In Support of Mandatory Thyroid Testing in Pregnancy

As we are nearing the first birthday of my son, I have spent some time in reflection on the journey that we have undergone over the last few years to get to this place.

Unknowingly, the beginning of my thyroid journey started with the back to back losses of two pregnancies. Every time I became pregnant, I literally gained 8-10 pounds in a matter of a week. After each miscarriage, I would lose a few of the pounds, but had a difficult time losing the rest despite my extremely active lifestyle and good diet. I went in to my general practitioner to specifically have my thyroid checked and it came back “in range”.

After the second miscarriage and my OB telling me it was just “bad luck”, I switched to an infertility clinic in an effort to prevent miscarriage number 3. I wasn’t sure my heart could handle another disappointment. The specialty clinic performed several tests including a check of my TSH levels. The numbers came back at 2.94, which I now know are not optimal for a succesful pregnancy, but at the time she said they were “in range” so I listened. My antibodies were never checked despite my family history of thyroid disease.

When we conceived what would (luckily) become our son, I was asked to come in immediately upon testing positive for pregnancy. More blood was drawn, and my progesterone levels came back dangerously low. I was supplemented immediately, and offered a regimen of baby aspirin and prednisone. Prednisone is a steroid and is classified as a Category C drug. My OB stated there was a theory that when taken in the first trimester, the prednisone could prevent a woman’s body from attacking the baby. There was no evidence that this was what was happening to me, but I decided it was worth a try as I had little confidence in my body’s ability to support a pregnancy. The risks of taking prednisone weighed heavily on me; low birth weight, premature delivery and cleft palate. However, I was desperate for something to work.

And work it did. Or maybe it was my pleading prayers to God. Perhaps a bit of both. My son was born just shy of 40 weeks gestation at 8 pounds 2 ounces and has perfect lips! However, any informed individual living with a thyroid disease could read the above 3 paragraphs and pick out immediately the warning signs that I was suffering from an undiagnosed thyroid disease. Rapid weight gain, miscarriages, low progesterone, strong family history, and although my TSH was “in range”, the American Thyroid Association recommends TSH levels in the first trimester be between .1-2.5. With a TSH at almost 3, I was suffering from overt hypothyroidism during my pregnancy and went untreated.

As mentioned in earlier posts, I wasn’t diagnosed until after my son was born…when my thyroid went completely haywire (thyroid storm) and the symptoms had me feeling like I belonged in the hospital or a mental institute! I can’t say I’m upset at the trajectory of my story, but more disappointed in the knowledge that this is likely happening to many more women. I’m a firm believer that things happen for a reason. If I had doctors that were more diligent and informed I wouldn’t have the son I have today. I also believe that God doesn’t allow anything so bad to happen to prevent any good from coming from it.

I wish for a day where early screening is mandatory as it is just a simple blood test. Currently this is a controversial subject as the experts are mixed about the cost effectiveness of screening all pregnant women. Meanwhile there is evidence that women with even mild thyroid dysfunction have double the risk of miscarriage and seven times greater risk of stillbirth.

This has become my new mission. I hope that through advocacy and spreading knowledge that someone gets their happily ever after before having to learn the hard way. So now, while other women are passing on tips to deal with morning sickness, I’m advocating for them to get their thyroid checked.

Me and my lil love 🙂

nolan and mom

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