Monday, September 21, 2015

Thyroid in Pregnancy


So on Friday, I mentioned that our final shot for figuring out what happened to Abigail was with the results of 4 vials of blood they drew.  Results that we expected to be completely unspectacular, and completely unhelpful.  The only reason that my doctor even did the autoimmune blood tests, was because I was once diagnosed with hypothyroidism.  Hypothyroidism is where you thyroid is underactive, and doesn't perform as it should.  It is mostly monitored by checking your thyroid stimulating hormone (TSH) levels.

The first of the test came back Friday afternoon.  First the TSH results were 1.75, well within normal range (higher than ever for me).  Next were the Thyroid antibodies.  They were high, incredibly high.  The nurse at the office couldn't tell me anything right away, and the doctor wanted to wait for the rest of the blood work before giving her opinion, but today they confirmed what I have read.  She will be referring me over to an endocrinologist if they have one in the system that accepts our insurance.  So, I did what you should never do.  I started searching the internet.  I quickly discovered that you can have thyroid problems even though you TSH levels appear normal, and that high thyroid antibodies can actually increase your risk of miscarriage 290% (follow the link for the article with the study).   Now I had never even heard of thyroid antibodies, but typically above average levels indicate that your immune system is systematically destroying your thyroid.  I also discovered that while the normal range for TSH is .27 to 4.2 that in the first trimester of pregnancy for women who have had hypothyroidism (that would be me) it shouldn't be higher than 2.5, and now looking back through the records at my initial appointment my TSH was at a 3.01.  In yet another study I read that high antibody levels can cause fetal tachycardia or thyroid problems in the baby.  A normal fetal heartbeat is 120 to 160, fetal tachycardia is 170 to 220.  A baby's heart rate is it's highest at 9-10 weeks, and it can get as high as 170 then.  That of course had me looking up Abigail's recorded heart rates.  Due to the new computer system there weren't any except what was saved on the ultrasound that we did at 9 weeks, 5 days.  Her heart rate was 181.  It is possible then that my dysfunctional thyroid caused my child to basically have a heart attack.  My body killed my baby.

On one hand this news is absolutely maddening.  I mean we KNEW I had hypothyroid issues in the past, and the midwife even told me it would need to be monitored.  But we weren't testing everything that needed to be tested and we weren't even measuring it on the right scale.  This could have been prevented.  My aunt and a Church member back in Indiana, suggested I find an actual thyroid specialist and not leave it up to the regular doctors.  I should have pursued that.  I feel STUPID for thinking oh it's back to "normal," no problem here.  I should have done more personal study, it's my health, my responsibility not just whatever-doctor-in-whatever-state-we-happen-to-be-in-at-the-moment's responsibility.  I mean do health problems ever just miraculously disappear?  On the other hand while this knowledge is now worthless for Abigail, it's good to know for the next pregnancy. Because next time, levothyroxine can be given which brings the rate of miscarriage back down to the same level as those without thyroid problems.  Also I need to have higher levels of iodine than usual in pregnancy, which might explain the salt cravings I was having.

As for me, that means I need to have more follow up work done with an endocrinologist, because high thyroid antibodies increases my risk of having masked hypothyroidism, most likely Hashimoto's Disease, or a slight possibility of thyroid cancer.  To be quite honest though, I could care less right now about what this means for me, because all it means to me is that my baby unnecessarily died.

The bracelet I made for Abigail.   I have it and my necklace on now, and feel much better.

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