Q: “I’ve had an overactive thyroid for eight months. I’ve just found out that I’m seven weeks pregnant. I visited my specialist who told me that my thyroid has started to go overactive again. I have to keep taking 20mg of carbimazole and
I am now more susceptible to miscarriage. I’ve been quite emotional about this.
I’m 35 and this is my first pregnancy. The only good thing is that at first I was on 50mg but this has decreased over the last seven months. Can you give me any guidelines on pregnancies for people with overactive thyroids and information about their success rate.
I work full time and have an evening job too. At present I don’t feel like doing either. Is this normal? I can’t sleep at night and am having trouble getting up in the mornings.”
A: The first thing to say it that it’s very, very normal to feel tired during the first three or four months of pregnancy. With or without a thyroid problem, almost all pregnant women feel a sense of overwhelming fatigue. Certainly working full time becomes
(for a time) very hard. Furthermore, many pregnant women find they just can’t keep going after 9pm – yet still feel tired the next day. At the same time, it’s also normal to have disturbed sleep – especially if you have to wake up at intervals to go to the toilet, or have things on your mind. So no wonder you find keeping up with your two jobs difficult at present!
It’s good that you’ve seen your specialist and that your medication has been reviewed. Whether or not there has been a previous problem, the thyroid gland is more active than usual during pregnancy. This can cause problems for women whose thyroid gland is already overactive so it’s not unusual to need additional medication. Occasionally it may be necessary to surgically remove part of the thyroid gland during pregnancy – since an underactive thyroid may be easier to manage than an overactive one.
You really need to be closely monitored by both your specialist and your obstetrician, and these are the people to ask for more information. An overactive thyroid may cause problems in pregnancy – including miscarriage, high blood pressure, preterm birth and a temporary thyroid imbalance in the baby – but these problems are by no means inevitable and expert care and careful treatment will minimise the risks considerably. Correctly supervised, you have a good chance of a healthy and normal pregnancy.
Hannah Hulme Hunter, Babyworld Midwife.