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This set of blogs cover my second pregnancy. To read the blogs about my first pregnancy, please click here. The biggest difference is that I was on NDT (Armour) alone for my first pregnancy. I am on a combination of Armour and Levothyroxine for my second pregnancy.
Going through a pregnancy with Hashimoto’s and hypothyroidism and being on unconventional medication for this (a combination of Armour NDT and Levothyroxine) definitely presented some extra questions and challenges.
However, with this being my second pregnancy, I was more confident in that I could indeed have a healthy pregnancy and baby at the end of it all. I knew what bumps we may come up against, based on my first pregnancy experience, and was overall less anxious about navigating pregnancy with Hypothyroidism, Hashimoto’s and on privately prescribed Armour and Levothyroxine.
Just like last time, I wanted to blog about my experiences of going through a ‘thyroid pregnancy’ to give an insight in to how my thyroid medication worked for me during this time, but also as to how medical professionals managed me and what the overall experience was like.
Related Article: Were My Thyroid Pregnancies What I Expected?
Note: I am in the UK and besides my thyroid medication being prescribed by a private doctor, all other healthcare mentioned was on the NHS unless otherwise stated.
What is The First Trimester?
The first trimester is commonly said to be between weeks four and thirteen (since you’re already four weeks pregnant by the time you miss your period), so this is the time period this blog will be covering.
Finding Out I Was Pregnant
I actually confirmed my pregnancy about four days before my period was due. Besides trying to conceive and so having an inkling I could be pregnant, I didn’t really have any other signs or symptoms yet.
I made appointments to speak to my private GP and NHS GP as soon as I discovered the pregnancy.
At the time of falling pregnant, I was on 180mg Armour Thyroid and 25mcg Levothyroxine. All thyroid levels (TSH, Free T3, Free T4, Reverse T3, thyroid peroxidase antibodies and thyroglobulin antibodies) were optimal and I was in great health. My Hashimoto’s was also in remission.
First Trimester Appointments
I spoke to the private GP I see for my thyroid meds for the first time during this pregnancy when I was 4 weeks pregnant.
He was very happy for me and had no issues with me carrying on my NDT + Levothyroxine combination during pregnancy at all. He said that as long as I felt well and blood tests taken regularly looked optimal, then we could carry on.
We planned to manage my thyroid meds in the same way we had done with the first pregnancy; testing my TSH, Free T3 and Free T4 every 4-6 weeks and then monitoring these to make adjustments as necessary.
My NHS GP appointment (also at 4 weeks pregnant) went well too. I was still with the same NHS GP as my first pregnancy over two years before, and he remembered it well. He had no concerns this time around and said that unlike last time, he didn’t see a need to refer me to an endocrinologist or obstetrician as he was confident I would be fine again.
The NHS GP agreed with my private GP on needing to test the full thyroid panel every four to six weeks throughout pregnancy and that my private doctor could then use these results too, to save us running more tests than was necessary.
The ranges used on my thyroid tests were the following (as they’re adjusted when you’re pregnant):
(Non-pregnancy range for TSH is usually around 0.5 – 4.4 mu/L)
- 1st Trimester: 0.09 – 2.83 mu/L
- 2nd Trimester: 0.2 – 2.8 mu/L
- 3rd Trimester: 0.31 – 2.9 mu/L
(Non-pregnancy range for Free T4 is usually around 10 -20 pmol/L)
- 1st Trimester: 10.5 – 18.3 pmol/L
- 2nd Trimester: 9.5 – 15. 7 pmol/L
- 3rd Trimester: 8.6 – 13.6 pmol/L
(Non-pregnancy range for Free T3 is usually around 3.5 -6.5 pmol/L)
- 1st Trimester: 3.5 – 6.2 pmol/L
- 2nd Trimester: 3.4 – 5.8 pmol/L
- 3rd Trimester: 3.3 – 5.6 pmol/L
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.
I booked in for my first thyroid blood test and had it taken at 5 weeks pregnant. The results came back with my thyroid levels still optimal so we kept medication dosage the same for now.
The midwife referral was also made for when I was 9 weeks pregnant. I would have my next set of bloods taken at this too.
At 7 weeks pregnant, I had a private ultrasound scan, just to calm my anxiety about a small amount of bleeding I had. Baby was measuring well and the heartbeat was strong, which was a huge relief.
My first midwife appointment went well; she didn’t bat an eye at my thyroid medication. I had my blood drawn again at 9 weeks pregnant, and they came back a few days later, with a change. My Free T4 had now dropped to the bottom of the range although my Free T3 had barely moved. Both the NHS and private GP’s agreed that an increase in Levothyroxine was needed. I went from 180mg Armour + 25mcg Levothyroxine to 180mg Armour + 50mcg Levothyroxine.
Within a few weeks I was feeling much better.
My first NHS ultrasound scan was performed at 12 weeks which showed that everything was going well and baby was developing perfectly.
See related post: Are Pregnant Women With Thyroid Problems Considered High Risk?
How My Health Was in The First Trimester
Weeks 4 – 5
I felt achey and tired, with a ‘heavy feeling body’ some days and overall very fatigued. I had no appetite, very sore breasts and a lot of acne.
I had some light spotting which only lasted for the one day.
I also had cramps similar to period cramps.
Nausea, some vomiting, sore breasts, feeling very hungry often, and very itchy skin all over my body.
I had many days in a row of debilitating migraines.
Craving salads! Still ravenous for much of the day but also feeling very bloated. Not too tired anymore. Very bad acne on my face and my chest and back are really itchy.
Migraines, bloating, nausea. Urgh.
Feeling tired and hazy. I am hungry all the time and struggling to stay asleep at night.
Still feeling tired and nauseous all the time. Horrid migraines but the acne seems less angry so that’s a plus. I’m feeling really slow and stiff.
The itching is calming down but the doctor called to tell me I have a UTI. I’m still nauseous and bloated and having sciatic pain.
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”.