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I was very anxious about the prospect of a pregnancy with my thyroid conditions, and in particular, in regards to whether me not being on Levothyroxine (like most people with hypothyroidism) would make it a more stressful experience. I wanted to blog about my experiences of going through pregnancy on NDT to give an insight in to how this medication worked for me during this time, but also as to how medical professionals reacted to it.
I’m in the UK and besides my NDT thyroid medication being prescribed by a private doctor, all other healthcare was on the NHS unless otherwise stated.
The second trimester is commonly said to be between weeks thirteen and twenty-eight, so this is what this blog will be covering!
Second Trimester Appointments
I had my first NHS scan at thirteen weeks, which showed that everything was developing normally. I had a same day appointment with an obstetrician, which my GP had referred me to due to being on unconventional thyroid medication.
However, she had no cause for concern and didn’t see hypothyroidism, Hashimoto’s or NDT as a specific risk factor in the pregnancy, but did want to monitor me closely to make sure the private GP was dosing the NDT correctly.
By this time in my pregnancy, I had a visible bump.
I also developed itchy hands and a rash – dermatitis – at thirteen weeks, which was triggered by my hands beginning to swell ever so slightly, making my wedding and engagement ring tighter. A blood test came back with mildly elevated AST and ALT levels, so a same day appointment with the GP was made by my midwife, but they weren’t concerned. My AST and ALT levels were checked every six to eight weeks throughout pregnancy from this point and they dropped back in to normal range, so it appeared to be a bit of a blip. Whenever I tried to put my wedding ring back on, the rash came back! So I abandoned the idea eventually…
At fourteen weeks, I had a thyroid panel blood test, which was being tested every four weeks, and my results were still very good. I still did not require an increase in medication. (My TSH was suppressed, Free T4 midrange and Free T3 at the top of the range.) In my blog about my first trimester, I speak about how my doctor immediately increased my NDT dosage when we found out I was pregnant, by half a grain (30mg) which sent me very overmedicated (Free T3 and T4 over range). Increasing meds immediately is what’s usually done but as with everything, we’re all individuals and there is no one-size-fits-all. I went back to my previous dose which took my levels back to optimal and felt much better.
Something worth keeping in mind is that HCG, the pregnancy hormone, stimulates the thyroid, often leading to a lower TSH compared to before pregnancy. This is why test ranges change for pregnant women.
At sixteen weeks, we heard baby’s heartbeat for the first time at a midwife appointment and all was developing well.
At eighteen weeks, the full thyroid panel was tested again and results were still the same as previously, showing no NDT dosage needed still. We were all quite surprised by this but assumed that the dosage increase would be any time now. With Levothyroxine, it’s standard that the dose is increased as soon as a woman falls pregnant, but managing NDT medications during pregnancy can be very different.
The anatomy scan was performed at nineteen weeks, where everything looked perfect and baby was even measuring a little ahead of his due date. Yes, we also found out it was a boy!
The obstetrician saw me again at this appointment and had nothing else to add. Happy with the private GP handling my thyroid stuff, she discharged me, recommending that the NHS GP still keep testing my thyroid levels every six weeks throughout pregnancy, as opposed to the usual NHS practise of testing once more around 20 weeks and 30 weeks. I also had my flu and whooping cough jabs, with no issues to report.
By twenty-three weeks, I was a little concerned about some heart palpitations I was experiencing occasionally, so after some more thyroid panel checking and an ECG, a referral to a cardiologist was made, but he didn’t believe it to be of any concern and put it down to a somewhat common pregnancy symptom. They think it was due to the extra blood volume and pressure on the body whilst pregnant.
I did however cut out all forms of caffeine and watched my sugar intake closely, whilst making sure I exercised often (and gently) which seemed to help reduce them. The thyroid panel again, came back the same as five weeks prior. My iron was slightly low, so I was advised to eat more red meat and take a supplement.
The midwife check-up at twenty-five weeks reassured us that everything was going smoothly, with no real concerns from anyone. Baby was still measuring slightly big and we heard his heartbeat again. I had a couple of thyroid flare up days towards the end of my second trimester, but they were very brief.
How My Health Was in The Second Trimester
Acne, itchy skin, acid reflux, lots of sneezing and constipation all featured! At the start of the second trimester, my energy came back (compared to the first trimester) and I felt as good as I did before I was pregnant. I was feeling really well.
I was still having period-like cramping.
I unfortunately started to experience a lot of trapped wind/gas, but found that yoga poses I was learning at my antenatal yoga classes helped a lot. I started to feel quite congested at night and in the morning, too. I felt baby move for the first time this week!
Week 15 brought with it another migraine and I also caught a cold. I released my second book You, Me and Hypothyroidism, as well as the thyroid patient course Freedom From Thyroid Fatigue this week, so I was probably just a bit worn down. I was feeling more tired again.
Needing to urinate frequently began this week. The joy!
An itchy scalp drove me mad, as did acid reflux and another migraine (the last for the duration of the pregnancy). Mood swings started to occur and I wanted to be alone quite often as a result. I couldn’t place my finger on why I felt this way though, so put it down to pregnancy hormones.
I decided to stop my salsa dance lessons this week and switch to more walking, yoga and swimming instead.
An itchiness all over my body was keeping me awake all night, but I didn’t have a rash or hives. A very common pregnancy symptom due to stretching skin and extra hormones, it did eventually calm down but it was making me lose the plot!
Feeling baby move a lot more was making up for it though.
I noticed that my eyebrows were thinning a bit at this point and the acid reflux was still in full force. My skin was looking very clear, but my feet were feeling tired more quickly than usual. The bump really came on in size. We took a short holiday to Spain which really helped me to unwind and find more time to just appreciate this pregnancy.
At 21 Weeks, we made the decision to announce my pregnancy to The Invisible Hypothyroidism followers, posting a blog and post on social media.
22 weeks brought with it an ear infection, due to a blockage, but this quickly cleared up with antibiotic drops. Unfortunately, I am very much prone to ear infections and get a few of them every year.
I also started to experience leg cramps at night, but my pregnancy pillow came in very handy and helped to stop them quite early on! Epsom salts also helped. I was starting to feel more tired and overall achey again as I got to the end of the second trimester.
Sciatica began, in my lower back, hips and legs, which would come and go depending on how much I was overexerting myself and resting. Hot water bottles, yoga and my pregnancy pillow all helped a tonne.
The indigestion from the first trimester came back from this point. I was feeling bloated and full easily, with acid reflux.
The acne was coming back! I was also struggling to sleep for various reasons in the last few weeks of the second trimester, but my energy levels weren’t too bad considering.
You can click on the hyperlinks in the above post to learn more and see references to information given.
Books I found useful in my pregnancy:
- Your Healthy Pregnancy with Thyroid Disease
- The Thyroid Hormone Breakthrough
- The Positive Birth Book
- The Pregnancy Encyclopedia
- What to Expect When You’re Expecting
- Healing Your Body Naturally After Childbirth
- The Positive Breastfeeding Book: Everything you need to feed your baby with confidence
- Mindful Hypnobirthing: Hypnosis and Mindfulness Techniques for a Calm and Confident Birth
Rachel Hill is the highly ranked and multi-award winning thyroid patient advocate, writer, speaker and author behind The Invisible Hypothyroidism. Her thyroid advocacy work includes writing articles, authoring books, producing her Thyroid Family email newsletters and speaking on podcasts, as well as being a founding board member for the American College of Thyroidology. She is well-recognised as a crucial and influential contributor to the thyroid community and has a large social media presence. Her books include “Be Your Own Thyroid Advocate” and “You, Me and Hypothyroidism”.