Whenever I consult with a pregnant woman who has either Graves’ Disease or Hashimoto’s Thyroiditis, there is understandably a concern about how this condition can affect the health of her baby. There without question are risks for someone who is pregnant and who has an autoimmune thyroid condition. And of course there are limitations when it comes to having a pregnant woman take certain supplements and herbs to help suppress the autoimmune response. And so this can present a challenge for someone who has an autoimmune thyroid condition and is looking to get pregnant.
It’s not uncommon to consult with a woman who has either Graves’ Disease or Hashimoto’s Thyroiditis who is thinking about becoming pregnant in the near future. There are two different sets of risks a pregnant woman with an autoimmune thyroid condition has to face. One has to do with the autoimmune component of the condition, while the other relates to the imbalance in thyroid hormone levels. I’m going to discuss each one of these separately.
Why Having Normal Thyroid Hormone Levels During Pregnancy Is Important
Having normal levels of thyroid hormone is very important to having a healthy pregnancy, as maternal thyroid hormones play a vital role in the development and function of both the fetus and placenta (1). This is especially true in the first trimester, as the fetus doesn’t have the ability to produce its own thyroid hormone. This is why it’s important for most women with a hypothyroid condition to take thyroid hormone during the pregnancy. While I’m all for trying to address the cause of the problem, one needs to look at the risks vs. the benefits, and if someone has low thyroid hormone levels during pregnancy it is important to take thyroid hormone for the health of the baby.
On the other hand, if someone has a hyperthyroid condition then this does need to be managed. Too much thyroid hormone can cause problems for the developing fetus. So while I’m not thrilled about women taking medication during pregnancy, this is yet another situation where the risks and benefits need to be looked at. And the risks of untreated hyperthyroidism is usually greater than the risk of the medication causing problems, such as congenital malformations. This is especially true in severe cases of hyperthyroidism during pregnancy, as maternal risks include congestive heart failure, thyroid storm, preterm labor, preeclampsia, and increased mortality, whereas the fetus may be stillborn or small for gestational age or may develop congenital malformations (1).
What Are The Potential Consequences Of High Thyroid Antibody Levels During Pregnancy?
When I consult with a woman who has Graves’ Disease or Hashimoto’s Thyroiditis who is looking to become pregnant in the near future, the autoimmune component of her condition is of greater concern than the imbalance in thyroid hormone levels. The reason for this is because in most cases it is much easier to manage high or low thyroid hormone levels during pregnancy than to suppress the autoimmune response. On the other hand, if someone has high thyroid antibodies, this can cause harm to the fetus, and it can be a challenge to lower these antibodies. Numerous studies have shown a significant positive association between the presence of thyroid antibodies and miscarriage rate (2) (3).
But isn’t it possible that the pregnancy itself can result in a suppression of the autoimmune response, and therefore a lowering of the thyroid antibodies? This without question is possible, and of course is the ideal situation for a woman with an autoimmune condition of any kind who becomes pregnant. However, there is no guarantee that the pregnancy will result in a decrease in thyroid antibodies, as sometimes the antibodies actually increase during pregnancy.
There is some concern as to whether the antibodies will affect the thyroid function of the fetus. Studies show that of the different types of thyroid antibodies, only those directed against the TSH receptor have been shown to cause fetal thyroid dysfunction (4). As a result, if someone has high TSI antibodies during pregnancy then this is a cause of concern when it comes to the thyroid health of the fetus, whereas thyroperoxidase and thyroglobulin antibodies don’t seem to have a detrimental effect on the thyroid gland of the developing fetus.
Can A Pregnant Woman With An Autoimmune Thyroid Condition Benefit From Natural Treatment Methods?
If a woman happens to become pregnant while her autoimmune thyroid condition is still active, there of course will be limitations as to which supplements and herbs she can take. While I’m conservative with the herbs, when I’m dealing with a patient who becomes pregnant I will try to do things to help with the inflammatory component of the autoimmune condition, usually through fish oils and a good source of GLA (i.e. borage oil, black currant seed oil). Selenium can sometimes help to lower the thyroid antibodies, and while most pregnant women can take a separate selenium supplement, you want to be careful not to take too high of a dosage.
As for balancing the thyroid hormone levels, a woman with an autoimmune hypothyroid condition very well might need to take thyroid hormone. Even if she doesn’t want to take any medication, taking thyroid hormone might be important for the health of the baby. I’m not saying that every pregnant woman who has Hashimoto’s Thyroiditis needs to take thyroid hormone, but many do. While my goal is to attempt to restore someone’s thyroid health back to normal, one doesn’t want to jeopardize the health of the developing fetus.
