your are pregnant.

"I have Graves' disease, and just found out I'm pregnant. How will my disorder be treated during my pregnancy? Will anything change?

It depends on what medication you're currently taking to control your disease. Two medications are typically used for controlling hyperthyroidism in pregnancy: methimazole (Tapazole) and propylthiouracil (PTU). Usually PTU is the drug of choice, since it's considered safer during pregnancy and causes less risk of crossing the placenta or harming your baby's developing thyroid gland. Some antithyroid drugs are never used during pregnancy, like Tapazole, which can be associated with some birth defects. Radioactive iodine (RAI) treatment is not done during pregnancy, because it can harm the baby's thyroid gland.

You may be one of the lucky women whose Graves' disease actually improves – or even goes into complete remission - during pregnancy. However, the disease returns postpartum, and sometimes worsens.

Generally, if you are pregnant and on PTU, you'll be taking less medication than you need when you're not pregnant. Your healthier provider will need to monitor your pregnancy closely and order frequent tests of your TSH, Free T4 and Free T3, so you'll probably see the doctor more often than pregnant women without your condition"

And here's the other one:

New York Thyroid Center Home

he radioactive form of iodine (I-131) has been used for 40 years to treat hyperthyroidism and thyroid cancer, and in small doses, to test thyroid function. Since iodine is a natural substance your thyroid uses to make thyroid hormone, radioactive iodine (RAI) is collected by your thyroid gland in the same way as non-radioactive iodine. Since the thyroid gland is the only area of the body that uses iodine, RAI does not travel to any other areas of the body, and the RAI that is not taken up by thyroid cells is eliminated from your body, primarily in urine. It is therefore a safe and effective way to test and treat thyroid conditions. Extensive studies have shown that patients who have been treated with radioactive iodine are not an increased incidence of thyroid cancer or any other type of cancer. Children and young adults who have undergone this form of treatment, have also been carefully studied, and there do not appear to be any increased cancer risks.

It is important to note, that pregnant or breast feeding woman should never receive RAI for any reason because it may destroy the developing fetus' thyroid. You should wait 6 to 12 months before attempting to get pregnant. If you plan to have a baby, you should discuss your situation with your doctor. Although RAI can pose a risk to your baby's thyroid, radioactive iodine itself does not cause infertility or other birth defects. (See section on pregnancy and fertility)

And the whole article is here: http://cpmcnet.columbia.edu/dept/thyroid/RAI.html

Me again - why can't you continue on the meds throughout the pregnancy? They are not known to cause any damage to the baby and it is the usual course of action for one year when treating hyperthyroidism. Why does your doctor want to operate on your thyroid? And how it is related to your liver - do you know? Sorry for all the questions but it helps to know what your facing so I can look up articles and research for you Cathy :)

iVillage Member
Registered: 06-06-2003
Tue, 11-30-2004 - 10:42am

Thanks for your great information, Emily. I am being treated for Thyroid by an Endocrinologist and he is working together with my OB, who stated she will do extra ultrasounds throughout the pregnancy to be sure the baby isn't developing a goiter.

I also thought it was pregnancy-induced thyroiditis but I went through the whole 2-day scan thing and he said, "No, it's Graves". So....I am doing as my research as I can to see what I can do.

I have a feeling I'm going to have to ride this out on my minimal PTU until the pregnancy is over in June and then have the IR treatment.

Thanks again,
Nadine

iVillage Member
Registered: 06-06-2003
Tue, 11-30-2004 - 10:48am

Those are great articles, Cathy. Thank you.

My Endo said that one of the side effects of PTU is the development of liver problems. With the liver function jumping to 3x its normal function in the last month, that is why he has concern and greatly reduced my dosage.

I was worried that he would want to do surgery to remove the thyroid but we haven't met to discuss this yet. I am scheduled for an abdominal ultrasound next week to look at the gallbladder and liver. I'm hoping he'll just ride me out on this minimal PTU dosage until I'm due in June and then possible RAI treatment.

Hearing the whole "liver function greatly abnormal" really scared me. I'm just going to keep researching and doing what I can to educate myself. Thanks again for your help, I'm SO glad I found this board.

Nadine

iVillage Member
Registered: 05-27-2003
Tue, 11-30-2004 - 12:52pm

Nadine, I may be way out of line here and if I am, just say so.

 

iVillage Member
Registered: 11-09-2001
Tue, 11-30-2004 - 4:04pm
Hi Emily - I didn't have a chance to looks at your articles yet but PTU is fine during pregnancy. It's one of the medications of choice since thre are no side effects for the baby. Good to see you again!! Cathy ;)
iVillage Member
Registered: 05-27-2003
Tue, 11-30-2004 - 5:52pm

Oh, I know it is the drug of choice during pregnancy.

 

iVillage Member
Registered: 06-06-2003
Wed, 12-01-2004 - 11:51am

I think you're both right. My Endo explained that he has treated hundreds of pregnant women with PTU and there hasn't been any problems but that doesn't mean there won't be. I could be his first. I think that is why he is trying to work so closely with my OB to keep an eye on everything.

That whole Category D thing made me nervous, too. However everything I've found on the internet shows it to be the treatment choice for pregnant women.

Thanks for your hard work in getting those articles for me to go over. I've calmed down since this weekend :) and am eager for my ultrasound next week to see what is going on and what is the next step I need to take. I'll be sure to update this post.

Thank you, both.

Nadine

iVillage Member
Registered: 05-27-2003
Wed, 12-01-2004 - 12:27pm
Your Endo is right.

 

iVillage Member
Registered: 10-22-2004
Wed, 12-01-2004 - 1:27pm

Since I am familiar with liver problems, I thought I would jump in with my 2 cents.

When you say your liver function was 3x normal, what were they testing - liver enzymes or ferritin level? These both indicate problems with the liver and can be caused by a variety of things. The most common is an infection. Another cause can be a drug interaction.

Another cause that most doctors don't look for in women (and should) is hemochromatosis. This is a genetic disorder that causes the body to store too much iron. A lot of women don't develop any symptoms until menopause or during pregnancy. If your doctor hasn't already done so, get a full blood workup including ferritin.

And, get a copy of all lab results for your own records. I can't stress how important this is. My husband had an extremely high ferritin level (over 10x normal). That went by 3 doctors (including a liver specialist) without one of them commenting on it. If we would have had copies of those records at the beginning, my husband would have been diagnosed 18 months earlier and might not have the endocrine and liver damage that he has to live with.

Chris

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