pregnancy and graves disease

[Brandi 1249]

I have been trying to get pregnant for a year now and no luck.  I was diagnosed three years ago with Graves disease and had two treatments of RAI, the second worked that was more then two years ago.  The doctors still can not seem to regulate my medicine to get both by THS and by T4  level.  Currently my doctor has taking my medicine of 125 MCG six days a week and on Sunday I do not take anything.  My last TSH came in at 0.15, but six weeks before that it was at 0.49, just above normal for the first time in three years.  My current free T4 came in at 1.15 which improved from 1.32 when my TSH was at 0.49.  I am so confused and my husband and I are ready for a baby.  I am really worry this is causing me not to get pregnant and wondering if anyone has ran in too this.  One they too note is that my cycle come about every 19-21 days, so it is very short and I have been on birth control for a year now.

At this time I thinking it is time to seek another doctor, they have had three year to get this straighten out and can't seem too.  On a side note I never showed any symptoms and my health is very very good, the graves disease does not effect my life any other way, except for trying to get pregnant.

Thanks,

Brandi Sweeney

[Mark Lupo, M.D.]

The TSH of 0.15 is a little low, but having a TSH slightly low is better than high for trying to conceive.  From a thyroid standpoint would think it would be appropriate to start trying for pregnancy.  Ideal TSH is 0.5 (or the lower end of lab reference range) to 2.0 when trying to conceive - so a slight dose decrease may be helpful.  The dose of T4 usually increases by 25-40% during pregnancy -- very important to monitor closely, esp during 1st trimester  Remind OB to check TSI level early 3rd trimester to make sure not very elevated (increased risk of neonatal Graves).