And the same concept applies to hyperthyroid conditions. Without question there are potential risks to the baby when taking antithyroid medication during pregnancy. But as I mentioned earlier in this post, it all comes down to risks vs. benefits. And if someone has high thyroid hormone levels, it is important to get these down.
In summary, there definitely are risks for someone who is pregnant and who has an autoimmune thyroid condition. The autoimmune component itself of both Graves’ Disease and Hashimoto’s Thyroiditis poses a risk to the baby. In addition to dealing with the autoimmune component of the condition, it is important to have healthy thyroid hormone levels. This very well might mean that a woman with Hashimoto’s Thyroiditis who is pregnant might need to take thyroid hormone, while a pregnant woman with Graves’ Disease might need to take antithyroid medication. It all comes down to risks vs. benefits, and during pregnancy, when following a natural treatment protocol it’s important to carefully consider the risks and benefits of everything.
Hi Dr. Eric,
Thanks for posting this helpful information!I have Hashimoto’s, but normal TSH level. I am on 65mg Naturethroid and trying to get pregnant. My doctor said once I fall pregnant, I need to increase the dosage because of everything you explained in your article. However, I am concerned about the prenatal vitamins that pregnant women are told to take. I am confused if iodine is good or bad for Hashimoto’s and most prenatal vitamins contain iodine. Is iodine good or bad for pregnant women with Hashimoto’s? Plus, many prenatals contain extract of ginger, broccoli and Kale to help with morning sickness and blood clotting. I am also worried that they are goitrogens. Do you have any prenatal vitamins that you can recommend?
Thanks!
Iodine is very controversial, and although I’m without question pro-iodine, I am somewhat cautious when it comes to recommending iodine to my patients with Hashimoto’s Thyroiditis. On the other hand, Dr. David Brownstein deals with a lot of Hashimoto’s patients, wrote a book on iodine, and recommends iodine to most of his patients and doesn’t seem to have a problem. Once again, everything comes down to risks vs. benefits, and while I understand the concern that iodine might make your condition worse, the amount in most prenatal vitamins are small, and of course iodine is very important for the health of the developing fetus. So ultimately it is up to you as to whether or not to take a multivitamin with iodine, but I usually recommend this to my patients with Hashimoto’s Thyroiditis.
I’m not too concerned about the goitrogens, as if they are consumed in normal amounts they usually don’t cause any problems. Two multivitamins I like are Garden of Life Raw Prenatal, and Thorne Research Basic Prenatal.
What are your thoughts on Subclinical Hyperthyroidism? All of my levels are good except my TSH which can be anywhere from .02 – .2 and I’ve gone to three different endocrinologist and have gotten three different answers. I have already decided radiation and surgery are not an option for me (2 of the 3 suggested this) and we have been trying to get pregnant for over 2 years. If I need to do something about my levels before I get pregnant, I will – I’m just not convinced the benefits are greater than the reward…
Hi Rebecca,
Here’s an article I wrote on subclinical hyperthyroidism:
https://www.naturalendocrinesolutions.com/articles/natural-treatment-methods-for-subclinical-hyperthyroidism/
With regards to pregnancy, I’m not too concerned about a depressed TSH if the thyroid hormone levels are within normal limits. If the thyroid antibodies are high this might be a different story, but assuming they are normal then I wouldn’t be too concerned. A low TSH itself shouldn’t cause harm to the baby, although keep in mind that this can progress to overt hyperthyroidism or Graves’ Disease, and so if you do become pregnant I would monitor the thyroid hormone levels on a regular basis.
Hi Dr
I have the same issue (subclinical hyperthyroidism) but also have high TSH receptor antibodies and thyroglobulin antibodies – as far as I understand I have both hashimotos and graves.
I am actively trying to concieve and am also on clomid to help me ovulate as I have pcos.
Can you pls explain the risks and how to manage so I may become pregnant and have a healthy baby?
Hello,
I did talk about this in the article, as I spoke about the risks associated with the different types of antibodies. Both the antibodies for Graves’ Disease and Hashimoto’s can increase the risk of miscarriage, and the TSH receptor antibodies can affect the thyroid gland of the fetus. The best way to “manage” this is to try addressing the autoimmune component before becoming pregnant. If someone with the antibodies to both Graves’ Disease and Hashimoto’s is already pregnant then I would still try to do things to help suppress the autoimmune component and help with the inflammation, which I have discussed in other articles and blog posts. Of course one does need to be cautious about the supplements taken during pregnancy, as well as the dosage. As for the PCOS, I’ve written a separate article on this:
https://www.naturalendocrinesolutions.com/articles/polycystic-ovarian-syndrome-thyroid-health/
Hi. My name is ayan iam 38 years old lady i have overactive thyroid and putuitary gland tumor i have been told to have putuitary gland surgery and thyroid neck surgery i do not want to have any surgery becouse first i want to treat wat cousisand also want only natural treatment iam soo happy that i come across your webside please Dr Eric tell me wat do to with my condition i want to have a baby soon Thanks
Hi Ayan,
I honestly don’t have much experience dealing with pituitary gland tumors, and so for this you might want to work with someone who focuses on these problems. You might want to look into the Gerson therapy, and find a doctor who focuses on this. Here is some additional information:
http://gerson.org/gerpress/the-gerson-therapy/
Hello Dr. Eric,
My TSH level is at 0.981 uIU/mL
T4 Free is at 1.07 ng/dl
Ferritin Serum 49ng/mL
Thyroid Peroxidade (TPO) Ab is at 65 which I was told was elevated.
