Read The Second Trimester: My Pregnancy on Armour and Levothyroxine blog here.
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 which 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’, in order 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.
The third trimester is commonly said to be anytime from week twenty-eight onwards.
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Third Trimester Appointments
The bloods I had taken at 27 weeks came back when I was 28 weeks pregnant and showed that my thyroid levels were still optimal, with my FT4 midrange and FT3 in the top quarter of the range. Both the NHS GP and Private GP were happy with this. I also felt well, i.e. no thyroid symptoms at this point.
A thyroid blood test was repeated at 32 weeks pregnant, which also came back with levels optimal still and having not moved. I was still having my thyroid panel checked every month throughout pregnancy.
The ranges used on my thyroid tests were the following (as they’re adjusted when you’re pregnant):
TSH:
(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
Free T4:
(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
Free T3:
(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. Since I am on a T3-containing thyroid medication (Armour), my TSH was suppressed for both pregnancies.
Midwife appointments were happening every 2-3 weeks at this point and going well. No concerns were had and the midwife was happy with everything. Baby was incredibly active and already head down by 30 weeks.
I didn’t experience any thyroid flare days during the third trimester but did feel overall more tired.
Due to the non-thyroid related complications that labelled me as higher risk for this pregnancy (explained here), I had extra ultrasound scans at 28 weeks, 32 weeks, 34 weeks and 36 weeks pregnant. Every scan went perfectly well and showed baby growing as expected and with no issues.
I had opted for a birth at a midwife-led unit from the beginning and was on track to have this following my high risk status being withdrawn from the results of the 36 week scan.
See related post: Are Pregnant Women With Thyroid Problems Considered High Risk?
However, at 34 weeks, we experienced a preterm labour scare after I caught a vomiting bug which quickly dehydrated me so much so that it triggered contractions and I was sent to the hospital to be assessed. Midwives and doctors acted quickly and halted the contractions and I stayed at the hospital for three days before being cleared to go home – as long as I agreed to “not overdo things”.
At 36 weeks, the consultant discharged me and put me back to being midwife led and no longer ‘high risk‘, based on the growth scans and other tests and vitals being consistently good. This was fabulous news.
My last thyroid blood test was taken at 37 weeks, receiving the results two days later. My Free T4 had once again fell suddenly below range, with my Free T3 still optimal. My Levothyroxine dose was therefore increased again, making my final thyroid medication combination: 180mg Armour Thyroid + 100mcg Levothyroxine. I had begun the pregnancy on 180mg Armour Thyroid + 25mcg Levothyroxine.
I can’t stress enough how important it is to have thyroid levels checked often in pregnancy. Having mine checked every 4 weeks meant we caught any sudden drops in hormone very quickly.
My midwife appointments at 35 and 37 weeks all went well, with normal blood pressure noted, exams showing baby was head down and ‘engaged’ and a normal fetal heartbeat.
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How My Health Was in The Third Trimester
Week 28
I was experiencing a lot of heartburn and also noticed that I was getting tired quicker when on my feet.
Week 29
Leg cramps! I also noticed I was producing small amounts of colostrum. My belly was aching a lot from the weight of the bump. Headaches also occured this week.
Week 30
I had a sickness bug all week!
Week 31
Braxton hicks made their debut. Mood swings were making me feel quite grumpy at times and I was finding working increasingly more uncomfortable. Acid reflux came back again.
Week 32
My pregnancy/fitness ball helped a lot with reflux, back ache and sciatica.
I started napping quite a bit during the day. Hot flushes appeared and Adam (my husband) and I made the decision to prioritise being at home and resting whenever possible from now on, in order to avoid thyroid flares.
Week 33
I felt uncomfortable in one way or another all the time now and baby was keeping me awake at night with his which didn’t help. I felt tired and achy pretty much all the time, but it was different to ‘thyroid tired’. The bump was feeling so heavy to carry around.
Week 34
My feet and fingers started to swell a little. I was waking up with cramps in my hands which the midwife explained is due to reduced circulation and extremely common late in pregnancy.
I had another sickness bug which lead to a preterm labour scare (explained above).
Week 35
I was just tired constantly, needing to put my feet up a lot and nap whenever I could. It was almost impossible to play on the floor with my two-year-old at this point because I couldn’t get back up!
Baby ‘dropped’ this week.
Week 36
Feeling very tired now. Not sleeping well either. Lots of cramping.
Week 37
Officially classed as ‘full term’, I felt much like the week before. Lots of braxton hicks.
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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
See also:
The book: Thyroid Superhero: A Kid’s Guide To Understanding Their Grown-up’s Hypothyroidism, which helps children to understand their caregiver’s thyroid medication, flare days, symptoms and much more. Add it to their bookshelf today.
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