risk of pregnancy after thyroidectomy for graves

[hapygolky1]

i had a totally thyroidectomy 3/1/10 for Graves and Hashimotos disease. all went great. now i am evaluating the risks of having a second baby. rheumatoid arthritis runs in my family 1 niece, 1 aunt and 1 uncle. all with crippling rheumatoid. so. the endocrinologist said my risk of developing what already runs in my family yes, is increased with a second pregnancy. regarding the baby, i risk passing  my antibodies onto her/him which can potentially cause transient (he says) neonatal graves disease. he says transient because the antibodies will be eliminated/drop off after 6 weeks and during that first 6 weeks the baby would need to be seen by a pediatric endocrinologist. so. here's my question. i am 39. i would love another baby, but not at a cost of hurting my baby or hugely increasing my risk of developing the same crippling arthritis as my other family. is TREATED graves in an infant still critical? if it were you, would you risk it? i wouldnt do it if it meant i could even TEMPORARILY hurt/cause pain/cause hospitalization to my newborn. i am just looking for guidance until i can talk to a peds endocrinologist.. i am just obesessing. thx so much

[Mark Lupo, M.D.]

The risk is very low of neonatal graves.
Would make sure TSH is in good range (0.3-2.0 usually) before pregancy on a stable dose of a levothyroxine product (brand preferred in pregnancy for consistency), with expectation of increasing the dose by 25-40% during pregnancy (usually within first 16 weeks).
Test TSI during second trimester - if >3-5 x higher than upper end of normal (not common), then fetal ultrasound and close following with high-risk OB is usually indicated.

[alex32]

I had the same surger in October 2008 anh in March 2009 I was pregnant to my second baby.
I followed what Dr Lupo advised you and everything went great.
All the best for you as well