Triiodothyronine Free Serum 2.3 pg/mL
I am 29 weeks pregnant and I’m concerned about the high TPO level. Is there anything I can do to lower these antibodies and are they really high to were it might affect my baby? Any advice would be if great help! I have recently modified my diet and started cutting out gluten and wheat products.
Dear Dr Eric,
My wife was found to have Minimally invasive hurthle cell carcinoma on a background of chronic hashimoto thyroiditis. She had total thyroidectomy a year ago. Despite being married for 7 years she never got pregnant.. I wonder if total thyroidectomy would remove the advert effects of elevated ATA and TPO antibodies on pregnancy and on fetus… By the way, she has PCO disease…
Hi Gareth,
As I mentioned in the article, according to the research, the ATA and TPO antibodies shouldn’t directly harm the fetus. If the thyroid antibodies have significantly reduced since she had her thyroid removed then this would reduce her risks of having a miscarriage.
Hi Dr. Eric,
Thanks for posting this. I’m 28 years old, with a 2 year old boy. I have had extremely high antibodies after my first pregnancy. My TSH is 0.8. I was having trouble getting pregnant, so my endo put me on 25 mg of Levothyroxine. Sure enough, I got pregnant the first month after! Then I had miscarriage. I have had a chemical pregnancy and a miscarriage in the last 4 months. The only thing wrong with blood-work is the antibodies. I feel hopeless, and I really want to have a healthy pregnancy. Is that possible with antibodies? Have you seen lots of patients have healthy pregnancy with hasimotos? 🙁
Thank you.
Hi Karii,
It is possible for someone with Hashimoto’s to get pregnant even with the high autoantibodies, although as I mentioned in the post, having elevated antibodies will increase the risk of miscarriage. Of course there can be other factors as well that can cause a miscarriage, such as low progesterone levels.
When I was 17 I had my right ovary and falopian tube removed due to having a cyst, I have been trying for a baby for the past 8years and nothing has happened ,my partner and i have undergo ivf but it doesn’t work, until i saw somelady comment here how she got pregnant by the help of a spiritulist named azuba who did a pregnancy and a cleanse spell for her, i then decided to give a try 2months ago and contacted the same prophet azuba and did the spell , and my doctor just confirm it that am pregnant , thanks every1 for the support and for putting the email of the spell caster that helped me , you can also contact Azuba for what every situation you are on:azubaspelltemple@gmail.com or +2348149271063
I know this post is a few years old but I have a question if anyone is still answering posts…
I was diagnosed with endometriosis in July 2014 and had surgery for removal in May 2015. This seemed to clear up my symptoms. Then…
I was diagnosed in July 2015 with both Graves and Hashimotos. My endocrinologist put me on methimazole 10mg every other day and kept me on it until July 2016, due to my explaining that my husband and I wanted to try to get pregnant. I was put on a PTU 6 days a week at 50 mg. We conceived Sept 2016, but lost our angel around 10 weeks – baby had a heartbeat of 160 and was measuring correctly at 8 weeks, but failed to be at size or have a heartbeat at our 11 week appt.
I am looking for any alternatives to the treatment for my Graves (my dr has not even started the treatment for Hashimotos yet) to allow me to still conceive and have a healthy pregnancy and baby. I am aware of surgery and iodine treatments, and I would really like to avoid having to do either, but I feel like I am running out of options.
Any ideas or help?
Thank you!
When i got married, i could not give birth, it has been 4 years now we are married no child, i was having marriage crisis as a result of this, my husband was thinking of divorcing me. i was tired and frustrated and i love my husband so much, what should i do was the question on my mind, i came across Fertility Cure Home , who i contacted and great healer prayed for me and help me with a herbal remedy which i apply. after which few months later i conceive my first baby, all my thanks to Fertility Cure Home, the great roots and herbs temple. If you out there need help to get pregnant, you should contact Fertility Cure Home through his email via fertilitycure@yahoo.com