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Pregnancy (Expert Forum)
9.5 months pregnant & Synthroid pharmacy error
Answered by
Keith Downing, MD - Obstetrics, Gynecology
MA
This forum is for questions and support regarding pregnancy issues such as: Alcohol/Drugs, Bleeding, Caesarean Section, Childbirth, Diabetes, Depression, Fetal Monitoring, Genetic Testing, Hormonal Changes, Labor, Lamaze, Morning Sickness, Nutrition, Parenting, Prenatal Care, Weight gain.
9.5 months pregnant & Synthroid pharmacy error
by nycmonica, Dec 20, 2007 09:12AM
I was diagnosed with Hashimoto's disease and Hypothyroidism in October 2006 and have been treated with synthroid. I am currently 9.5 months pregnant with an estimated delivery date in 9 days.
I have been treated with 125 mcg of synthroid during pregnancy, which was increased once (during pregnancy) from 100 mcg. My endocrinologist has tested my levels every 6 weeks during pregnancy.
Yesterday I realized that the pharmacy made an error with my prescription. Unfortunately, 25 mcg tablets were placed in my 125mcg prescription bottle. This means that I was only taking 1/5th of my necessary dosage for 14 days. My endocrinologist had me take 200 mcg yesterday and today and will have me go back to 125 mcg tomorrow.
Last week I felt my hypo symptoms return, which of course I attributed to being close to my delivery date. I have also noticed reduced fetal movement which I also attributed to being close to delivery and the baby not having as much room to move.
My last labs taken on 11/7/07 showed:
T4, Free (Direct): 1.08 (Reference range 0.61- 1.76)
TSH: .643 (reference range 0.350- 5.500)
My most pressing concern is about the health of the baby. Should I be concerned about two weeks of severely reduced thyroid supplementation this late in my pregnancy? What effects could if have on my baby? Do you recommend any other sort of treatment? I had labs taken yesterday and will be tested again in one week. I have had no other problems with my pregnancy except for anemia and have been supplementing with slow-fe in my third trimester.
I am greatly concerned about this pharmacy error and any advice that you can offer is sincerely appreciated.
My best,
Monica
I have been treated with 125 mcg of synthroid during pregnancy, which was increased once (during pregnancy) from 100 mcg. My endocrinologist has tested my levels every 6 weeks during pregnancy.
Yesterday I realized that the pharmacy made an error with my prescription. Unfortunately, 25 mcg tablets were placed in my 125mcg prescription bottle. This means that I was only taking 1/5th of my necessary dosage for 14 days. My endocrinologist had me take 200 mcg yesterday and today and will have me go back to 125 mcg tomorrow.
Last week I felt my hypo symptoms return, which of course I attributed to being close to my delivery date. I have also noticed reduced fetal movement which I also attributed to being close to delivery and the baby not having as much room to move.
My last labs taken on 11/7/07 showed:
T4, Free (Direct): 1.08 (Reference range 0.61- 1.76)
TSH: .643 (reference range 0.350- 5.500)
My most pressing concern is about the health of the baby. Should I be concerned about two weeks of severely reduced thyroid supplementation this late in my pregnancy? What effects could if have on my baby? Do you recommend any other sort of treatment? I had labs taken yesterday and will be tested again in one week. I have had no other problems with my pregnancy except for anemia and have been supplementing with slow-fe in my third trimester.
I am greatly concerned about this pharmacy error and any advice that you can offer is sincerely appreciated.
My best,
Monica
Doctor's Answer
by Keith Downing, MD, Dec 24, 2007 12:46PM
, Dec 24, 2007 12:46PM
Hello,
Your levels have been normal when tested, so that is reassuring. Given the timing and brief duration of this mistake, there is little concern for an adverse affect on your infant. I would refer you to your endocrinologist regarding your questions about other treatments.
Best regards,
Dr. Downing
Your levels have been normal when tested, so that is reassuring. Given the timing and brief duration of this mistake, there is little concern for an adverse affect on your infant. I would refer you to your endocrinologist regarding your questions about other treatments.
Best regards,
Dr. Downing
During my first pregnancy, my thyroid was low and I should have received Synthroid at the time. Instead (this was YEARS ago) my OB doctor ignored it, and let my thyroid stay low the entire pregnancy. Postpartum, my thyroid completely failed around 4 months. I actually experienced myxedema at the time, and was the worst hypo case diagnosed at the clinic. But then I started replacement (finally)! Having gone with it so low my entire pregnancy put me at the risk of miscarriage and my son becoming retarded. Well -- fortunately my son is quite intelligent, and I'm reasonably healthy after years of being on thyroid medication. Based on my experience, two weeks is not a huge period of time to have your medication altered -- it really takes weeks(or even months) to feel the full effects of a change in dosage. Your body keeps thyroid hormone "in reserve", and it really does take a while longer to exhaust those reserves (T4 hormone). So don't worry -- you should be fine!
Lindy